CBO On The New Help Bill

By: Donald Marron Friday, July 03, 2009 11:54 AM

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On Thursday evening, the Congressional Budget Office (CBO) released a preliminary analysis of the latest version of Title I of the Affordable Health Choices Act, commonly known as the HELP bill or the Kennedy bill (since it’s the product of the Senate Committee on Health, Education, Labor, and Pensions which Senator Kennedy chairs).

Based on a quick review, here are the top six things I think you should know about the cost estimate:

1. The analysis is preliminary. CBO and the Joint Committee on Taxation have not yet had time to analyze every provision in the bill, some provisions remain in flux, and new provisions may be added. Health policy continues to be a moving target.

2. The headline cost of the bill — about $600 billion over ten years — is significantly lower than the $1 trillion net cost of the previous version of the bill. The net costs declined because (i) the subsidies for coverage through health insurance exchanges are now smaller, (ii) employers would have to pay a penalty if they do not offer insurance to their workers, and (iii) it would be much harder for employees to get subsidies in the exchange if their employer offers health insurance.

Note: The new CBO tables cover Title I of the bill, which has a net budget cost of $597 billion. CBO had earlier scored other portions of the bill as costing $14 billion. As a result, you will hear some commentators using the $597 billion figure and others using $611 billion.

3. As usual, it’s important to unpack the headline cost into its constituent parts: the 10-year cost of expanding health insurance coverage in Title I is about $743 billion and a separate provision adds an additional $10 billion. That $753 billion cost is then partially offset by penalties on employers who don’t offer coverage to their workers ($52 billion), penalties on uninsured individuals ($36 billion), higher income and payroll taxes ($10 billion), and the net premiums generated by a program (CLASS) to provide long-term care insurance ($58 billion). The income and payroll tax offset is much smaller than in the previous version of the bill because the current draft would have a much smaller impact on employer-provided health insurance.

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7/3/2009 12:27:29 PM Promising Report by hsr0601 The independently-funded healthcare policy research organization, The Commonwealth Fund, compared possible savings 'a health insurance exchange' could bring under three different scenarios. One would include a Medicare-like plan along with private insurance. Another would instead offer only a government-run plan with rates somewhat higher than Medicare. The final one would be private insurance with no government plan at all. Commonwealth's study found cumulative health system savings between 2010 and 2020, compared with projected trends for that period, would range from $3.0 trillion under a Medicare-like plan along with private insurance paying providers at Medicare rates in competition with private plans, to $2.0 trillion for a public plan paying providers at rates between Medicare and private plan rates, to $1.2 trillion in the private plan-only scenario. All three options would help insure nearly all Americans, it said, with the number of uninsured dropping to about 4 million people by 2012. 'Such an exchange' would offer a central point for consumers to shop for and compare health plans. Under the Medicare-like plan along with private insurance, all U.S. residents would be required to obtain health coverage. The plan would establish a new government-sponsored health program for people younger than age 65 who are not eligible for Medicare. More than 40 million people would be expected to enroll in the program, according to Cathy Schoen of the Commonwealth Fund. The government-operated insurance exchange would be similar to an existing program in Massachusetts and would allow people to compare coverage offered by private insurers and the new public program. In addition, the plan supports wide adoption of health information technology, better disease prevention efforts and 'changes to the insurance payment system' that promote efficiency. Health spending would continue to increase under the plan, but at a slower rate than current projections over the next 10 years. The Commonwealth Fund said the plan would reduce annual health care spending growth from a projected 6.7% to 5.5% and save a cumulative total of about '$3 trillion' by 2020, adding a national health insurance exchange program that includes a federally managed health insurance option could potentially save $1.8 trillion more than a plan consisting only of private plans. The group's analysis assumed other changes would also be made to the U.S. healthcare market. These include an expansion of existing government coverage and new regulations that would require insurers to cover a wider range of consumers. Hospitals and doctors would also see their revenues grow with any of the three exchanges but at a slower rate, the report said. The proposal's advocates have argued that a government-sponsored insurance plan would offer the 46 million uninsured Americans an affordable alternative to costly private insurance, adding that It would provide a strong incentive for private plans to strealine, innovate and compete. Thank You ! Reply Rating: (0) (0)

The independently-funded healthcare policy research organization, The Commonwealth Fund, compared possible savings 'a health insurance exchange' could bring under three different scenarios. One would include a Medicare-like plan along with private insurance. Another would instead offer only a government-run plan with rates somewhat higher than Medicare. The final one would be private insurance with no government plan at all.
Commonwealth's study found cumulative health system savings between 2010 and 2020, compared with projected trends for that period, would range from $3.0 trillion under a Medicare-like plan along with private insurance paying providers at Medicare rates in competition with private plans, to $2.0 trillion for a public plan paying providers at rates between Medicare and private plan rates, to $1.2 trillion in the private plan-only scenario. All three options would help insure nearly all Americans, it said, with the number of uninsured dropping to about 4 million people by 2012. 'Such an exchange' would offer a central point for consumers to shop for and compare health plans.
Under the Medicare-like plan along with private insurance, all U.S. residents would be required to obtain health coverage. The plan would establish a new government-sponsored health program for people younger than age 65 who are not eligible for Medicare. More than 40 million people would be expected to enroll in the program, according to Cathy Schoen of the Commonwealth Fund.

The government-operated insurance exchange would be similar to an existing program in Massachusetts and would allow people to compare coverage offered by private insurers and the new public program. In addition, the plan supports wide adoption of health information technology, better disease prevention efforts and 'changes to the insurance payment system' that promote efficiency. Health spending would continue to increase under the plan, but at a slower rate than current projections over the next 10 years. The Commonwealth Fund said the plan would reduce annual health care spending growth from a projected 6.7% to 5.5% and save a cumulative total of about '$3 trillion' by 2020, adding a national health insurance exchange program that includes a federally managed health insurance option could potentially save $1.8 trillion more than a plan consisting only of private plans.
The group's analysis assumed other changes would also be made to the U.S. healthcare market. These include an expansion of existing government coverage and new regulations that would require insurers to cover a wider range of consumers. Hospitals and doctors would also see their revenues grow with any of the three exchanges but at a slower rate, the report said.
The proposal's advocates have argued that a government-sponsored insurance plan would offer the 46 million uninsured Americans an affordable alternative to costly private insurance, adding that It would provide a strong incentive for private plans to strealine, innovate and compete.
Thank You !

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