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View Diary: Whither Medicaid and CHIP Under Reform? (54 comments)

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  •  Yes (8+ / 0-)

    If there's no robust public option, this is just a backdoor way of eliminating CHIP, which the Republicans couldn't even accomplish with both houses and a Republican president.

    •  What's wrong with eliminating S-CHIP ... (1+ / 0-)
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      ... if children have the opportunity to get something better?

      S-CHIP was never eliminated under Republican rule because a Republican Congress created the program.  Orrin Hatch teamed up with Ted Kennedy to create the program in 1997.  Chuck Grassley, Hatch, and Olympia Snowe have repeatedly voted for its expansion -- including the bills President Bush vetoed.

      I think the public option will be a "bare bones" policy, actuarially equivalent to Blue Cross/Blue Shield Basic Option (not really "bare bones" and certainly richer than a high-deductible health plan), and won't have some of the protections Medicaid and S-CHIP recipients currently enjoy.  The public option won't be some "gold-plated" plan, or it will face the insurer tax the Senate Finance Committee is considering.

      •  having it disappear (4+ / 0-)

        is not an issue; it's already set to expire in 2013. The question on the table is what replaces it, and is it better, worse or the same?

        "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

        by Greg Dworkin on Wed Jul 29, 2009 at 10:53:56 AM PDT

        [ Parent ]

        •  Because programs are never renewed. n/t (0+ / 0-)
        •  DemFromCT (2+ / 0-)
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          DemFromCT, QuestionAuthority

          On another note (and not about our discussion) I just wanted you to look at Ezra's column today.  I think it's quite good.  Here's an excerpt:

          This is what the health insurance exchange is designed to do. It is arguably the single most important element of health-care reform, because it is the bridge between the system we have and the system we want. But amid the clamor over public insurance options -- which, incidentally, would be housed on the exchange -- and employer tax exclusions and all the other points of controversy, the health insurance exchange is hardly being discussed. And there are signs that it, and thus the long-term promise of reform, might be in danger.

          •  Ezra's big on exchanges (2+ / 0-)
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            jim bow, QuestionAuthority

            and yes, it is a good piece.

            Someone has to explain to the public what the exchange is, how big it will be and when it reaches critical mass, as well as who is eligible.

            "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

            by Greg Dworkin on Wed Jul 29, 2009 at 11:31:29 AM PDT

            [ Parent ]

            •  Because Ezra's right. (1+ / 0-)
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              There's no way for the public option to work if the Exchange doesn't work.  The more people, the greater the competition and bargaining power.

              The political problem is the more people who are eligible to purchase health insurance on the Exchange, the more the program costs.  The more you'll see adds, saying, "X million people will lose their current coverage."

              The way to lower health care costs is to get more people on the Exchange.  More people will see the full cost of health insurance, be willing to choose the cheaper plans (i.e., an HMO instead of their current PPO, or a more generic-drug focused plan than one that has huge discounts for brand-name drugs), and pocket the difference in costs.  As an example, facing major increases in health care costs, my employer chose a cheaper health plan that slighly limits our choice of doctor.  Our health care costs went down by a miniscule amount, but it was worth the tradeoff in costs.

              As I've written in many diaries, I like Wyden's idea of replacing the employer exclusion with a tax subsidy to purchase health insurance on the Exchange, along with a requirement that employers who drop coverage be required to raise wages by their contribution to their employees' health insurance.

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