"Only dull people are brilliant at breakfast" -Oscar Wilde |
"The liberal soul shall be made fat, and he that watereth, shall be watered also himself." -- Proverbs 11:25 |
The bill "reflects a revamping of the whole insurance system," said Charles N. Kahn III, president of the Federation of American Hospitals.
It would prohibit the denial of coverage based on preexisting conditions and would insist that any insurance policy that includes children must provide that coverage through age 26.
Most striking, the legislation would require that insurers report to the federal government how premiums are being spent -- clinical services, claims processing, etc. -- and give a rebate to beneficiaries if a percentage of the premium does not go to patient benefits. Insurers would be forced to clamp down on administrative costs or profits.
Over the long run, the industry would probably adapt to the new standards, but in the short term it "takes a harsher edge with insurers," said Dan Mendelson, president of Avalere Health, a research and consulting firm.
[snip]
Modeled after a Massachusetts reform implemented three years ago, the Kennedy approach would insist that everyone buy insurance, though subsidies would be given to people who could not afford it. The draft document suggests offering premium aid to people earning as much as 500 percent of the poverty level, or $110,000 for a family of four. That idea has Republicans outraged and fellow Democrats nervous about the cost.
Rep. Jim Cooper (D-Tenn.) said the draft by Kennedy aides and other ideas circulating among party leaders are unrealistically generous, while an employer mandate hurts workers and consumers.
"Congress just doesn't get it," he said.
Labels: health care