Fix Health Care Policy

The Public Option: Alive and Well in Obamacare

Thought the “public option” was dead? Think again. Chief among the most dangerous provisions in Obamacare is the creation of government-sponsored national health plans, which are, in effect, another embodiment of the public option.

Through its multi-year implementation, the law steadily evolves into a national single-payer health care system.

Here’s the background: In 2014, the Office of Personnel Management (OPM), the small agency that runs the federal civil service, will administer at least two nationwide health plans to compete against private insurance. OPM will be responsible for negotiating the new health plans’ medical-loss ratio, profit margins, and premiums.

The OPM-sponsored plans will automatically qualify to compete against private health plans in the new state exchanges and thus will not be subject to the same qualifications and standards outlined in Obamacare for private plans in the exchanges. OPM must contract with an already existing large insurer, because such a plan must be offered in 60 percent of states in year one.

Read the rest on The Foundry…

Tags: medical loss ratio, Office of Personnel Management, premiums, private coverage, profit margins, public option, sponsoring health plans, state health exchange

Another Public Option? How Many Do We Need?

The public option has reared its head once again. Last week, H.R. 5808 was introduced in the House Ways and Means Committee to add a public option to the Patient Protection and Affordable Care Act (PPACA).

The plan would be administered by the Secretary of Health and Human Services. Payment rates for providers would be set at Medicare rates plus 5 percent and would grow according to increasing physicians’ costs. The plan would be required to maintain solvency, so premiums would have to cover benefits offered and administrative costs.

Momentarily setting aside the major drawbacks of a public plan, this legislation isn’t necessary—the PPACA already lays the groundwork for a robust public option. The new law will allow the Office of Personnel Management (OPM), which currently oversees federal employees’ health benefits, to administer plans in the exchanges. These plans would be offered by private insurers but run by unelected government officials. (more…)

Tags: limited choice, Medicaid, Medicare, Office of Personnel Management, public option

New Bill Not Necessary: Public Option Already in Obamacare

Like many federal efforts in Washington, last week’s reintroduction from House Democrats to create a public health insurance option, which would become part of the 2014 insurance exchanges created by Obamacare, is a bureaucratic redundancy. Stuart Butler points out that the health reform law already has its own “public option” through expanded powers to the Office of Personnel Management (OPM).

Calling the House bill a “smokescreen” for the nation’s opposition against a public option, Butler says the real story is in the “OPM alternative.” “Far from being an alternative, it is the fast road to a public plan — as I warned before the legislation passed. Why? Because the ‘alternative’ gives the OPM the power to establish national plans. These are to be private — but in name only.”

With “enormous reserve powers,” the federal government would be able to set premiums that would drive other private health insurers out of the market, leaving Americans with no choice but to enroll in the government-mandated health plan.

Tags: health insurance premiums, ObamaCare, Office of Personnel Management, private insurers, public option

Battle Over Health Care Reform Has Only Just Begun

Before passage of the president’s health care legislation in March, House Speaker Nancy Pelosi (D-CA) infamously exclaimed that “we have to pass the bill so that you can find out what is in it.” It has now been months since the Patient Protection and Affordable Care Act became law, and as Heritage expert Stuart Butler explains in a recent paper, the consequences of the bill remain to be determined. Moreover, the ambiguity of the legislation and the amount of decision-making left to administrators means that several controversial questions surrounding the legislation remain unanswered.

Butler highlights the following areas as those in which Americans may find that critical future decisions could drastically change the direction of the health care overhaul: (more…)

Tags: employer-sponsored insurance, health care debate, health exchanges, House Speaker Nancy Pelosi, ObamaCare, public option, repeal, start over

The Long War of Repealing Obamacare

In the depressing aftermath of Congress’s passage of the Democratic health-care legislation, there has been an understandable temptation among conservatives to think that all their effort over the last year to derail what was coming down the tracks may have been for naught. After all, the bill did pass. The president and his allies got their signing ceremony and their victory lap, as well as a barrage of premature but predictable pronouncements from the national media that we are now witnessing a historic moment of irreversible liberal progress.

And there’s no use sugarcoating what has happened. It’s a debacle from every possible vantage point. The Democrats have created another massive entitlement program while expanding federal power and reach in a manner not seen since the heyday of Franklin D. Roosevelt. If allowed to stand, the new health-care law will tether America’s middle class to the federal government in ways that will fundamentally alter — and not for the better — the relationship between citizens and the state. The result will be worse health care, distorted politics, less medical innovation and economic vitality, and depleted wealth.

