Big Release

by digby

As dday mentions in the previous post, the House has finally released its plan “America’s Affordable Health Choices Act” and, pending those issues dday talks about, according to Jonathan Cohn, it looks pretty good:

The three House committees writing health care legislation have just released the full text of their bill. And my immediate, admittedly tentative reaction is strongly positive. Once fully implemented, this reform plan will accomplish most of the goals on my mental checklist:

• Generous subisidies, available to people making up to 400 percent of the poverty line
• Expansion of Medicaid to cover people making less than 133 percent of the poverty line
• Guarantees of solid benefits for everybody, with limits on out-of-pocket spending
• Strong regulation of insurers, including requirements that insurers provide insurance to people with pre-existing conditions without higher rates
• An individual mandate, so that everybody (or what passes for everybody in these discussions) gets into the system and assumes some financial responsibility
• A public plan, one that appears to be strong, although I’ll reserve judgment on that until I hear from the experts
• Choice of public and private plan, at first just for individuals and small businesses, but later for larger businesses and–possibly–eventually for everybody
• Efforts at payment reform, if not necessarily as strong as they could be
• Investment in primary care and prevention, which is not sexy but potentially important for general health .

Cohn says it takes longer to come fully online than he would have hoped, but that is likely due to the arbitrary budget cap.

The “public plan” is actually several public plans, all of which will be available as soon as the plan is operational. (This should not be confused with the HCAN requirement of “available on day one” which was in response to the trigger option, which is not included. It was never intended to be a requirement that everyone be covered the day the bill was signed, which would be physically impossible.)

As dday points out, this plan is self-financing, so any nonsense about “taxpayers being forced to pay for things they don’t believe in” (in my case, paying for John Ensign’s Viagra) must be ignored. Premiums will pay for this, so if you don’t like what it covers, don’t buy it.

I’ll look forward to reading everyone’s impressions of the bill as the wonks get their grubby paws on it. But remember, it’s only step one. We stil have to see what emerges from the House of Lords. And then the games really begin.

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