Sunday, October 4, 2009

Health Care Reform Moving Forward

The Senate Finance Committee's approval of a health care bill last week is being portrayed as a major watershed in the path towards legislation.

Max Baucus
, only a week after being villainized for a mishmash that allegedly pleased no one, is now being credited with having shepherded through the Finance Committee a bill that is likely to reflect what can/will ultimately be passed and signed into law.

My sense is the Administration is aiming to have a bill passed before Christmas.

There are, however, a number of big issues yet to be resolved, including:
  • The public option - it certainly seems that the votes for a public option aren't there, but liberal Democrats are not yet giving up on it.

  • A universal mandate - it's unclear what the penalties will be for not obtaining insurance. The Republicans are attempting to paint any penalties as tax increases.

  • The nature of subsidies (including an expansion of Medicaid) to enable poorer people to comply with the universal mandate.

  • How we'll pay for the legislation, which is expected to cost around $900 billion over ten years. The Senate bills contemplate a tax on high-cost insurance plans, while the House bills include taxes on the wealthy.

  • The extent to which employers will be required to offer insurance coverage to their employees.