Progress Illinois

BaucusCare is here! That, and the latest local news in today's health care round-up.

Health Care Professionals Demand Real Reform

Before we get to the Senate Finance Committee, be sure to watch the latest video courtesy of the Sargent Shriver National Center on Poverty Law and United Action for Power and Justice. In it, we hear from three health care professionals who are on the ground in Illinois helping people navigate through the treacherous health insurance industry:

BaucusCare Introduced ... Finally

After months of anticipation and fractured bipartisan negotiations, Sen. Max Baucus (D-MT) finally released his committee's proposal (PDF) to remake the nation's health care system yesterday.

On policy, it's a mixed bag. (I'll rely a good deal on Ezra Klein's blogging from yesterday, as it's the most substantive I've seen. Be sure to check out his Washington Post site for the nitty gritty.)

To be clear, there are some glaring problems with this bill. For starters, no public option is included, as was expected. Instead, a co-op proposal, described by Klein as "neutered," has emerged. No employer mandate exists, either. Also, rather than require employers to cover their workers, the bill relies on something called "free rider" requirement, which would merely slap a fee on those who refuse to provide coverage to workers if those workers qualify for federal subsides.  The Center for Budget and Policy Priorities points out this provision's massive flaw: it discriminates against low-income workers, specifically single parents.  Dana Goldstein has more.

The subsidies offered by the Baucus bill to working and middle-class folks purchasing private insurance are also far too small. Nick Beaudrot's widely-circulated chart comparing premium costs in Massachusetts under Commonwealth Care and the Senate Finance bill is instructive here.

On the plus side, the Health Insurance Exchanges (which would house the public option, if it is created) are much more robust than any bill unveiled to date. Businesses with up to 50 employees could buy into the exchanges and states would have the option of increasing that threshold to 100. Even better, states must develop plans to incorporate firms with more than 50 employees by 2017. By 2022, virtually every American would have access to the highly-regulated, transparent marketplace. The basic coverage structures laid out in the competing bills exist in Baucus' proposal as well. Medicaid would be expanded for all adults who have incomes at or below 133 percent of the Federal Poverty Level. And that means an additional 500,000 currently-uninsured Illinoisans would have access to the public plan. (As far as the state-federal financing ratio is concerned, the mark-up says the feds will "pay a greater share of the costs for individuals newly eligible for Medicaid" and it will be on a sliding scale based on the quality of coverage, but the amount is unclear and it will only be offered through 2018.) In all, the CBO estimates that 94 percent of legal residents will be covered. That's not universal, but it is much closer.

Now to the political realities. Baucus -- who took months to build bipartisan consensus in his committee -- seems to have alienated both liberals and conservatives with his bill. House Republicans -- such as Illinois' own Rep. Judy Biggert -- as well as senators not involved in committee negotiations have dismissed it out of hand. Some liberals, most notably Sen. John Rockefeller (D-WV), were just as critical for the reasons outlined above. And even members of the so-called "Gang of Six" expressed reservations; Sen. Olympia Snowe, while open to discussions, said she was not ready to endorse the plan. Yesterday, Matt Yglesias slammed Baucus' delayed timing: "If he’d just stuck to the schedule, we would have been at this point in the process at a time when Barack Obama’s approval rating was considerably higher."

The good news is that, with the Baucus bill finally out in the open, the process can move forward. The measure will surely be modified this week and next (Klein offers some useful suggestions), and the Montana Democrat hopes to bring it up for a full committee vote next week.

Burris, Bean On The Public Option

While the Baucus legislation does not include a public option, there is still a chance that a government-run plan could be added to the Exchanges, either in the final Senate bill or in conference committee.  In a statement yesterday, Sen. Roland Burris became the first U.S. Senator to join House progressives in pledging not to support any health care bill that does not include a public option:

"We need real reform now. The inclusion of a public option as a central component to any healthcare reform legislation is the only way to create meaningful competition with the insurance companies, and in turn, bring down costs and improve quality of care for the people of Illinois and all Americans."

He did not specify, however, whether or not he would vote no on cloture (thereby enabling a filibuster) if such a bill emerged in his chamber.

Meanwhile, 8th District Rep. Melissa Bean reinforced her stance on the public option earlier this week as well. During a tele-town hall meeting on Tuesday, the Barrington Democrat assured her constituents that the public option "is not a government takeover of health care" and expressed her support for it so long as "it’s done in a way that is paid for in a premium and not subsidized by the government.”

Gutierrez Blasts White House For Wilson Cave

After his ridiculous outburst at last week's presidential address, Rep. Joe Wilson was scorned by the national media and attacked by potential congressional challengers. But he might have influenced the reform fight in the process. And not in a productive or humane way.

To disarm opponents making false claims that the health care proposals in Congress would provide subsidies to undocumented immigrants, the White House has expressed a preference for barring undocumented immigrants from buying insurance on the health insurance exchanges, even with their own money. While it appeases anti-immigrant legislators, it will also increase health care costs across the system by providing a disincentive for immigrants to purchase private insurance, thus raising the chances that more will continue to flood emergency rooms for costly, inefficient, and publicly-financed coverage.

Rep. Luis Gutierrez wasn't pleased with the shift, telling a crowd of Latino leaders on Monday that the administration was "giving Rep. Wilson exactly what he wants." Wilson and his friends in Congress certainly don't deserve that.

Three Reasons To Pass Reform

Many political opponents of health care reform understand that our current system produces poor outcomes at a high cost for patients lucky enough to have insurance. Some just haven't internalized how dangerous the challenges we face truly are. A quick glance through some recent news demonstrates the urgency that's required on this issue.

Take this new report (PDF) from Families USA. Their research shows that the increased use and cost of health services, a lack of necessary oversight and competition in the health insurance marketplace, and implicit payments to care for the uninsured have dramatically increased the cost of employer-based insurance premiums in Illinois, which rose 86 percent (from $7,220 to $13,397) since 2009. At the same time, the median earnings of Illinois workers rose just 17 percent, from $26,806 to $31,414 (Click for an expanded version here):

Or read this Tribune profile of 17-year-old Brianna Rice, a Deerfield resident whose insurance was rescinded after her health insurance company found out she had celiac disease:

Her parents, Dale and Pat Rice of Deerfield, insist they were truthful on Brianna's application and say the insurance company is trying to back out of covering their daughter because of the February diagnosis. American Community disagrees, saying that if the Rices had given the company Brianna's full heath history when they applied for coverage, it would never have been granted. [...]

The family's situation shows just how quickly health insurance problems can lead to financial ruin. With their daughter's unpaid medical bills exceeding $20,000 and mounting, the Rices fear losing their home. Pat Rice said she cashed in some of her retirement account to pay bills.

"The next step is really bankruptcy," her husband said.

Finally, ponder this stark fact: single-payer advocate Dr. Quentin Young relayed to a group of north suburban college students last night: there are 45,000 people dead in this country because of a lack of health care, up from 18,000 in 2002.

This reform fight is literally a battle of life and death. The time for political delays and capitulation has passed.