Sen. Max Baucus, D-Mont., on Wednesday made public his own plan for addressing what ails the health care system. It includes several features of President-elect Obama's plan, such as guaranteed insurance coverage regardless of pre-existing illness. He also would set up an insurance exchange, a sort of government-administered shopping center where people could go to buy coverage.
Baucus goes beyond Obama's plan by requiring everybody to purchase health insurance once affordable options are available.
The plan will stop the shifting of costs for care of the uninsured onto those who have health coverage, Baucus said, and it will bring down the average cost of insuring each American - which can help to make many individual premiums more affordable.
"Coverage of all Americans will also make reforms work better, from insurance market reforms to a cost-saving focus on preventive care," he said. "Those who cannot afford coverage will not be required to purchase it - there will be other options for them."
The plan also would help prevent people from waiting until they get sick to buy insurance.
"If a significant portion of Americans does not purchase coverage until sick, then premiums for all enrollees will increase to cover insurer outlays, and the problem of unaffordable coverage will persist," Baucus's 89-page report said.
Baucus' committee has jurisdiction over health programs financed by a specific tax or trust fund, such as Medicare and Medicaid. Sen. Edward M. Kennedy, D-Mass., the chairman of the Senate's Health, Education, Labor and Pensions Committee, will also play a role in any major overhaul of the system. He, too, has said health care changes can't wait.
But paying for expanding health coverage will be expensive, and many independent analysts question whether Congress can make it happen under current economic conditions. Baucus did not offer a way to pay for his proposal, which included such costly provisions as allowing people ages 55-64 to buy into Medicare and eliminating the requirement that disabled people wait two years from when they become disabled to enroll in Medicare.
"We all must realize that the costs of inaction, both in human and financial terms, will eventually be far greater than any initial outlays," the report said.
The question before Obama will be whether to pursue health reform incrementally or to try for comprehensive change in one massive bill next year. It's unclear which approach will be pursued, but Obama has listed the issue as one of his top domestic priorities.
"President-elect Obama applauds Chairman Baucus's work to draw attention to the challenges of the health system and looks forward to working closely with the chairman and other congressional leaders, as well as the American public, to make quality, affordable health care a reality for all Americans." said Tommy Vietor, a spokesman for Obama's transition team.
Baucus also embraces the idea that the current tax treatment of health insurance produces inflationary pressures contributing to the high cost of insurance. He said one way to reduce those pressures would be to limit the amount of money that can be directed toward health insurance on a tax-free basis. Once people reached the limit, the money employers spend for health insurance would be treated as taxable income.
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