Wednesday, December 9, 2009

Healthcare Compromise in the Works

Senate Democrats have reached a tentative deal on healthcare reform that could trade out the public option for a compromise that will pass. Brian Beutler at TPM has the details.

If this trade-off carries the day, the opt out public option is gone.

In its place will be many of the alternatives we’ve been hearing about, including a Medicare expansion and a triggered, federally-based public option, the aide said.

As has been widely reported, one of the trade-offs will be to extend a version of the Federal Employees Health Benefits Plan to consumers in the exchanges. Insurance companies will have the option of creating nationally-based non-profit insurance plans that would offered on the exchanges in every state. However, according to the aide, if insurance companies don’t step up to the plate to offer such plans, that will trigger a national public option.

Beyond that, the group agreed–contingent upon CBO analysis–to a Medicare buy in.

That buy-in option would initially be made available to uninsured people aged 55-64 in 2011, three years before the exchanges open. For the period between 2011 and 2014, when the exchanges do open, the Medicare option will not be subsidized–people will have to pay in without federal premium assistance–and so will likely be quite expensive, the aide noted. However, after the exchanges launch, the Medicare option would be offered in the exchanges, where people could pay into it with their subsidies.

It appears as if liberals lost out on a Medicaid expansion that would have opened the program up to everybody under 150 percent of the poverty line. That ceiling will likely remain at 133 percent, as is called for in the current bill.

In addition to the new insurance options, the group has tentatively agreed to new, and strengthened, insurance regulations, which the aide could not divulge at this time.

Ezra Klein of the the Washington Post has a preliminary analysis here. It’s too early to know exactly what this will mean — sausage-making takes time — and it could all be moot if Sen. Joe Lieberman, the drama queen who wants to feel “relevant” throws a snit, but if they can get around him, he won’t matter.

What will matter is what the Congressional Budget Office has to say, so stay tuned.