The Mandatory Option

Whether you call it Obamacare, the “government option” or, as Nancy Pelosi would like, the “competitive option,” millions of Americans know it by the name used first to describe it: the Public Option.

And, despite being pulled from the legislation which came from Max Baucus’ committee bill due to obvious backlash from the American people, the “public option” is back in H.R. 3962. Two hundred and eleven pages into Pelosi’s 1,990-page monstrosity, you’ll find section 321, entitled: “Establishment and Administration of a Public Health Insurance Option as an Exchange-Qualified Health Benefits Plan.” We’ve heard this song before, but for these purposes, the initial legislative description goes a little something like this:

(a) Establishment — For years beginning with Y1, the Secretary of Health and Human Services (in this subtitle referred to as the `Secretary’) shall provide for the offering of an Exchange-participating health benefits plan (in this division referred to as the `public health insurance option’) that ensures choice, competition, and stability of affordable, high quality coverage throughout the United States in accordance with this subtitle. In designing the option, the Secretary’s primary responsibility is to create a low-cost plan without compromising quality or access to care.

Choice. Competition. Stability. Affordable. High-quality. Low-cost. Maintained quality and access. If we’ve learned anything by now, it’s that words from this administration and the Democrats who run Congress mean absolutely nothing.

Sure, the public option will provide choice and competition. For now. The problem, however, is that the government does not need to show a profit and can set the rules for the very marketplace in which it hopes to merely “compete.” According to testimony before the House Energy and Commerce Committee in June, non-partisan actuaries at The Lewin Group predict that the public option model would absolutely decimate the rolls of those with private insurance coverage. From that testimony (emphasis mine):

The bill would permit individuals and employers to purchase health insurance from a newly created “public plan” modeled on Medicare. The public plan would compete for enrollment with private insurers in a newly formed network of “exchanges” that present a selection of competing health plans to consumers. The public plan would be required to follow the same rules concerning pre-existing conditions and premium rating practices that apply to private plans.

We estimate that the public plan under the House bill would have premiums that are 20 percent to 25 percent less than for comparable private coverage. The bill specifies that the program would pay providers at Medicare levels, which are 20 percent to 30 percent less than what private plans pay for the same services. The bill would pay physicians at Medicare levels plus 5 percent if the provider agrees to serve both Medicare and public plan participants. Also, the public plan does not require an allowance for profits and there would be no broker/agent commissions.

We estimate that the bill would cover about 24.0 million of the 48.9 million people that we estimate will be uninsured in 2010. Medicaid enrollment would increase by 16.0 million people. If the plan is implemented without a public plan option, the number of people with private insurance coverage would increase by 8.0 million people. The public plan under the House bill would result in a substantial decline in the number of people with private insurance coverage, even in the early years of the program. In the first year of the program, individuals and firms with fewer than 10 workers are eligible to enroll in the public plan. We estimate that enrollment in the public plan would be 29,300 people in that year, with a reduction in private coverage of 20,600 people. In the second year, the bill extends eligibility to firms with fewer than 20 workers as well. Thus, in the second year, private insurance coverage would decline by 30.8 million people.

Beginning in the third year, the newly established “Health Choices Commissioner” would be permitted to extend eligibility to include all employers. If the plan is opened to individuals and all employers, the number of people in the public plan would rise to 122.9 million people. Private coverage would decline by about 113.5 million people.

So, let’s review: Doctors would be paid less. The uninsured still would not be covered. Medicaid rolls would increase. And health care reform legislation with a public option, such as H.R. 3962, would cause more than 114 million Americans to lose their private coverage, while the same legislation without a public option would increase those Americans who have private coverage by eight million.

So much for the promises from Barack Obama and the Democrats that those who like their coverage would be able to keep it. Heck, considering the individual mandates in the bill and the other authority grabbed by the federal government, so much for any of the words in that flubbed Oath of Office — you know, the one where the president swore to “faithfully execute the office of President of the United States,” and to the best of his ability “preserve, protect and defend the Constitution of the United States.” Thanks to section 321 and the rest of the 1,990-page Affordable Health Care for America Act, hundreds of millions of Americans will be robbed of their freedom to choose for themselves.



  1. Boston Blackie says:

    When Obamama and Congress sign up for this plan then and only then will I listen to what they have to say but until then….
    If you want a preview of Obamacare just look at the V.A. or ever worse, go visit a V.A. hospital, then tell me what you think. My husband is a Vietnam vet who says he wouldn't go there even if he was homeless. We are living this healthcare nightmare already here in mASSachusetts. If it's not for the fact that the state is broke thanks to mini Obamama here, the state would be broke from the mandatory universal healthcare.

  2. Anonymous says:

    I'm still trying to figure out why more people don't see the plurality of the government's use of anti-trust laws to keep insurance companies from competing over state lines and the "elephant in the room" Public Option that WILL be allowed to operate across state lines in direct competition. Not to mention that the Public Option will be subsidized by tax payer money.

  3. Anonymous says:

    Ever wonder what this whole debate would look like if one were to substitute "education" for "heal care?"

  4. Rix says:

    The bill gives the whole new meaning to the term "statutory rape". I would actually be surprized if we have half the currently practicing doctors still working five years into this abomination.

    What do you, as a responsible parent, do when your kid throws a tantrum? You take away the allowance. And if the kid steals the allowance money from your wallet, you put your belt to good use and start locking your money. That's how we should build our relationship with the government – and, I reckon, it is about time to use the belt.

  5. Rix says:

    Couldn't hold it: AR's series of articles regarding ObamaCare was complimented on The Right Side of Life, one of – IMHO – the most intelligent right-wing blogs I ever happened across. Hats off for Dr. Schreiber!

Speak Your Mind