The Senate Finance Bill Forces You To Pay 35% of The Bill!

[Joanne98]

This is precisely why we need the public option as a cost containment in the final bill product, and why we MUST work hard to influence the final conference report! According to the Los Angeles Times, the Senate Finance Bill is a "bonanza" for private insurers because without a public option to lower premium costs and provide competition, what insurance companies get are 47 million new captive customers with big fat government subsidies (i.e. bailouts) that are forced to buy junk insurance plans.

"It's a bonanza," said Robert Laszewski, a health insurance executive for 20 years who now tracks reform legislation as president of the consulting firm Health Policy and Strategy Associates Inc.

And you know what's egregiously bad about this? Private insurance companies currently pay about 80% of insurance policy claims, and in the Senate Finance Bill, the requirement for them will be lowered to 65%! That means you'd be required to pick up 35% of your medical bills. See? You get covered, but you're forced to pay 35% of your bills.

That's why I keep saying that universal coverage does not equate affordability.

slinkerwink's diary :: :: In May, the Senate Finance Committee discussed requiring that insurers reimburse at least 76% of policyholders' medical costs under their most affordable plans. Now the committee is considering setting that rate as low as 65%, meaning insurers would be required to cover just about two-thirds of patients' healthcare bills. According to a committee aide, the change was being considered so that companies could hold down premiums for the policies.

Most group health plans cover 80% to 90% or more of a policyholder's medical bills, according to a report by the Congressional Research Service. Industry officials urged that the government set the floor lower so insurers could provide flexible, more affordable plans.

Who here thinks that insurance companies will really hold down premiums for the policies if they're obligated to pay just 65% instead of 80% to 90% of medical bills? I really don't see anything out of the Senate Finance Bill that requires private insurers to hold down premiums for policies, so it's the case of the mouse trusting the alligator to carry it across the river without being eaten.

Where's the affordability really for the middle-class in this crappy Senate Finance Bill? I don't see it, especially not with a community rating of 7:1 in that bill, which means you could pay seven times what a young adult pays especially if you're an adult in your 50s or 60s.

1.Go to these townhalls to THANK our progressive Democrats for saying that the public option is a necessary cost containment on making health insurance premiums affordable! Thank them for saying that the public option is the line in the sand for them, and show as much support as you can!

http://www.dailykos.com/storyonly/2009/8/24/771571/-The-Senate-Finance-Bill-Forces-You-To-Pay-35-of-The-Bill!

[JeanGrey]

1. Welcome to reality. And it won't be pretty.

[tj2001]

2. Go to Hell, Tom Daschle

This fucker is probably the sneakiest asshole that must be exposed.

[Lasher]

3. The devil's in the details.

Thanks for the heads-up.

[QC]

4. How very, very hopeful and changealicious! n/t

[SammyWinstonJack]

12. +1

:evilgrin:

[ixion]

5. such is what passes for 'reform'

Almost without fail, every time congress decides to 'reform' an industry, it translates to huge windfall profits for the target industry, and additional cost to the individual.

Mandatory insurance is NOT healthcare 'reform'. It is, in fact, a massive new revenue stream for private insurers, and an additional burden to the individual, just like the many so-called 'reforms' before it.

Case in point: The Consumer Protection Act, which was a huge give-away to banks and CC companies.

[billyoc]

6. But we're 13-0 going into health care reform!

:rofl:

[BalancedGoat]

7. Misleading title as well as false claims.

unrec'ed

[rucky]

10. If you know something, please share.

[BalancedGoat]

11. The bill would set a lower limit for reimbursement.

That is a far cry from "forces you to pay 35%".

"Private insurance companies currently pay about 80% of insurance policy claims, and in the Senate Finance Bill, the requirement for them will be lowered to 65%"

It is my understanding that there isn't currently a federal requirement for insurance reimbursement. You can't lower something that doesn't exist. There is certainly a point to be made about the effectiveness of a limit that is so much lower than the average, but it seems to me that the author of the article would rather distort than discuss facts.

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x6378922

I prefer that post because it lacks the hyperbolic distortion that this post has.

[rucky]

13. Thanks!

[karynnj]

17. This is the first time there has been a federal minimum standard

I know Massachusetts has one, because my daughter just graduated from college there and each year, she had to sign a form that specified that our family plan met certain criteria before she could waive the school's insurance.

It seems that the only thing they lowered it from was the percent in earlier committee discussions.

[karynnj]

16. +1 (though I didn't unreccomend, because at least the article is correct

[bluestateguy]

8. I don't really care anymore about that committee

Six other committees have reported bills. Why all the suspense behind what these paper pushers do?

[OHdem10]

9. Mr. President, This may not be the time to increase Health Insurance

Costs for Americans. The GOP have put the word out that
we all will be paying higher Premiums.

May I respectfully suggest that saying Health Insurance
Premiums will be increasing anyway does not cut it.
Americans are fickle politically. They have to experience
more increases from Insurance Companies. It will be a
different story if they believe the deliberately raised
premiums.

It is beginning to look as if this whole thing is a scheme
to fix Medicare in the name of Insurance Reform. This program
is being paid for by cutting Medicare or on the backs of
seniors. This is another picture to clean up.

Most of us believe the Baucus Committee is a gift to
Insurance Companies.

Remember your promise to look out for the Middle Class.

No bill is better than a bad bill.

[dembotoz]

14. 35 % = instant bankruptcy

about 25 years ago my wife developed leukemia.
her first stint in the hospital with all the problems she developed what over 100K

and that was in 1984 dollars.......

35 grand would have meant bankruptcy then and it would mean bankruptcy now.

[karynnj]

18. Most plans now have both a % copay and a maximum out of pocket

Look at your current plan.

[karynnj]

15. You missed the words "at least" before 65%

The bill is trying to set standards that allow for various types of plans. This allows people to select different insurance packages. Not knowing the other requirements, this might allow a company to let people choose between the following options.

Plan 1 - pays 90%
maximum annual out of pocket charges: $M
cost X (for purpose of example, make this the insured cost)

Plan 2 - pays 65%
maximum annual out of pocket: $M
cost .8X (for purpose of example, make this the insured cost)


If I were just out of college, young and healthy, I might opt for plan 2 as it very likely will be cheaper in terms of the likely total cost of my portion of each bill and my cost of the policy. The maximum risk in both these cases is intentionally set the same and is why I made the cost of plan B higher than the ratio would make it.