Affordability and the Public Option
Posted on September 8th, 2009 by Jason Rosenbaum in Solutions that Work
 |
As the nation looks forward to President Obama's address on health care Wednesday, progressives need to be concerned about reports that some in the White House are pushing to scale back proposals in two areas - making health care affordable and the public health insurance option. We should be equally concerned with both.
In a column this week, David Brooks argued that Obama was losing support with independents because of being seen as big spender. The implication is that spending on health care should be scaled back. But doing so would result in fewer people getting subsidies for affordable health care or a reduction in the level of guaranteed benefits. And that's the last thing that voters, including independents, want.
In a poll taken by Joel Benenson, the President's pollster, and commissioned by AFSCME, SEIU, and Health Care for America Now (HCAN), voters were asked to choose between limiting federal spending or assuring affordability for families and small businesses. The results were strikingly clear.
- 66% agreed that "As long as we don't increase the federal deficit, we should invest enough in health care to make sure that health coverage is really affordable to middle-class families and small businesses."
- 18% agreed that "It is important that we put a spending cap on health care reform at one trillion dollars so the cost doesn't spiral out of control, increasing our deficit and weakening our economy overall."
HCAN asked pollster John Anzalone to ask a similar question to voters in Blue Dog districts where people were slightly more likely to have voted for McCain than Obama. Here are the results from that question:
- 66% of voters and 63% of independents agreed that "The key to health insurance reform is making coverage affordable to families and small business. As long as we don't increase the federal deficit, we should invest enough to make sure that health coverage is really affordable to middle-class families and small businesses."
- 21% of voters and 20% of independents agreed that: "It is important that we put a spending cap on healthcare reform at one trillion dollars so the cost doesn't spiral out of control, increasing our deficit and weakening our economy overall."
This makes sense. At the end of the day, the way that most Americans will measure reform is by asking, "Do I have good health care that I can afford?"
The health care reform bill in the House includes several key provisions designed to make health care affordable to families: a requirement that health insurance policies offered by employers and through the new health insurance "exchange" include decent benefits with limits on out of pocket costs; a requirement that employers pay a reasonable share of premiums for employees and their dependents; subsidies for families that earn up to $88,000 to purchase coverage; and the creation of a public health insurance option that will lower costs both directly and by forcing private insurers to compete.
The public option is a key structural change to affordability because without it, the same private insurers that have driven costs through the roof will be getting a gift from the government. If reform mandates everyone buy insurance but there is no public health insurance option in the mix, then we are just delivering millions of new customers - and billions more in profits - to the private health insurance industry. And as an example of how a public option could lower costs all around, Medicare actually has a lower rate of health care inflation - 4.4% from 1997-2007 compared to private insurance's increase of 7.4%.
Affordability and the choice of a public health insurance option are both essential to legislation that will achieve the President's goals of making good health care affordable to everyone. We have come too far not to get it right.
Little attention has been paid to the importance of health care reform for people with disabilities because the organizations that serve us have viewed it as a way to address the service needs of one group or another, rather than advance the interests of people with disabilities as a whole.
Next Step, incorporated as People with Disabilities for Social & Economic Justice, sees it differently. We believe that no one whom this society devalues, including us, can live with pride as equals until we all do. Health care reform is a step in that direction, one that we must all take together. That’s why Next Step was one of the first to join the HCAN coalition and why we support HR 3200 and the public option in it.
Altogether, 55 million Americans have disabilities. HR 3200 and the public option will benefit many of us and too little effort has been made to let them know that. Let me make a start and, in doing so, request that the other members of HCAN spread the word.
Here’s some important features of H.R. 3200:
• Every health insurance company must offer a plan that covers everyone’s needs.
• One of those plans will be the government public option, which will compete with private plans to reduce costs; it will also offer insurance to those who can’t get it now or don’t like what they can get.
• All the plans are in one place so you can compare what each one offers and costs.
• No plan can refuse to cover anyone with a pre-existing condition or charge more if they have one.
• It provides a subsidy of up to 80% for people who can’t afford to pay the full cost.
• It increases the amount of money doctors will be paid for treating people on Medicaid and Medicare so more doctors will take them.
• It maintains the same eligibility for Medicaid and Medicare so no one will lose those benefits.
Here’s how they help us.
If you have a disability and get a job, you can get health insurance you can afford. You can work as many hours and earn as much as you can and not worry about losing your Medicaid or Medicare because you won’t need it. The government will pay up to four-fifths of your private insurance bill if you can’t afford the whole amount. The insurance company you choose can never drop you or charge you more because of your disability or any illness.
If you can’t work, you can stay on SSI or SSDI and get Medicare and/or Medicaid. The only difference will be that doctors will be paid more for treating you so it will be easier to find one who will.
Here’s how it benefits the disability community and the country.
Twelve million people with disabilities are on SSI or SSDI and get Medicare and/or Medicaid. Surveys show that more than 90% of them want to work. Many of them are not looking for work or are only working part-time because they can’t get private insurance and can’t risk losing their Medicaid/Medicare by earning too much – the maximum is $940 a month and $11,280 a year.
Not all 12 million will find jobs – discrimination is still alive and well in this country. But several million can and will and the more that do, the less discrimination the rest of us will face in finding work and becoming independent.
And the more people with disabilities become independent, the more will bring their resources to the struggle to live with pride as equals in this country. As i said, that’s what Next Step is all about. That’s reason enough to unite with others across the nation to pass H.R. 3200.
Exactly! Medicare is not just for seniors and that is the only reference they ever make to it.
Thank you Ethan! I often think the same exact thing when they only mention Medicare as something seniors have.