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Everybody In. Nobody Out.

Alternatives Do Not Cover Everyone


Summary

As now clearly documented and communicated from multiple sources, at least 15 to 20 million people will either “fall through the cracks” or be deliberately excluded with alternatives other than non-profit single-payer national health insurance. Two examples are included below, primarily the Congress’ plan for health care reform.

There are two reasons why the alternative of the Congress’ plan does not cover everyone:
* the complexity of the plan, which is the case for all of the alternatives
* the decision to exclude undocumented workers, illegal aliens

In contrast, people will not “fall through the cracks” with single-payer, which will automatically cover all residents.


Sources

— The Lewin Group, which is a company that is well-known for its expertise in doing health care policy economic evaluations
— Two health care economists at U.S. Senate Roundtable; May 15,2009
— U.S. Senator Max Baucus’ communications on May 21, 2009 about who will be covered.

Report by Lewin Group, which evaluates the proposal advocated by Health Care for America Now (HCAN)**

It was documented by the Lewin Group: “The Health Care for America Proposal would … (leave) … about 1.3 million people uninsured.”
Executive Summary (pdf) - Page 3

Statements about (the Senate version of) the Congress’ plan to the U.S. Senate Finance Committee by Two Economic Experts Discussing “Uncompensated Care”

It was clearly stated to on May 15, 2009 at the U.S. Senate Finance Committee roundtable panel of experts on health care reform:
— “The number of uninsured is not gonna go to zero. It won’t in Massachusetts. It won’t in the nation as a whole … even in a universal coverage world.”
— “I agree with the comment that … no matter what the expansions in coverage we have … there will be some people who slip through the cracks and remain uninsured. The question is whether we … use the “safety net hospitals” as the “providers of last resort.”

—— Transcript of statements made by two economists: first, Dr. Jonathan Gruber, then Dr. Gail Wilensky

Statements about (the Senate version of) the Congress’ plan by U.S. Senator Max Baucus, chairman of the U.S. Senate Finance Committee — As reported in the Chicago Tribune, as per the Associated Press (bolding added)

WASHINGTON (AP) — Illegal immigrants won’t be entitled to medical insurance under the health legislation Congress is working on, a leading lawmaker said Thursday.

Sen. Max Baucus, D-Mont., said the health overhaul would cover nearly everyone — 94 percent to 96 percent of the population — but not undocumented workers. Baucus is chairman of the Finance Committee, which has taken the lead in drafting the sweeping legislation.

We aren’t going to cover undocumented workers because that’s too politically explosive,” Baucus said during a session with reporters, in which he previewed legislation he expects to introduce by mid-June.

President Barack Obama wants Congress to revamp health care this year, and Baucus says he’s confident a bill can pass with support from both parties.

Baucus said his bill would build on the current system in which employers, government and individuals share in paying health care costs. It’s likely to include a requirement that individuals get insurance coverage, either through an employer, a government plan or on their own. He said the plan will include “incentives” — and perhaps requirements — for employers to help pay.

People would be able to keep the coverage they already have. But those who can’t find coverage now — and people who are looking for something better — would be able to buy a plan through a new kind of purchasing pool called an “exchange.” Consumers would have a choice of private insurance plans, and most likely, a government-sponsored one as well.

Plans in the exchange would have to offer at least a standard benefits package and wouldn’t be able to discriminate against people with health problems. The government would provide subsidies for low- and middle-income households who can’t afford the whole premium. [Note: this is for pre-tax incomes up to $88,200.]

Baucus didn’t say how much his plan would cost, but outside estimates have put the price tag in the range of $1.5 trillion over ten years. Most of the money would be raised by making the health care system more efficient, said Baucus. Government programs like Medicare would start paying for the quality of care, not the number of tests and procedures that patients get.

Nonetheless, Baucus said tax increases will be needed to pay the upfront costs of expanding coverage. One of his main revenue-raising options is at odds with Obama’s preferences. Baucus wants to limit the tax-free status of job-based health care benefits to raise money and rein in health care spending. Obama says he’s opposed to that, but he’s left the door open to changing his mind.

Baucus said coverage for all will probably have to be phased in over a number of years — he wouldn’t say how many. Even when the legislation is fully implemented some people may still be uninsured.

“The goal is for everybody to have coverage but, by definition, there’s a few who slip through the cracks,” he said.

Nearly 50 million people now lack health insurance, or about 16 percent of the population.

Baucus said his plan would reduce the share who are uninsured to around 4 percent to 6 percent of the population. That could still amount to 15 million to 20 million uninsured.

Baucus said he’s looking at ways to automatically enroll people who try to avoid the requirement to get health insurance. That includes signing them up if they go to the emergency room, or requiring that school children show proof of insurance coverage.

Even though illegal immigrants won’t be able to get benefits under the legislation, they can still get health care at hospital emergency rooms and through federally funded community health centers.

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