In a previous post, I offered my impressions on the Coburn-Burr-Ryan-Nunes health care reform bill, based on my reading of the bill summary prepared by their staff. The very next day, I had a friendly discussion with those staffers about the legislation. (They were most gracious; many thanks to them.) It turns out some of the things I wrote were inaccurate. So I’d like to make the following corrections.
Based on my reading of the bill summary and my discussions with staff, my previous post ought to have read that the Coburn et al. bill would:
- Mandate that Offer federal subsidies to states that create a new regulatory bureaucracy called a “State Health Insurance Exchange,”
- Mandate Require that all plans offered through those exchanges meet federal regulatory standards,
- Mandate Require “guaranteed issue” in those exchanges,
- Mandate Create “uniform and reliable measures by which to report quality and price information,”
- Impose price controls on those plans by prohibiting risk-rating,
- Launch a government takeover of the “insurance” part of health insurance, by means of a “risk-adjustment” program intended to cope with the problems created by price controls, and Require that states creating an exchange also create some mechanism for providing coverage to people with high-cost illnesses, including but not limited to risk-adjustment, risk pools, or reinsurance, and
- Fall just short of an individual mandate by setting up (mandating?) Require that states creating an exchange take steps to facilitate enrollment, which may include automatic enrollment in exchange plans at “places of employment, emergency rooms, the DMV, etc.” — essentially, trying to achieve universal coverage by nagging Americans their residents to death.
My description of the legislation as a “Mandate-Price-Control Bill”? Not accurate. My claim that the bill involves tax increases? Based on my erroneous impression that the bill would impose price controls on insurance premiums. The bill may lead to some tax increases (it proposes new categories of federal spending after all), but for the moment I take staff at their word that on net the bill would not increase taxes or government spending.