Obama and Baucus Disagree Over Heathcare Mandate

Nov 12 2008 Published by under Featured News

The chairman of the Senate Finance Committee, Max Baucus unveiled his plan to overhaul the nation’s healthcare system. Much of his plan is in line with the goals that Obama laid out during his presidential campaign, but the Baucus plan imposes a mandate that everyone must be covered, which Obama opposes.

There are three parts to the plan, coverage for all Americans, insistence that greater coverage be coupled with higher quality, and long term less costly care along with designing a financing system that works for the taxpayers. The Baucus plan embraces the creation of a nationwide insurance pool, which he calls the Health Insurance Exchange. The senator’s plan agrees with Obama’s idea that people who already have healthcare coverage can keep it.

Here is how the plan describes the Exchange, “But for those who need affordable, guaranteed coverage, the Exchange would be a marketplace where Americans could easily compare and purchase the plans of their choice. Private insurers offering coverage through the Exchange would be precluded from discrimination based on pre-existing conditions. Premium subsidies would be available to qualifying families and small businesses. By making health care more affordable and universally available to all Americans, the Baucus plan would take a major step toward eliminating racial and ethnic health disparities.”

The Baucus plan is interesting because it isn’t government run healthcare. It uses the marketplace model, and competition to lower healthcare costs. The political problem with his plan is the mandate, “Once affordable, high-quality, and meaningful health insurance options are available to all Americans through their employers or through the Exchange, individuals would have a responsibility to have health coverage. This step is necessary for insurance market reforms to function properly and to end the cost shifting that occurs within the system. It is expected that the vast majority of American employers would continue to provide coverage as a competitive benefit to attract employees. Except for small firms, employers that choose otherwise must contribute to a fund that would help cover those who remain uninsured.”

Notice the exemption for small business, and for individuals who are uninsured Baucus would provide a health insurance card which would give these individuals access to basic preventive care such as physical exams, immunizations, and cancer screenings. The Baucus plan is a good plan, but Obama has been opposed to a healthcare mandate. It looks like he and his party could be headed for their first conflict.

As Baucus points out in his introductory letter, this isn’t a legislative proposal. This is his personal vision for healthcare. He and Obama are in agreement on most of this, but I think that Obama is going to take a more incremental approach. You won’t see a comprehensive healthcare proposal. Instead, he is going to tackle healthcare piece by piece starting with the CHIP program, and prescription drug costs. If congressional Democrats do come up with a bill that includes a mandate, it will be interesting to see what Obama does.

The Baucus Plan in PDF

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