Senate Finance Committee Chair Max Baucus released his much-anticipated "bipartisan" healthcare reform bill that devoured lord-knows-how-many months of valuable time, and yet, the results were roundly panned by both liberals and conservatives. And for solid reasons.
Which, of course, is exactly what House Speaker Nancy Pelosi told President Obama and Senate Majority Leader Harry Reid happens whenever a bill is repeatedly revisited to please the widest possible swath of politicos... when she uttered in January 2009:
"I didn’t come here to be partisan, I didn’t come here to be bipartisan. I came here... to be nonpartisan, to work for the American people, to do what is in their interest."
Baucus's bill was altered incessantly to please six U.S. senators (who represent merely 2.7% of the U.S. population), finally rendering the legislation a predictably incomprehensible mess that satisfied no one except lobbyists and their corporate overlords.
The GOOD ENOUGH, the BAD and the UGLY of the Baucus health care bill is that it meets merely one of President Obama's three mandatory goals for healthcare reform legislation:
- THE GOOD ENOUGH: Goal #1 - Reform of Private Insurance Practices - From detail thus far released, the Baucus bill does appear to require some reform of private insurers including: no more pre-existing conditions; coverage must be offered to all applicants; premiums may not be adjusted due to illness; no caps on annual health care expenses for an individual. Also, gender discrimination in policy rates would be prohibited.
As far I can tell without reading the fine print, the Baucus healthcare plan admirably covers all eight of President Obama's consumer health insurance reforms.
That said, the rest of the plan is an aimless catastrophe that pleases only private health insurers, big pharma, and major corporations who are heaving "sighs of relief, sparing them the higher costs and more burdensome rules included in other Democratic-written alternatives," per AP.
- THE BAD: Goal #2 - Provide Insurance to the 30+ Million Uninsured - The Baucus bill mandates that all Americans buy health insurance, and assesses stiff penalties for not doing so. All well and good, if insurance is affordable, and if lower income American are provided subsidies to help them afford this mandate. Therein lies the rub.
To bring the projected cost of this plan under an artificially set amount, cash subsidies to offset high health coverage costs for lower-income Americans have been slashed to smithereens. The burden is made even heavier by the Baucus bill substituting tax credits for immediate cash subsidies to beleaguered families.
The burden arises because, under tax credits, lower-income citizens would be required to pay up-front for their policies, and later, recoup their out-of-pocket payments 15 months or more months later. Tax credits will cause a cash-flow hardship for most lower-income families. And some families won't be able to afford it.
Many contend that skimpy tax credits, rather than immediate subsidies, are a clever ploy to cause the program to crash-and-burn... which it eventually will. Others cynically believe that imposition of heavy penalties for families unable to pay is quietly planned as a rich, new source of government revenues.
The inescapable truth is, though, that the Baucus bill does a poor job of providing health insurance to the 30+ million uninsured Americans.
- THE UGLY: Goal #3 - Slow the Growth of Healthcare Costs - There's a great reason why health insurers stocks rose the day after Sen. Max Baucus released his plan: the bill does absolutely nothing to decrease the exorbitant costs presently charged by private insurers, and nothing to stem future increases in costs to consumers.
The purpose of a Medicare-like public plan is to give sufficient cost competition to force private insurers to lower the prices of their policies. The Baucus plan does not include a public plan option.
In lieu of a public plan option, the Baucus bill profers convoluted co-op insurance exchanges that the non-partisan Congressional Budget Office concludes "seem unlikely to establish a significant market presence in many areas of the country or to noticeably affect federal subsidy payments." Translation: Baucus insurance exchanges are impotent.
The Washington Post's Ezra Klein accurately observes, "The co-ops have never been a satisfying alternative to the public option. But the version in Baucus's bill isn't even a satisfying alternative to the co-op option. It's a neutered version of the co-op idea, which was in turn a neutered version of the public option."
The UGLY is that because the Baucus healthcare bill doesn't provide meaningful market competition for private insurers, this legislative package is a big, fat gift to the industry: millions of more customers, and absolutely no cap on costs to consumers.
What Next for a Senate Bill
Hopefully, President Obama has finally learned that his treasured "bipartisanship" is fool's gold on healthcare reform. All those non-sensical compromises, and not one Republican Senate vote to show for thenm.
Here's the real deal: The Senate will somehow, some way, pass something they dub "healthcare reform legislation." The bill will include GOOD ENOUGH health insurance industry reforms, and God-knows what else. Anything, absolutely anything to get something passed.
In conference, when the House and Senate bills are reconciled and melded together, the ineffective, inefficient, and objectionable sections of both bills will be eliminated.
The House will pass the reconstituted, final bill, and the Senate will pass it by a simple majority using the controversial reconciliation procedure.
Senate Republicans and centrist Democrats will squeal like stuck pigs. But it won't matter.
During the 111th Congress, President Obama will sign a fairly good health care reform bill. And any weaknesses and imperfections in the bill can and will be corrected legislatively going forward.
I only hope that President Obama thanks Speaker Pelosi for showing him the way. And that Obama has learned the Speaker's lesson about doing what is in the best interest of the American people... and losing his too-cute political tricks of partisanship and bipartisanship.
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