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Tags: $1.2 trillion cost, conservative opposition, doctor-patient relationship, massive entitlement program, Medicaid Expansion, Medicare cuts, ObamaCare, Public Opinion, public option, repeal

What the House Would Have to Swallow in the Senate Bill

Amidst all the intense speculation about quickly passing the President’s health care agenda through the Budget Reconciliation process before the Easter Recess, ordinary Americans should remember one thing: the House of Representatives must first pass the 2,700-page, $2.5 trillion, Senate health bill. So, the next big step in the national health care debate is floor action in the House of Representatives, where House Speaker Nancy Pelosi must round up at least 216 votes.

Heritage analysts have conducted some extensive research and analysis of the provisions of the giant Senate bill. If the House passes the Senate bill and it goes to the President’s desk for signature, it then would become the law of the land. For all intents and purposes, the legislative debate would then be over.

Regardless of Administration or Senate leadership promises to “fix” the new law (the Senate bill) through the Budget Reconciliation process, there are no guarantees. Any “fixes”– if they did come about — would have to survive another round of Senate floor action. So it is worth recalling what the Senate bill would mean for Americans were it to become law. (more…)

Tags: Cornhusker Kickback, House Speaker Nancy Pelosi, Individual Mandate, Office of Personnel Management, President's proposal, public option, Senate Health Bill

The Public Option Threat Still Buried in the Senate Bill

Most Americans now believe that major health care legislation will not pass this year. But as Heritage Vice President Stuart Butler explains in The New England Journal Medicine one seemingly minor proposal in the Senate health care bill could end up having huge repercussions for our entire health care system:

“The Senate legislation contains strong directives to the OPM, requiring it to negotiate medical-loss ratios (the percentage of premiums that insurers actually spend on medical care for enrollees), minimum benefits, profit margins, premiums, and “such other terms and conditions of coverage as are in the interests of enrollees in such plans.” Crucially, the legislation also specifies that the OPM-administered plans would automatically be deemed to meet all the requirements for plans to be offered through the health exchanges created by the legislation.1 This means that OPM-administered plans could in practice operate free of many of the financial regulations that exchanges might impose on other plans, allowing the plans to operate under their own OPM-designed regulations.” (more…)

Tags: New England Journal of Medicine, OPM, public option, Senate Bill, Stuart Butler

OPM: The Public Option in Disguise

In order to secure the votes to pass a health care bill, Senate Democrats were forced to scrap the widely unpopular public option. But before chalking this up as a victory for opponents of government-run health care, though, its replacement deserves a closer look. As described in Sec 1334 of the Senate bill, the Director of the Office for Personnel Management (OPM) would now be charged with sponsoring a set of multi-state health plans to compete with private insurers. As a recently published detailed analysis by Heritage’s Bob Moffit and Kathryn Nix shows, this new program is simply a placeholder for the public option.

On January 20, The Heritage Foundation hosted three former OPM directors to explore the ramifications of the new proposal. Former Director Linda Springer opened by questioning the role of OPM in the proposal. OPM currently administers the successful Federal Employee Health Benefits Program, and it is due to this expertise that the agency was chosen to run the new multi-state plans. However, Springer warned that overstretching OPM beyond its traditional role could result in the cannibalization of the existing FEHB program.

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Tags: Federal Employee Health Benefits Program, OPM, public option

Sen. Nelson Says “No” to Public Option A Bit Too Late

In the wake of widespread public backlash over his eleventh-hour deal to get increased federal taxpayer Medicaid funding for his vote, Sen. Ben Nelson (D-Neb.) has been hitting the media circuit, assuring reporters that he won’t vote for any merged health care bill that funds abortions with taxpayer dollars or has a government-run health insurance plan.

“There is zero chance (of a public option),” he said to The Chadron Record. “I’ve made it so clear. It isn’t going to happen.” But Sen. Nelson has already allowed a “public option” to flourish by voting for the Senate version last month.

Medicare, for example, is the quintessential public plan. Instead of the Medicare bureaucracy contracting with private carriers to provide health coverage, as it does today, the latest Senate bill turns that responsibility over to the Office of Personnel Management (OPM), the agency that runs the federal civil service and the popular Federal Employees Health Benefits Program (FEBHP). Under the Senate bill, OPM would sponsor two “multi-state” health plans —one of which must be nonprofit — to compete against private plans in the country.

In other words, there could be health plan competition on a national level in every state, but only the federal government would field these national health plans. These government-sponsored health plans would have an exclusive franchise: No private health plans would be able to compete in the same way as the selected health plans sponsored by OPM. In effect, the Senate bill creates a set of “public options” that are thinly disguised as private health plans.

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Tags: FEBHP, Medicare, Office of Personnel Management, public option, Sen. Ben Nelson