HEALTH REFORM: Building on Finance with Cents and Sensibility

October 14, 2009 - 8:05am

Robert Greenstein over at the Center on Budget and Policy Priorities finds plenty to like about the bill the Senate Finance committee has approved -- and much that still needs work. With his usual mix of progressive values and budgetary common sense, here's how he balances it out:

The bill is a "major step toward enactment of legislation to extend health care to tens of millions of people who lack it, strengthen insurance protections for millions more who are underinsured or face exorbitant charges, and begin to address the nation's most serious fiscal threat -- the relentless rise in health care costs." It is fiscally responsible and will modestly reduce the budget deficit.

It also has "serious shortcomings." The tax credits don't go far enough to make insurance affordable to people of "modest means." Premiums for low-income households are higher than in the HELP and House bills. (See a related CBPP brief) And the benefit packages are less comprehensive, meaning higher deductibles and co-payments. This is another area where the bill merits improvement. (They have a brief on this too). Greenstein noted that the bill was scored at $829 billion -- so there is money to spend on making it better before hitting President Obama's $900 billion limit.

Greenstein is not a fan of Finance's "free rider" provision because it might actually make it harder for low- and moderate- income people to get or hold their job. It was also designed in a way that would be cumbersome to administer. (More here.)

He concluded that what we need is really the best of the congressional committee worlds:

Policymakers should continue to move health reform legislation through the legislative process. In so doing, they should blend the best provisions from the various bills in a way that is fiscally responsible, addresses the shortcomings that remain in the Finance Committee package, and can command the votes to pass Congress in final form.

And even though that's a tall order, it seems more likely to be fulfilled with each passing day.

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