On the eve of the Senate Finance Committee’s release of its much anticipated health care plan, Wendell Potter – the insurance industry whistle blower and former communications director of health insurance giant Cigna – called the Baucus framework “an absolute gift to the industry.” “And if that is what we see in the legislation, [America’s Health Insurance Plans chief] Karen Ignagni will surely get a huge bonus,” Potter said at a briefing for reporters.
The bill establishes a new regulated health insurance exchange and compels every American to purchase qualified health insurance coverage by 2013. Americans with employer-sponsored insurance can stay in their existing plans, while the uninsured would have to enroll in an expanded Medicaid program, a new plan in the Exchange or the now-regulated individual health insurance market. According to a report released by the Congressional Budget Office, the bill would cover 94% of Americans and cost $880 billion over 10 years.
Potter argued that the lax employer requirements would shift the cost and risk of coverage onto the individual and maintained that the bill’s ‘network of cooperatives‘ would be unable to compete in today’s concentrated health insurance markets. “The co-ops won’t stand a chance,” he concluded.
Reform must also do more to regulate insurers, who have agreed to accept applicants with pre-existing conditions but are insisting on benefit and rate flexibility. Potter argued that the benefit package standards in the Exchange and the high deductible option for younger beneficiaries would allow insures to design almost anything that they can sell in the health market place and push the country towards consumer driven health care.
Under the Baucus legislation, private insurers could also charge older individuals up to five times more for coverage. “You’re just using age as a proxy for health status,” Uwe Reinhardt, an economics professor at Princeton University told the New York Times. Reinhardt estimates that “Senator Baucus’s age-rating plan would allow insurers to cover roughly 70 percent of the additional risk they’d take on by being required to accept all comers, regardless of health.”