There's good news, okay news, and could be better news in the House's "American's Affordable Health Choices Act" (full bill text and fact sheets on various provisions available at that link).
For the really good news that should blunt Republican criticism and public concern over costs, the bill pays for itself--it will not increase the deficit, it will not bankrupt the country. (Like the Iraq War did. As always, it's interesting to see where funding priorities lie.)
According to an analysis by the Congressional Budget Office, the legislation would cost $1 trillion over 10 years and cover 94 percent of Americans (97% if you don’t count the undocumented).
As Jonathan Cohn reports, "between savings and a new surtax on the wealthy, the bill pays for itself. In other words, it won’t inflate the deficit." Five hundred billion comes from savings in Medicare and Medicaid and "the rest comes from a surtax on the richest 1.5 percent."
Most importantly, the CBO coverage tables undermine the conservative claim that a public option would eliminate private insurance and erode employer-sponsored coverage. The House bill actually increases the number of people who receive coverage through their employer by 2 million and shifts most of the uninsured into private coverage.
At the above Think Progress link, Igor Volsky provides a handy table of the bill's provisions and the estimated savings. It also has a column entited "sexy facts," which makes it worth taking a look at in and of itself.
The not so good news is that implementation timeline for some of the key provisions--he insurance exchange, subsidies, some insurance regulations, and the public plan--don't come online until 2013. There will be some signficant improvements beginning immediately, as pointed out by Cohn:
On the bright side, some provisions--filling in the Medicare drug donut hole, bolsteirng the primary care workforce, among others--would start in the next two years.
And at least one key insurer regulation would kick in right away: Come 2010, insurers could no longer yank coverage from people retroactively because they've uncovered new evidence of pre-existing conditions. This practice, known as "rescission," is among the most patently unjust features of our health care system.
The health insurance exchange and the public option should be priorities for brining online day one of the plan, though that could sacrifice some of the savings they hope to achieve. Ezra explains:
The slow start is a way of holding down costs in the 10-year budget window. If the bill begins in 2010, but the subsidies don't kick in until 2013, then that's three years that are under the budget but aren't costing much money. That means the new health-care system can really cost an average of $140 billion each year, as opposed to $100 billion, and that means you can afford a better system.
In another post, Ezra has more good economic news from the proposal--it "opens the door to eventually federalizing the Medicaid program." Medicaid has been a large burden for states, a burden that's been increasing with the economic downturn. This bill would expand Medicaid eligibility with federal money. Stabilizing the program with federal investment could relieve some of the states' burden.
President Obama welcomed the legislation, saying in part:
This proposal controls the skyrocketing cost of health care by rooting out waste and fraud and promoting quality and accountability. Its savings of more than $500 billion over 10 years will strengthen Medicare and contribute to our goal of reforming health care in a fiscally responsible way. It will change the incentives in our health care system so that Americans can receive the best care, not the most expensive care. And it will offer families and businesses more choices and more affordable health care.
This proposal will also prevent insurance companies from denying people coverage because of a pre-existing medical condition. It will ensure that workers can still have health insurance if they lose their job, change their job or start a new business. And it includes a health insurance exchange that will allow families and small businesses to compare prices and quality so they can choose the health care plan that best suits their needs. Among the choices that would be available in the exchange would be a public health insurance option that would make health care affordable by increasing competition, providing more choices, and keeping the insurance companies honest.
The House proposal will begin the process of fixing what’s broken about our health care system, reducing costs for all, building on what works, and covering an estimated 97% of all Americans. And by emphasizing prevention and wellness, it will also help improve the quality of health care for every American.
The better White House news comes from this Bloomberg story which suggests that the whole team is getting on the same page about this whole "bipartisanship" thing.
Both Axelrod and White House Chief of Staff Rahm Emanuel said taking a partisan route to enacting major health-care legislation isn’t the president’s preferred choice. Yet in separate interviews, each man left that option open.
"We’d like to do it with the votes of members of both parties," Axelrod said. "But the worst result would be to not get health-care reform done."
Emanuel, making a theoretical case for a party-line vote, offered a definition of bipartisanship based not on roll-call votes but on whether Democrats have accepted Republican ideas during the process of negotiations.... "That’s a test of bipartisanship -- whether you took ideas from both parties," Emanuel said. "At the end of the day, the test isn’t whether they voted for it," he said, referring to Republicans. "The test is whether the final product represented some of their ideas. And I think it will."