Well, this is a surprise! But in the really good way. My, how things change; just last week, we learned of Anthem/Wellpoint's attempt to raise CA insurance rates by 39% and by 23% in Maine and who knows how much elsewhere.
And in what had to be a Senate record for response time, Dianne Feinstein introduced a bill to limit insurance companies' ability to raise rates. It would establish a new federal agency with authority to review proposed premium increases and more importantly, to say "no."
Even more importantly, her bill has been incorporated into the health care reform plan Obama will be presenting at the summit.
The main tenets of Feinstein's bill were these:
In states such as California that lack authority to bar excessive health care premium hikes, she says, the federal government should step in.
The senator's legislation would empower the secretary of the Health and Human Services Department to draft criteria for deciding whether a rate hike was justified, and then to block or modify a premium increase if it was deemed excessive.
The rules would apply to the roughly half of all states that lack authority to regulate health insurance rates.
And today we learn that what is now "the bill" has incorporated it:
The president’s bill would grant the federal health and human services secretary new authority to review, and to block, premium increases by private insurers, potentially superseding state insurance regulators. The bill would create a new Health Insurance Rate Authority, comprised of health industry experts that would issue an annual report setting the parameters for reasonable rate increases based on conditions in the market.
Officials said they envisioned the provision taking effect immediately after the health care bill is signed into law.
There don't seem to be too many surprises beyond that. The compromise bill is more or less the fixes they worked out in conference: improving the subsidy equation, closing the Medicare Part D doughnut hole. And it now looks like a compromise on the excise tax might have fallen through. But another smallish pleasant surprise is that the new bill includes a national-level exchange, instead of the state-based exchanges. [no longer true - see update below]
Will these improvements be enough to get this done? Who can tell? For whatever reasons, Obama clearly prefers to find a bill that can pass with 60 votes. I think it's a combination of timing issues and wanting to break the gridlock in Congress. Getting the Republican caucus to behave and actually take governing seriously is important for so many things beyond health care.
Hopefully, the summit will wake them up; it's already gotten their attention in the worst (for them - I'm lovin' it!) way. They're obstructionist before it even starts, thanks to their own intransigence, and it isn't going to get one whit easier for them once it's over. If what we've heard about the proposed fixes is accurate and complete, they are in for a world of hurt.
Obama and the dems will be at the summit, on national teevee, explaining to the world that the Administration's health care reform proposal closes the Medicare Part D doughnut hole. They will also get to introduce for all the world the new HHS agency to put an end to random capricious rate hikes. If political television were eligible, the summit would win an Emmy for that alone. The recent rate hike shenanigans are all over the news and on everyone's radar. It will resonate.
This is total win-win, if you ask me. Either the GOP gets real and figures out that snubbing AARP and the states of California and Maine, et al is political suicide and they vote for the White House plan. Or they stand on the Senate floor while everyone watches them squirming desperately in their attempts to justify doing nothing to stop rate hike gouges. That'll fly! I double dog dare them to look even just one AARP member in the eye and try to explain voting against closing the Medicare Part D doughnut hole. Hell, I triple dog dare them!
They are really in a pickle here, especially with the news that Reid is confident they'll have worked out a reconciliation fix to have a finished bill by Easter, more or less. Thanks to the Bennet letter, there are threats and rumors that the reconciliation package fix might end up including the Public Option. So one or two GOP members can exert their sanity and vote for a bill negotiated from the summit, or they can remain their pathetic, obdurate selves hell bent on living the GOP motto of ineffective government.
What any of this means for the public option is anybody's guess. It is not currently in the WH plan, although both Reid and Obama have both stated they are open to it. If the summit is unsuccessful in talking sense (or at least striking fear) into the GOP and reconciliation is put back on the table, then the Public Option might stage a comeback. But this week is all about the summit and the plan Obama is presenting to Congress. I'm guessing it will be at least another week from today before we see what we'll get from the GOP. So, the PO may well rise again, just not this week it seems.
Even if it doesn't, we've got the national exchange and the new protections against rate increases. I'd wager they would be as effective as the Public Option in achieving the goals of price controls and keeping insurance companies honest. I also think threatening to just pass it without the GOP via reconciliation is just delicious; I'm okay with them using the PO for negotiating leverage.
But whatever comes of the summit, we are still very deeply in the woods and it isn't until Thursday. I hope everyone is continuing to call both the House and the Senate and telling them that you don't care who goes first or what's on second, they just need to figure it the !@#$%& out and get it the !@#$%& done.
Hey...maybe we should send thank you cards to Anthem/Wellpoint while we're at it!
; P
Update [2010-2-22 9:56:57 by Cedwyn]: Talk of the plan is starting to hit the news wires. This report sounds like pretty favorable/strong coverage.
Update [2010-2-22 10:20:22 by Cedwyn]: At long last, details of the White House plan. From the Overview:
The President’s Proposal bridges the gap between the House and Senate bills and includes new provisions to crack down on waste, fraud and abuse.
It includes a targeted set of changes to the Patient Protection and Affordable Care Act, the Senate-passed health insurance reform bill. The President’s Proposal reflects policies from the House-passed bill and the President’s priorities. Key changes include:
* Eliminating the Nebraska FMAP provision and providing significant additional Federal financing to all States for the expansion of Medicaid;
* Closing the Medicare prescription drug "donut hole" coverage gap;
* Strengthening the Senate bill’s provisions that make insurance affordable for individuals and families;
* Strengthening the provisions to fight fraud, waste, and abuse in Medicare and Medicaid;
* Increasing the threshold for the excise tax on the most expensive health plans from $23,000 for a family plan to $27,500 and starting it in 2018 for all plans;
* Improving insurance protections for consumers and creating a new Health Insurance Rate Authority to provide Federal assistance and oversight to States in conducting reviews of unreasonable rate increases and other unfair practices of insurance plans.
Update [2010-2-22 11:8:34 by Cedwyn]: And the national exchange is out. I guess maybe that's the trade-off. I guess this makes enough sense, since we heard pretty consistent reports that the fixes would be what was agreed upon in conference. The news that a national exchange was back in the mix came as a surprise. Maybe DiFi's bill put them back on the state exchanges path. One step forward, two sideways?
He opted for the Senate’s proposal to create state-based insurance exchanges, or marketplaces, rather than a single national exchange as proposed by the House. Many House Democrats worry that state exchanges would create uneven results by allowing states with lax insurance regulations to continue a hands-off approach.
I can't find for sure yay or nay from the proposal.
This comment by dmhlt 66 has a nifty comparison chart for the three bills, Obama/House/Senate and this comment by Femlaw has info about the WH blog feature where you can calculate how his proposal would impact you.