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Stories tagged with “Philip Bredesen

Health

Will Employers Just Dump Their Workers Into The Exchanges?

Gov. Philip Bredsen (D-TN)

Gov. Philip Bredesen (D-TN)

I agree with Jon Gruber’s argument that the expectation that a large number of employers will dump coverage into the Exchanges is overstated. As Gruber writes, in response to this piece by Gov. Philip Bredesen (D-TN), this argument overlooks some fairly important real-world experiences:

The gist of Bredesen’s argument is pretty simple: Some firms will find it more attractive to stop offering insurance and let employees get coverage through the new insurance exchanges, where generous subsidies will be available. But the Affordable Care Act, which I’ve long supported, imposes strong penalties on firms that do not offer insurance, as well as sizeable tax credits for smaller firms that encourage them to offer. And in most firms, the majority of employees will make too much money to be eligible for large subsidies anyway. It is for this reason that the Congressional Budget Office estimated that PPACA will reduce employer sponsored insurance in the U.S. by only about 2.5 percent by 2019. In other words, the effect on employer sponsored coverage will likely be small.

CBO projections aren’t perfect, of course. But this particular projection is consistent with the best evidence we have–evidence that, once again, Bredesen completely ignores. In 2006, the state of Massachusetts put in place a system much like the one the Affordable Care Act will create nationally–with subsidies for low income groups (subsidies that are even more generous than those in the Affordable Care Act) and an individual mandate, but without the small group tax credit or meaningful penalties on firms that don’t offer insurance. The result? Employer-sponsored insurance has risen in the state by more than 100,000 persons.

Bredesen’s claim that employees would move from employer coverage to subsidized insurance in the exchange also ignores that the government is already subsidizing employer plans through the tax code and will continue to do so (at lower levels due to the excise tax) under the Affordable Care Act.

Economists and many Democrats generally agree that the ACA’s employer responsibility requirement could be strengthened and many supported a true pay or play provision that would have ensured less employer coverage erosion. But they were opposed by the very same conservative Democrats and Republicans who are now echoing Bredesen’s claims. Rather than shoring up employer sponsored insurance (ESI), these lawmakers instead listened to the hysterical arguments of groups like the National Federation of Independent Businesses (NFIB) and the Chamber of Commerce and strongly opposed the very provisions that would have avoided what they’re now predicting.

However, the general question of why employers choose to offer coverage is a good one and the best explanation I’ve heard argues that employers feel more comfortable with the existing system within which they themselves can define their contribution towards health care. In other words, rather than leaving it up to the government to set the amount they’ll have to contribute, companies want to be more in control of their own costs. Austin Frakt believes CEOs are wrong for thinking this, but agrees that employer coverage is here to stay.

Politics

Bredesen: ‘Advocacy Groups Don’t Matter Nearly As Much As The Pharmaceutical Groups’

ap070131025002.jpg It’s clear that Tennessee Gov. Phil Bredesen (D) desperately wants to become President Obama’s Health and Human Services Secretary. In fact, as the Nashville Post blog points out, he was campaigning for the job in his State of the State address yesterday, stating, “[T]his recession has truly underlined for me something that I’ve believed for a long time: that we need a national solution for health insurance.”

His candidacy, however, has been widely opposed by health care experts. Ron Pollack of FamiliesUSA summarized some of the problems with Bredesen:

Phil Bredesen presided over the largest state cutback of public health programs in the history of our nation, so how can one not be worried about him? I worry that the relationship he would have to the Obama team would harm the credibility of what the president is trying to do. And I think it would create a firestorm among the strongest supporters of health care reform.

FamiliesUSA, in fact, released a whole book on Bredesen’s devastating cuts to the state’s Medicaid program, TennCare, which resulted in 320,000 low-income residents losing health coverage. As Ezra Klein explains, “He eventually limited TennCare enrollees to four prescriptions per month, 12 doctors visits per year and 20 days in the hospital each year. He refused to allow Tennesseans to pay higher premiums to keep their coverage. … In 2008, Tennessee ranked 47th in the respected health rankings compiled by the Robert Woods Johnson Foundation.”

Bredesen is now biting back at these criticisms:

“Anybody who’s got some real scars and experience is going to have their detractors,” the governor said Monday in an interview with The Wall Street Journal. “People at the White House are smart enough to be able to assess that.” And he took a swipe at his opponents, saying that “advocacy groups don’t matter nearly as much as the pharmaceutical groups, the hospitals, the doctors’ groups. There’s a lot of very powerful interest groups that will play in this thing.”

This quote by Bredesen — dismissing advocacy groups and embracing industry interests — is typical of his tenure in office. In 2005, Bredesen’s wife, Andrea Conte, embarked on a $9.4 million renovation of the governor’s mansion. The largest donor to the project? BlueCross BlueShield of Tennessee, which gave $150,000.

While in making cuts to TennCare, Bredesen largely “cast aside” the “cost saving ideas of advocates” that would have increase health care coverage while also addressing the state’s budget crisis. But as TNR’s Jonathan Cohn notes, advocates will be necessary in pushing health care reform through Congress; a lack of coordinated support amongst liberal allies was part of the reason that President Clinton’s health care plan failed to conservative attacks.

The Wonk Room’s Igor Volsky has put together a list of the leading HHS candidates here.

Update

Bredesen is now denying that he was campaigning for the job in yesterday’s speech.

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