KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Debate Focuses On Cost For Coverage Mandates

The Democratic reform proposals in Congress mandate that people have health insurance and provide for different levels of government subsidies, which causes debate on how much people should pay for their health care. NPR reports on the bill released Wednesday by Senate Finance Committee Chairman Max Baucus: "The latest bill, however, provides less generous subsidies, which could make it harder for middle-class families to afford the mandatory insurance."

NPR interviewed Mark Freedman, an economics teacher who made slightly more than the cut-off point for subsidized insurance in Massachusetts and has been unable to afford insurance. NPR reports: "Critics complain the Baucus bill would lead to big, out-of-pocket expenses for middle income families. They'd be required to buy insurance or pay a penalty of up to $3,800 a year. In a bid for Republican votes, the Baucus plan does not include a public insurance option, which proponents say would help lower cost. Baucus says he is still committed to providing choice in competition in the insurance market through nonprofit co-ops, if necessary. In Massachusetts, the combination of mandatory insurance and public subsidies has worked, all but about four percent of working age adults in the state now have insurance. But researcher (Carol Pryor of the Access Project) says for many middle income families affordable coverage is still out of reach" (Horsley, 9/16).

The Associated Press: "For consumers, the Baucus plan comes with costs and benefits, rights and responsibilities. Though people with employer-provided health care would not see dramatic changes, the plan is broad enough that it would touch every American family in some way. … A family of three earning about $55,000 - three times the federal poverty level - would have to pay 13 percent of its income. That's roughly $7,100 a year. It compares with costs of about $5,500 under the House bill, and $4,300 in the Senate health committee bill. A three-person family earning about $27,500 would have to pay 5.5 percent of its income, a premium of about $1,570. That compares with $824 a year in the House legislation, and $275 under the Senate health committee proposal" (Alonso-Zaldivar, 9/16).

Meanwhile, Kaiser Health News reports on the issue of price and affordability noting that "there is not a firm consensus among lawmakers, economists and health policy experts-and that is complicating efforts to come up with a common approach. At issue is how much Americans should be expected to spend on insurance premiums before getting help from the government-or before being exempted from any proposed requirement to have coverage. The problem involves underlying disagreements about the nature of what's affordable and how to calculate it."

"Different approaches produce vastly different results: the latest health overhaul proposal, unveiled Wednesday by Senate Finance Chairman Max Baucus, D-Mont., would subsidize the insurance costs of 8 million fewer Americans in 2019 than would the original House bill introduced in July, according to projections from the Congressional Budget Office. Not coincidentally, under Baucus' plan, 25 million Americans would lack health coverage in 2019 - 8 million more than envisioned under the original House plan. Currently, about 46 million Americans are uninsured" (Rau, 9/17).

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