Both the New York Times and the Wall Street Journal report today on Senator Max Baucus’
healthcare reform proposal. By releasing his plan at this point, Baucus, the chair of the Senate Finance Committee, is both signaling a commitment to major healthcare reform and stealing a bit of President-elect Obama’s thunder.
The Baucus plan is similar to Obama’s except for its adoption of the Massachusetts model of requiring everyone to purchase health insurance. (This was Hillary Clinton’s campaign proposal.) Like Obama, Baucus proposes the “Health Insurance Exchange,” a national marketplace in which individuals and small businesses can buy coverage with income-based subsidization. Most employers would be required to offer insurance to their workers or pay into a fund based on their size and revenues. Other interesting aspects of the Baucus Plan:
- allowing “pre-Medicare” seniors (55-64) to buy Medicare coverage if they do not have access to a public insurance program or a group health plan;
- expanding Medicaid availability to all Americans below the poverty level;
- expanding State Children’s Health Insurance Program (SCHIP) to cover all uninsured youngsters in families with incomes at or below 250% of the poverty level;
- Lifting the Medicare and SCHIP ban on legal immigrants in their first five years in the United States;
As undeniably broken as the existing system is, providers may want to think twice before getting behind the Baucus Plan or any future Obama Plan. Perhaps the most telling warning sign is the position of the big health plans, which are licking their chops at the mandate that every American purchase health insurance. Although Senator Baucus would place limits on their ability to charge high premiums or exclude preexisting conditions, his proposal would lead to an even larger slice of every dollar spent on healthcare going to payors rather than providers. In addition, it doesn’t take much of a stretch of the imagination to see new restrictions imposed on providers in the future to ensure that they treat the wave of new low-reimbursement patients that will flow from reform.
