Does health reform have you completely baffled? Same
here. So we asked Jennifer Tolbert, a principal policy analyst at
the nonpartisan Kaiser Family Foundation (and a mom), to break down
some of the key issues.
By Colleen Egan
Q. What's happening with health-reform legislation?
A. There are two bills out there right now: the House Tri-Committee bill (H.R. 3200), which has been passed out of three committees of jurisdiction in the House, [and] also a bill in the Senate that came out of the Senate Health, Education, Labor, and Pensions (HELP) committee. There's a second committee in the Senate, the U.S. Senate Committee on Finance, that is also working on a bill that's likely to look very different from the other two. The problem is that when you start talking about health reform and what it will mean and the implications, it may mean one thing under the provisions in the House bill and a little bit different under provisions in the Senate HELP Committee bill, and then [it's] likely to look much, much different when we finally see a bill out of Finance.
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Q. Tell us about the House bill.
[Ed. Note: This is the main bill in play right
now.]
A. What the House bill does is establish a floor of coverage, what is referred to as an essential-benefits package, that specifies what benefits have to be covered and sets limits on the amount of money that people have to pay out of their own pockets for health care, in the form of either deductibles or copayments. Any employer plans that don't meet those minimum standards today will have five years to come into compliance.
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Q. Will health reform affect people who have insurance through their employer?
A. People who have employer-based coverage are not likely to see much change after health reform.
Q. What about the public option?
A. The public option is part of this debate, but it's only one plan among many private plans that would be offered in this newly created health-insurance exchange. And this exchange, I like to think of it as a virtual marketplace—it's like Travelocity for health insurance. It's simply a place where people can go and compare plans on a number of different measures. [The exchange] will enable people to choose the plan that best meets their and their family's needs. This public option, if it does remain in the bill, will simply be one plan choice among many in this exchange. You will still have a choice of many different private plans.
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Q. What is the debate over the public plan?
A. The advocates of the public-plan option would say that one of the goals of having the option in place is to spur competition, to provide people with additional choice of plans—particularly in areas where there may not be, right now, much choice. The supporters of the public plan would say the goal is not necessarily to drive out private coverage, but simply to spur competition among plans. Critics ... say that it's a kind of a step toward erosion of private coverage entirely, to the extent that the public plan can offer lower premiums than the private plans, which simply can't compete, and eventually everyone will choose that public-plan option because it's cheaper.
Continue reading about health care reform...
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