BaucusCare Criticisms

Today, Sen. Max Baucus (D-Mont.) pulled back the curtains on Baucus-care, the definitive Gang of Six Finance Committee health care opus magnum we’ve been hearing so much about.

For his trouble, Baucus has been teared into by just about everyone. Progressives hate it, chiefly because it scrapped the public option, and even the trigger compromise, in favor of non-profit private health insurance cooperatives. Conservatives hate it because it costs a bunch, doesn’t do much to make insurance more affordable for those who already have it, includes an individual mandate that carries a hefty (up to $3,800 a year for a household) fine, and cuts nearly $500 billion from Medicare¹.

Though the plan was released today, The New York Times already assembled a bunch of really smart people to dissect it.

Here’s some snippets of the more interesting critiques.

Jacob S. Hacker, an apparent liberal and political science professor at Yale:

As I have argued elsewhere at length, cooperatives are not a serious means of reliably achieving any of the public plan’s three critical goals: providing choice for consumers, creating competition for insurers and controlling costs over the long term. They are unlikely to get off the ground quickly or broadly, or to have any real effect on the cost and quality of care.

Michael D. Tanner, a senior fellow at the conservative Cato Institute:

The Good:

The plan drops the idea of a government-run “public option” in favor of co-ops. Government involvement with these co-ops would essentially be limited to providing start-up grants. The co-ops are unlikely to have much, if any, impact on the cost or availability of health insurance, but are far preferable to a government run plan. (Ed: I’m not trying to make the man look like an idiot. I find it fascinating that he hates the public option so much as to prefer an alternative that he admits will be an ineffectual waste of money.)

The Bad:

The plan would force states to increase Medicaid eligibility to individuals at 133 percent of the poverty level, and to enroll single, childless adults. While the federal government would pick up some of the increased cost, states would be responsible for at least some of the increase, a provision that will undoubtedly strain already tight state budgets.

Dean Baker, a (I guess) left-leaning economist:

The big plus of the Baucus plan is that it will eliminate discrimination based on pre-existing conditions, which means that people will have real insurance.

The proposal does not include the option to buy into a public plan. This is important because the public plan provided a potential mechanism for effective cost control. It is hard to see how costs can be contained in this plan. Also, in the absence of a public plan, many people may resent being forced by the government to buy a private insurance plan.

Henry J. Aaron, senior fellow at the lefty Brookings Institute:

Senator Baucus’s plan lowers the overall cost by promising much less generous benefits than previous bills did.

Unfortunately, reducing one problem creates another. Health insurance is costly because health care is expensive. Someone has to cover those costs — individuals or taxpayers. So, reducing the subsidies heightens the risk that health insurance mandate may place undue financial burdens on low- and moderate income households.

It should be noted that many of the complaints on the left came from Baucus’ poor attempts to appease the Gang of Six’s right side. It should also be noted that none of those three Republican senators are all that enamored with the results (nor should they be) and none have said they’re on board.

In the bill’s defense, it did lower the price tag to under $800 billion (CBO estimate); it did address the political red herrings of abortion and illegal immigrant coverage²; and it did at least make a good-faith effort at paying for itself.

Still, unless something weird happens, I’ll defer to Mr. Hacker, who told The New York Times: “The Baucus bill should be dead on arrival.”

The bottom line is, Nancy Pelosi isn’t likely to budge on the public option, and if she did it wouldn’t be for a bill that’s getting universally panned.

¹It should be noted that Republicans seized upon this latter item not on principle, but for its electoral implications. Criticizing Medicare cuts is a sure-fire way to appeal to senior citizens. Were they the majority party, one would expect that tackling rising costs in Medicare would be central to any health care bill, as it should be. (See how much nicer “tackling rising costs” sounds than “cutting?”)

²I call illegal immigrant coverage a red herring with a caveat. Illegal immigrants are a legitimate issue when you talk about health care. However, the reason illegal immigrants are a drain on the health care system isn’t because they’re eligible for it, it’s because they suck up tax dollars at the emergency room. As it’s being discussed vis-a-vis the House bill, it’s a scare tactic with little basis in reality. Baucus’ version really just adds language that already exists in Medicaid law, but it should deter those who say it’s extending coverage to illegals, heaven forbid.


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About the Author

Brian Eason is a University of Missouri graduate with bachelor degrees in Journalism and Political Science. He has covered Congressional elections and local government for the Columbia Missourian and worked as a general assignment reporter for the State Journal-Register in Springfield, IL. Brian has also had articles published in Roll Call.

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