The health care law has emerged as a defining issue in the U.S. Senate campaign between Democrat Lee Fisher and Republican Rob Portman.
Fisher said he would have voted for the law, which when fully implanted in 2014 will provide health care coverage to millions of uninsured Americans.
But Portman has assailed it as a “new entitlement program we can’t afford,’’ and is vowing to vote to repeal the measure and “replace it with something better.’
Portman ticks off a list of ideas he insists would reduce crushing health care costs – limiting damage awards on medical malpractice lawsuits, offering refundable tax credits to help low and middle income people buy insurance, allowing small businesses to band together to buy less expensive policies, and permitting insurance companies to sell across state lines.
It would be so great if conservatives would find out what’s in the health care law before opposing or commenting on the health care law. I’m not even talking about reading the actual law, because it was really heavy to lift, as they demonstrated to us many times, and very long and complicated.
I’m talking about doing any reading, at all, on health care reform.
Currently, states regulate insurers. Liberals feel that’s too weak and allows for too much variation, and they want federal regulation of insurers. Conservatives feel that states over-regulate insurers, and they want insurers to be able to cluster in the state with the least regulation and offer policies nationwide, much as credit card companies do today.
To the surprise and dismay of many liberals, the Senate health-care bill included a compromise with the conservative vision for insurance regulation. The relevant policy is in Section 1333, which allows the formation of interstate compacts. Under this provision, Wyoming, Colorado, Arizona, Utah, and Idaho (for instance) could agree to allow insurers based in any of those states to sell plans in all of them. This prevents a race to the bottom, as Idaho has to be comfortable with Arizona’s regulations, and the policies have to have a minimum level of benefits (something that even Rep. Paul Ryan believes), but it’s a lot closer to the conservative ideal.
I don’t know if it’s sheer laziness or deliberate bad faith, but this seems to be Round Two of the conservative campaign to misinform on health care reform.
“Allow individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, the same way large corporations and labor unions do.” This is the very purpose of the exchanges, as defined in Section 1312. Insurers are required to pool the risk of all the small businesses and individuals in the new markets rather than treating them as small, single units. That gives the newly pooled consumers bargaining power akin to that of a massive corporation or labor union, just as conservatives want. It also gives insurers reason to compete aggressively for their business, which is key to the conservative vision. Finally, empowering the exchanges to use prudential purchasing maximizes the power and leverage that consumers will now enjoy.
There’s also a tax credit for small business, and the largest single provider of primary care in this country, federally-qualified community health centers, are protected from malpractice claims under the Federal Tort Claims Act.
When you hear “repeal and replace” think “death panels”. Same thing.