As the Republican-led House attempts to stir up enthusiasm against the health care bill passed last year, one of the things they are counting on is a widespread feeling that the bill has not improved anything yet. They are hoping that voters will not miss what they never had.
Too late. The health care bill has already made significant differences for Americans, directly or indirectly. Here is a reminder of what we have gained already.
- Medicare will expand to small, rural hospitals with few Medicare patients.
- “Uninsurable” people with preexisting conditions are eligible for insurance via high-risk pools that will last until exchanges take over in 2014.
- Insurers can no longer deny kids coverage.
- Your kids can stay on your insurance policy through age 26.
- Insurers can’t drop you if you get sick.
- No more lifetime limits on benefits.
- New insurance plans must offer free preventive care with no copays.
- Medicare patients receive free preventive care.
- The Medicare donut hole for prescription drug coverage has begun closing.
- Small businesses (fewer than 50 employees) tax credits for up to 50% of the cost of health insurance for employees.
- Help for companies that provide early retiree health benefits for age 55-64.
- “Double dipping” provisions for businesses that paid Medicare costs for employees have been eliminated.
- New plans must offer an appeals process for both coverage determination and claims.
- Insurance companies must reveal how much they are spending on care vs. overhead.
- Health insurers are limited to 15% overhead and must rebate any excess premiums.
- Health savings accounts and tax credits will be streamlined.
The Republicans would be foolish to claim that they want to restructure health care to reduce the deficit. First, there is the actual deficit reduction of $70 billion over the course of the rollout. But more than that, talking deficits goes down a road they don’t want to travel. When the health care bill was being debated, the Congressional Budget Office estimated that adding these provisions would save the following amounts:
- Medicare drug price negotiation ($300 billion)
- Public Option ($25-$110 billion)
- Drug reimportation ($19 billion)
- Shorter pathway to generic biologics ($71 billion)
Also, $350 billion a year could be saved on paperwork alone if the U.S. went to a single-payer system (is that the “job-destroying” part, Mr. Boehner? Fewer paper pushers?). Cost reform (for hospitals and drug companies) is worth hundreds of billions of dollars more.
Just bringing up health care again invites reopening this discussion, and I would love to see progressives get another chance at a national stage to educate people about the true costs and benefits of health care.
But here is what is really going on. This year, tax rates for the highest earners went up as a result of health care legislation. The capital gains tax rate changed from 15 to 20 percent, and the income tax top tier changed from 35 to 39.6 percent. More increases are scheduled to support larger provisions of the bill, and this, of course, is what Republicans have really shown up to take a stand against.
For Republicans, this is the same fight as keeping the Bush tax cuts: more money for the wealthy at the expense of the 98%ers—the rest of us.