The Senate Finance Committee is generally regarded as having the dominant voice on health care issues, in part because they have jurisdiction over Medicare, in part out of custom, and in part because the Finance Democrats are generally less progressive and thus closer to the pivot points for action. That said, the Health, Education, Labor, and Pensions Committee has “health” right up there up front, so they play a big role, too. And now details are starting to emerge about the legislation HELP will be putting forward. Igor Volsky describes the inclusion of a public plan that will pay Medicare reimbursement rates plus 10 percent. That means you’ll have savings relative to private plans, but it’ll still be more generous than Medicare. That should accomplish most of the hoped-for cost control goals of a public plan while throwing a decent bone to private industry.
Other key points:
— An individual and employer mandate for coverage.
— The legislation would expand the Medicaid program to cover individuals earning up to 150 percent of poverty.
— It would subsidize people earning up to 500 FPL to purchase insurance through state-based insurance exchanges.
— Expands the Children’s Health Insurance Program (CHIP) to people up to age 26.
— Establishing a “federal health reserve” type entity called a Medical Advisory Council that would assist in designing minimum standard benefits.
This sounds like an excellent set of proposals to me. Realistically, I doubt you could get all this through congress. But the question of how much support these proposals can acquire in the Senate will be an important element of shaping the bargaining terrain moving forward.