Legal Commentary

How About A Medicaid Buy-In?

By Big Tent Democrat

While something called "health care reform" will be passed, it's pretty clear now that there will be no real reform in the bill. If there is good remaining in the bill, it will be Medicaid expansion and subsidies for less well off person to purchase minimal insurance.

How can you get the good in this bill and still have a chance for health care reform in the future? The mandates are a sticking point of course. They are the lever for the political bargaining that might make health care reform possible in the future. But there are others. Ben Nelson is not done yet and Bart Stupak is still waiting in the House. The problem with the subsidies is that they are going to be channelled through exchanges which will be subject to a Stupak Amendment. The current bill makes that too bitter a pill to swallow I think.

There is a solution to these problems I think. Instead of channeling the subsidies through the exchanges, eliminate the exchanges and make all persons who would have been eligible for the exchanges able to use their subsidies to purchase Medicaid. More . . .

Medicaid is of course subject to the Hyde Amendment so there will be no need for a Stupak Amendment. That disposes of that problem.

It also disposes the Mandate problem. Either folks are mandated (or auto-enrolled) into a public insurance program or we can make the use of the subsidy voluntary. Eligibility (or auto-enrollment) for Medicaid Buy-In eliminates the need for the pay out to the insurance companies, as they will not be getting any of the money - it will all go to Medicaid.

Sure, we will not have reformed health insurance, but the current bill will not either. And we will be getting 900 billion dollars to less well off people so that they can get insurance. 30 million people will get health insurance. That will save lives.

I can not believe any one except folks possessed of sociopathic indifference would put the exchanges above insuring 30 million people and saving lives.

Speaking for me only

Full post as published by TalkLeft on December 16, 2009 (boomark / email).