The CBO report on the Baucus bill actually has some really good stuff in it for progressives. While I still remain pessimistic as to whether any good policy proposals will actually make it through, it provides significant room for progressives to strengthen the bill.
- It unequivocably says that co-ops suck (or really it says they are completely irrelevant and inconsequential). Contrast that to the cost-reducing public plans in the other bills.
- Its score comes in much lower than expected (due partially to some odd scoring but they're all fake numbers). Basically if the CBO is scoring it at $775 bln, that means there is another and $125 bln to be added to subsidies, which can mean substantial gains to affordability for the middle class.
- This is what the CBO report says on the co-ops.
The proposed co-ops had very little effect on the estimates of total enrollment in the exchanges or federal costs because, as they are described in the specifications, they seem unlikely to establish a significant market presence in many areas of the country or to noticeably affect federal subsidy payments.
Or in lay-mans terms, the co-ops suck. The clear implication is that they are not capable of adding significant competition, because if they did federal subsidy payments would be lower (people would be buying cheaper plans and therefore requiring less help from the gov't). In other words, the Baucus co-ops fail to satisfy the President's goal of providing competition in the insurance markets.
I am on the record as not being a big fan of obsessing over the public plan, but if we're going the co-op route we could at least design some co-ops that will actually make a difference.
This is a clear weakness that needs to be hit hard by progressives.
- Much attention has been given to the fact that the Baucus bill is inadequate in terms of providing adequate levels of subsidies for those between 200% and 400% of the poverty line. I also suspect that the reason the increase in coverage isn't terrible (i.e., increasing by 25 mil which is still less than the House bills) is because the affordability exception is set too high.
However, the fact that the score comes in at $775 blns means that an extra $125 bln in subsidies can be added to the bill. Still not great but a whole lot better.
Yes, the whole discussion is stupid because we should not be obessessing over round numbers that make no difference. But progressives now have a strong argument that the President asked for a $900 bln bill and we are giving him a $900 bln bill.
Also I think you could add in the triggers that the President talked about to make the CBO score the aspects that it has avoided and you could squeeze even more into the bill.
Anyway, who nows what Conrad and Snowe would think of all this but Rockefeller has to get something, right? Snowe at least seems amenable to greater affordability credits.
And if Grassley and Enzi can't support a $775 bln bill with no public plan, no end-of-life counseling, no abortion funding, no illegal immigrant participation at all, medical malpratice pilot programs, interstate competition through regional compacts, and funding through taxation on "cadillac" insurance plans, then they're not supporting anything.
