A reader suggested over the weekend that instead of just complaining about the lack of explanatory journalism in the mainstream press, I ought to actually do some and help people understand what’s in the various different pieces of health care legislation. To which I say read this post by my colleague Igor Volsky that even comes with a helpful table.
For my part, let me just talk about the bill that’s pending in the House of Representatives, prepped for passage at any time the House leadership feels assured that the Senate is prepared to move forward with something. One thing the House bill does is help the poor out by expanding Medicaid eligibility to all those earning up to 133 percent of the poverty line. Even if the bill did literally nothing else, this would be an important progressive measure that improves the lives of many Americans.
In addition, it establishes a Health Insurance Exchange on which the currently uninsured can buy health insurance on the individual market. In the Exchange, insurers would be severely curtailed in their ability to engage in price discrimination against potentially bad health risks (“community rating”), wouldn’t be able to turn anyone down (“guaranteed issue”), and wouldn’t be allowed to retroactively deny claims (“rescission”). In order to make this work, we need to ensure that sick and healthy alike buy health insurance, so there are mandates on both individuals and employers. But to ensure that people can afford to fulfill the mandate, there will be sliding-scale subsidies for people earning between 133 percent and 400 percent of the federal poverty line. Last, the Exchange will feature a public option to ensure the existence of an alternative to for-profit health insurance.
The bill has other provisions related to financing and delivery system reform, but that’s the crux of the matter. Medicaid expansion and the creation of a workable individual market will ensure that everyone has health insurance and that the currently insured won’t need to worry about losing the coverage we already have.