Wednesday, May 20, 2009

The Ryan Health Plan

Introduced in the House and Senate, this from the AmSpec. UPDATE: More here from Eggster, including links to Q&A.

The key to the bill is that it shifts the tax benefits for employer provided health insurance from corporations to all workers. As a result, every citizen not retired on Medicare will get a refundable tax credit of $2,300 per year for individual health insurance or $5,700 per year for family coverage. ...Workers with employer-provided coverage can keep that or use these credits to purchase their own preferred insurance instead. ...All consumers would be free to choose from the full range of coverage alternatives available in the marketplace, from Health Savings Accounts (HSAs) to Health Maintenance Organizations (HMOs) to standard fee-for-service coverage with different health provider network arrangements. ...Workers can take the health insurance they choose with them when they change jobs, as this new system makes such insurance fully portable.

The bill would also enable employers to devote a specified amount towards health coverage for each worker each month, with the worker to then use those funds to buy the health plan of his choice on the state Exchange, or outside the Exchange. This could potentially increase employer provided coverage quite substantially, because the employer would not have to carry the burden of choosing and administering a health plan, or commit to paying the full cost of such a plan, with unknown future cost increases. This would be particularly attractive to small and medium size businesses. Yet, the worker would still gain full control and choice over his or her coverage.

Insurance offered on the state Exchanges would have to be open to everyone, regardless of age or health condition. ...Each state would also set up an uninsurable risk pool, ensuring that a coverage option is available even to the sickest consumers in their state. Those without coverage who suffer costly and serious illnesses could always obtain coverage from the pool. addition to the tax credits for health insurance, the bill would enable low income consumers to choose to receive additional funds from Medicaid to help pay for private insurance coverage, like a health insurance voucher. This would enable the poor on Medicaid to receive the same private coverage and care on the same terms as everyone else

...The bill would increase the monthly voluntary contribution limits for HSAs to $3,000 for individuals and $5,950 for families. It would also allow HSA funds to be used for health insurance premiums and innovative health plans targeted to serve the sick [These are tax-free funds going in AND coming out for payments--Ed.]

...Medicare includes an option for retirees to choose private coverage, called Medicare Advantage. Almost 11 million retirees have chosen such private coverage, close to 25% of all Medicare enrollees. The Republican plan would expand this option by allowing private insurers to competitively bid down the Medicare payments they would receive for providing the specified benefits. The insurers would also be able to modify benefits to provide more of what seniors are telling them they want, and then compete in the marketplace to sell those benefits to seniors. This same competitive bidding system has been in use for Medicare prescription drug benefits and is estimated to have reduced costs by 26%, with premiums charged to seniors 37% lower than originally expected. This private option would enable seniors to avoid the increasing threat of rationing under Medicare.

...The bill implements as well the health information technology theme that Obama has also so heavily touted, which has been advanced by others such as Newt Gingrich and Hillary Clinton going back many years. The bill proposes a health care ATM card that would access fully digitized insurance and medical records from each doctor's office.

The bill would also finance specific state programs to end lawsuit abuses and excessive malpractice costs. Each state's health commissioner could appoint an expert panel of three medical and three legal experts to recommend a quick, low cost resolution for each case. States could also establish specialized, expert health courts

Another important innovation is the creation of a Health Services Commission (HSC) modeled after the Securities and Exchange Commission. The HSC, however, would not be regulatory. It would establish principles, standards and metrics for the reporting and publication of price and quality information by doctors, hospitals and other health providers, similarly to the Financial Accounting Systems Board for accounting principles. This would truly enable consumers to compare price and quality among competing providers [FINALLY!!!! --Ed]

All the good stuff, none of the trash that Gummint HealthCare is saddled with. You get to choose the plan you like, you get to put away large dollars in an HSA if you wish, your employer can significantly cut their expenses and STILL contribute to your health plan. There are cost controls through competitive bids, quality- and price-checking methods, and portability.


Congrats to Rep. Ryan, Rep. Nunez, Sen. Burr, and Sen. Coburn (who is also an MD and knows a bit about healthcare.)


Joe of St. Thérèse said...

Sounds like an actually intellegent plan. Now to get people to get with the program.

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