I am thrilled that the House passed its public option plan last week. It's going to be the beginning of a new era in the United States. Sadly, there have been some incorrect statements made about the public option plan by ill-informed writers. The purpose of my post is to give facts, and only facts about the public option.
The goal of health care reform is to provide quality, affordable health care for every American while preserving what works in today’s system, expanding choice, and containing costs. The Affordable Health Care for America Act creates a public health insurance option that would compete on a level playing field with private insurers within the Health Insurance Exchange. In the first years, the Health Insurance Exchange is targeted to serve employees of small businesses, the self-employed and the uninsured. The public option will not be limited to just a few Americans; it will be available for purchase, from day one, by all Americans that are uninsured, self-employed, or work for a small employer with less than 26 employees. The second year, the uninsured and self-employed will still be able to buy the public option but it will also be extended to even larger small employers, including those with less than 51 employees. By the third year, small employers with less than 101 employees will be folded in. The only place the public option will be available is in the 'Exchange.' These are the facts, as presented in the bill passed by the House:
- Today, many areas of the country are dominated by only one or two insurance companies. establishing a public health insurance option will create a new choice for individuals and families.
- Competition in consolidated markets, driven by the introduction of a more efficient and transparent plan, will help lower premiums for all plans as the private market is forced to compete on a level playing field for the first time.
- By creating an alternative in the market, both public and private plans will be accountable for their actions because people can leave one for the other during enrollment periods. For example, if the public option fails to maintain an adequate provider network, people will not enroll. Likewise, if the private plans inappropriately restrict access to care, people may choose the public option.
- The 'public option' plan is not free. It is purchased by paying premiums. Any American that wants to have his or her insurance provided by the public option plan will have to pay premiums to the plan.
- The public health insurance option must meet the same benefit requirements and comply with the same insurance market reforms as private plans.
- Like private plans, premiums for the public health insurance option will be established for the local market areas that are designated by the Exchange and will vary by region.
- Individuals in the Exchange can choose freely among the private carriers and the public option. Employers who participate in the Exchange cannot dictate employees’ participation in a particular plan.
- Some Americans may receive subsidies (called 'affordability credits') if their income levels are close to the poverty line. Affordability credits can be used for any plan in the Exchange — public or private.
- To ensure independence of the Exchange, the public health insurance option will be run by the Department of Health and Human Services, not the Exchange.
- Like private plans, the public health insurance option must be financially self-sustaining and maintain its operations using premium revenue.
- The public health insurance option will have lower administrative costs than private plans, and it will be accountable to its enrollees and taxpayers, not shareholders or highly-paid executives.
- The Secretary of Health and Human Services will negotiate provider payment rates, which can be no higher than the average private plan rates and no lower than Medicare.
- All Americans who are without insurance, who are self-employed or are employees in small businesses with less than 101 employees will be allowed to purchase the public option plan.
Anyone wanting facts rather than myths should go straight to the House of Representatives and to the bill itself. For more information about the public option, please consult this page: Affordable Health Care for America Act.
No one will be forced to purchase his or her health insurance from a private corporation.
However, any American who wants to purchase insurance from a private corporation (like Blue Cross, United or Aetna) can purchase from a private corporation.
Likewise, no one will be forced to purchase his or her health insurance from the public option either.
However, any American who is uninsured, self-employed or employed by a small employer will be able to purchase his or her insurance from the public option run by the government.
All Americans will be able to choose. They will be able to keep the insurance they have, purchase insurance through their employers, purchase insurance on the free market. All of these choices will be open to all Americans in the bill passed by the House last week.
Health insurance reform opponents continue to spread myths about components of America’s Affordable Health Choices Act. On Sunday, in a last-ditch effort to kill the health insurance reform moving through Congress, America’s Health Insurance Plans (AHIP) (the lobby for the health insurance industry) released a report that claims that the Senate Finance Committee bill would mean higher health care premiums for America’s families than current law. Independent analysts quickly labeled the report both incomplete and deeply flawed.
Health insurance reform opponents also continue to spread myths about components of America’s Affordable Health Choices Act, including the notion that mandating people to get health insurance coverage is like imposing a new tax on them.
Will all Americans be required to participate in a health care insurance plan? Yes. This is critical for the success of health care reform.
Fixing our health insurance system to ensure quality, affordable care – and to end an era where insurance companies can discriminate against you because you get sick – requires shared responsibility, on the part of individuals, employers and the government.
America’s Affordable Health Choices Act makes this idea of shared responsibility work by making affordable insurance available to all, offering small businesses exemptions and tax credits, and offering Americans affordability credits based on income to help pay their premiums. Furthermore, under the bill, there is a hardship exemption for those with circumstances that make no available insurance policies affordable.
A poll just released by Kaiser Family Foundation found that the American public strongly supports an individual mandate. In the poll, 68 percent of Americans state that they support “requiring all Americans to have health insurance, with financial help for those who can’t afford it.”
This coverage requirement is no different than states requiring drivers to purchase automobile insurance. Those who can afford to purchase health insurance and choose not to would be choosing not to comply with the law and would be subject to a penalty – much like those who choose to drive without insurance can be fined.
Right now, all insured Americans are paying a hidden health care tax to cover those who go without health insurance. For example, if a person who hasn’t purchased health insurance is hit by a car, all the rest of us pay for the health care they receive when they go to the hospital. Indeed, the average insured American family of four pays more than $1,000 a year to cover the cost of health care for the more than 46 million people who – either by choice or necessity – have no insurance.
Without reform, health care costs are expected to increase for the average family by $1,800 each year – that annual increase alone is more than the penalty for not being insured for most Americans.
For more about all of the other industrialized countries that do require mandatory participation by all of their citizens, see this website - Sick Around the World. It will teach that the U.S. is the only industrialized country that does not have mandatory participation requirements. When we have them, we will be just like all the other industrialized countries - fair, just and equitable.
For more information about the public option, please consult this page: Affordable Health Care for America Act.














Comments (2)
Great post Lola. Very informative and you give a strong point by point argument for the public option. A good explanation on why a public option is important to insure all Americans and it offers competition for states that have only one or two health insurance companies. Let's cross our fingers that Harry Reid is as persuasive in trying to get the needed 60 votes in the Senate.
Posted by Angelo Lopez
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November 12, 2009 9:09 AM
Posted on November 12, 2009 09:09
Great post! Another aspect is the proven track record of public health programs that could serve as a model for the larger public option. Here is one that I've been impressed by! http://cli.gs/23yYaM/
Posted by stephhunter
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November 12, 2009 11:51 AM
Posted on November 12, 2009 11:51