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Then, on June 4, HR 2718: Medicare Payment Advisory Commission (MedPAC) Reform Act of 2009 was introduced in the House (with no co-sponsors) for precisely the same purpose.
In other words, both bills will let White House appointed bureaucrats dictate future policies, including payment rates and benefits, trial programs, and various other initiatives outside of congressional control for the first time ever. Thus far, they remain in committees, so it's uncertain if Congress will relinquish its long held power. If it does, for Medicare and Medicaid combined, it will be step one toward eventually ending what over 100 million Americans rely on - a steadily rising total as the population ages and growing numbers of poor and lower income people have no other source of care.
House and Senate Health Care Reform Bills
The House bill is HR 3200: America's Affordable Health Choices Act of 2009. The Senate's version is America's Healthy Future Act of 2009. After clearing the Finance Committee on October 13, further consideration now moves to both floors where significant hurdles remain.
In an earlier article, this writer explained that House and Senate bills will ration health care, enrich insurers, drug companies, and large hospital chains, and make a dysfunctional system worse. If Obamacare passes, hundreds of billions in Medicare cuts will harm seniors. Most others as well, especially the poor, chronically ill, all working Americans paying more and getting less, and millions more left uninsured. In addition, employers will be able to opt out of providing coverage, but since insurance will be mandated, those without it will have to buy it or face hundreds of dollars in penalties - still a debated figure ahead of House and Senate floor debate, votes in both chambers, and if passed, approving final legislation to be sent to the President for signing.
Four of the five House and Senate versions include a public option. Only the Baucus bill excludes it. Instead, it calls for expanding nonprofit health care cooperatives, similar to ones in many states that sell insurance, can pick and choose their members, are able to charge premiums comparable to private insurers, and in most areas provide little, if any, real competition.
If a public option becomes law, it will provide fig leaf cover for a weak and ineffective plan, not what many want but won't get. Most, in fact, won't qualify because it'll be a limited to high-risk individuals, offloaded to the government for substandard care under an "adverse selection" process. Private insurers will get to skim off the cream, charge as much as they want, profit handsomely at low risk, and leave Washington stuck with ones the industry doesn't want.
Yet they want more, are using hyperinflated cost estimates well above projected increases without "reform" legislation, and claim Medicare cuts will mean higher costs for the privately insured. They also say taxing higher-priced "Cadillac" plans and being prohibited from denying preexisting conditions will raise costs for everyone.
More still according to Wendell Potter, former PR executive for CIGNA insurance, now a whisleblower exposing shenanigans he saw on the inside, including the industry's "Medical Loss Ratio" (MLR) profit margin. Until about two decades ago, it was five cents on the dollar. Now it's a quarter or five times as much, and they're still not satisfied, so they're going for broke on Obamacare to skim hundreds more billions off the top in what will be greater than ever grand theft if they get it.
Other likely final legislation features will include:
-- providing government subsidies of about $460 billion to lower income people over ten years to buy private insurance;
-- expanding cost-sharing with the states for an additional 14 million Medicaid recipients because of growing numbers of poor and lower income households needing it; in addition, raising the income threshold so more people qualify at a time the need is the greatest in decades;
-- exacting deep Medicare and other social service cuts to fund it - for starters, around $400 billion in federal programs for the elderly, poor, and disabled over 10 years; another $200 billion in lower payments to providers; and $113 billion in Medicare Advantage cuts affecting 10 million seniors getting benefits through private insurers;
-- taxing so-called "Cadillac" plans by levying them on insurers to be passed on to customers through higher premiums, larger deductibles, and/or less coverage, even though these plans mostly cover state employees, municipal union members, and other working Americans, not just the well-off;
-- exacting more Medicare cuts ahead, including from a White House appointed independent Medicare Commission to curb "excess cost growth" by rationing care through capping costs, denying expensive tests, procedures and drugs, and incrementally ending Medicare as we know it to deny future generations of seniors of what those covered now get - packaged as "health care reform" with deceptive promotion to disguise a scheme few will understand until they need expensive care and can't get it.
As bad, millions will be left uninsured or underinsured as Washington cuts back on its obligation to provide universal quality care as a human right. Instead, final legislation will be class-based on the ability to pay with growing millions of poor and lower income people offered sub-standard care, millions left out entirely, and a time coming when only those who can afford it will be covered, no others. That's Obamacare's bottom line, but expect no public discourse to explain it.
