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Ben Nelson and AHIP's Insurance Bailout

Posted on May 6th, 2009 by Jason Rosenbaum in Profits Before People

Ben Nelson (D-insurance industry) is out with his health care reform alternative [pdf]. Guess what? It's exactly the same as the one proposed by the insurance industry [pdf]. Like, almost point for point.

Here's AHIP on a mandate:

Combine guarantee-issue coverage with no pre-existing condition exclusions with an enforceable individual mandate: For guarantee-issue to work, it is necessary for everyone to be brought into the system and participate in obtaining coverage.  Achieving this objective will require specific attention to the mechanisms for making the mandate enforceable and may require coordinated action at multiple levels of government.

And Nelson:

America’s Health Insurance Plans and the Blue Cross Blue Shield Association have agreed to guarantee health care coverage to all Americans and to  transition away from charging higher premiums to those who are most ill, if Congress supports a requirement to obtain coverage.  While I have an aversion to mandates, I recognize that we all have a public responsibility to obtain health care coverage because we all pay higher premiums when providers are forced to write off expensive, uncompensated care. If we can provide affordable coverage and agree on this collective responsibility, we can make dramatic improvements on portability and access and reduce the impact of pre-existing conditions.

Here's AHIP on taxation and tax credits:

Create tax equity: Currently, individuals purchasing insurance on their own cannot deduct expenses for health insurance coverage unless total health care expenses exceed 7.5 percent of adjusted gross income. This should be corrected to promote tax equity and help make health care more affordable whether coverage is obtained through an employer or the individual market.

Provide premium assistance to ensure coverage is affordable for lower-income individuals and working families: Refundable, advanceable tax credits should be available on a sliding scale basis for those earning less than 400 percent of the Federal Poverty Level (FPL), as indicated below.

And Nelson:

Congress faces difficult decisions in finding ways to finance health care reform, which is critical to avoid worsening an already unsustainable deficit.  Some Americans currently have an unlimited tax advantage while others receive no tax benefit at all for the cost of their health insurance.  Congress should consider using a portion of the health insurance tax exclusion, while preserving a substantive amount of untaxed compensation for employers to offer their workers, to finance targeted tax credits and to further leverage our tax code to increase coverage.  These credits will help offset the premium impact of transitioning to adjusted community rating, entice younger individuals into the market, and help offset insurance costs for the disadvantaged.

And, of course, AHIP on the public health insurance option and protecting the employer based system from the supposed "threat" a new public program poses, from Karen Ignagni's testimony before the Senate Finance Committee yesterday [pdf]:

To achieve comprehensive health care reform, AHIP has proposed a plan that provides universal coverage, cost containment, and quality improvement.  Our plan focuses on fundamentally overhauling regulation in the marketplace, improving information and transparency for consumers, taking bold steps to ensure that coverage is affordable, and clearing obstacles to the next generation of quality improvement innovations.  As discussed below, this strategy would achieve universal coverage without jeopardizing quality improvement initiatives that are working in the system today, without exacerbating cost shifting already occurring, and without undermining employer-based coverage.

In addition to recognizing that a new public plan is not necessary to achieve successful health care reform, we believe it is important for policymakers to consider the unintended consequences that could result from establishing a public plan to compete against existing private health insurance plans under a reformed health care system.

And Nelson:

While some have called for establishing a public plan, I believe we cannot effectively resolve our health care crisis if Congress becomes weighted down by creating a government-run option to attract Americans away from their private coverage, with little more to offer than cosmetic improvements and the creation of an unlevel playing field.  Our Medicare system is already on its way to insolvency, and our delivery system would collapse if it were to become more reliant on Medicare rates.  In Nebraska, Medicare reimburses as low as 75 percent of what private insurers pay for medical services, which together with the cost shift from uncompensated care, can make up 10-15 percent of an individual’s private health coverage premium.

Employer-based system:  Preserving employer involvement is one of the single greatest ways to avoid destabilizing the coverage Americans currently have.  Employers help individuals navigate the insurance market, negotiate and advocate on their behalf, and help pay premiums.

The attacks are the same. The talking points are the same. It's like AHIP wrote Ben Nelson's plan.

And what is that plan, pray tell? It's actually pretty simple.

AHIP and Nelson want to force every American to buy health care coverage. But instead of giving them a true choice about what they have to buy, AHIP and Nelson want you to only be able to purchase private health insurance. Because most areas of the country don't really have a competitive marketplace for health insurance, that means you don't have much of a choice of what to buy.

Now, what if you can't afford the private health insurance you're forced to buy? AHIP and Nelson think the government should give you a tax credit so you can afford it. (This was also part of John McCain's plan, by the way.)

So, in effect, AHIP and Nelson want to force you to buy private health insurance, the same insurance that isn't meeting our needs right now, and then give those private companies free money to allow you to afford it. Nowhere does AHIP or Nelson propose controlling health care costs in any way. They just say the government should subsidize private industry in forcing us to buy a product we think is crap, at a price the insurance industry sets.

Put simply, AHIP and Nelson's health care plan is a giant bailout for the insurance industry.

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