Key week for health insurance bill

Burton Speakman

Nov. 3, 2009 (McClatchy-Tribune Regional News delivered by Newstex) -- GLASGOW -- This week the U.S. House of Representatives will consider a health care bill that could enact significant changes.

Glasgow's local representative Brett Guthrie, R-Bowling Green, has stated that in its current incarnation he will not support the health care bill that is being presented this week.

The 10-year, $1.2 trillion bill would extend coverage to tens of millions of uninsured Americans with a new requirement that almost everyone get insured, and give subsidies to help lower-income people afford plans. Businesses would be required to cover their employees, and insurance companies would no longer be able to turn people away because of their health status.

The biggest issue for the bill is that it contains a public option for health care insurance, Guthrie said. The public option is something that the Republican members of Congress are simply not willing to consider.

"I truly believe if we have a public option then within 10 years or maybe less we'll have a single-payer system," he said.

In addition, 85 percent of the public has health insurance, Guthrie said. If this bill passes, it would cause increases in the rates of everyone who already has health insurance.

Another problem is the way it has been proposed to pay for the bill, he said.

"They've said they plan to take half a trillion dollars from Medicare, although they are planning on spreading it out over 10 years," Guthrie said.

The claim is that this money can be removed without hurting benefits, he said. If that's true then the money should be used to help those with Medicare.

There is a need to change the insurance system, but there are better methods to use, Guthrie said.

He suggests allowing companies pool together to allow them to negotiate better insurance rates, something that is currently illegal, he said.

The bill as written also pushes a "big unfunded mandate onto states" by increasing the state payments for Medicaid, Guthrie said.

Although the changes are spread out, the decision occurs at a time when state budgets are stretched thin and schools, universities and services are currently fighting for funds, he said.

"An auto dealership with 10 employees may not be able to afford insurance, but I think we should allow them to work with 100 dealerships with 10 employees," Guthrie said.

The larger numbers would allow the companies to negotiate better rates, he said.

There are some good aspects of the bill. It does close the Medicare donut hole, Guthrie said. The donut hole is the difference in Medicare Part D, between the initial coverage limit and catastrophic coverage threshold.

Democratic leaders unveiled the bill with fanfare last week, a 1,990-page plan that sought to satisfy the concerns of both liberals and moderates while combining separate health bills passed by three different committees over the summer.

"Anything that long and complex is going to have unintended consequences," Guthrie said.

House leaders have made progress winning over liberals to back a new government insurance plan in the bill that's weaker than what liberals preferred. But they haven't quite closed the deal with enough members of their caucus. An initial vote tally showed them falling short of the 218-vote majority they need, according to Democratic aides.

The bill is funded largely from a 5.4 percent tax on individuals making more than $500,000 a year and couples making more than $1 million, starting in 2011. The tax increase would hit only 0.3 percent of tax filers, raising $460.5 billion over the next 10 years, according to congressional estimates.

But unlike other income tax rates, the new tax would not be indexed for inflation. As incomes rise over time because of inflation, more families -- and more small business owners -- would be hit by the tax.

Under the bill, individuals are required to obtain health insurance coverage or pay penalties, which are described as taxes in the legislation. The penalty would be equal to the cost of an average insurance plan or a 2.5 percent tax on incomes above the standard threshold for filing a tax return, whichever is less. There would be waivers for financial hardships.

To help afford insurance, families with incomes up to four times the federal poverty level would qualify for subsidies. The poverty level for a family of four is $22,050 this year.

The polls from just a few months ago showed the public was against it, he said. The key could have been in the way the questions were asked.

"I'd like to see the wording of the question," Guthrie said.

Democratic leaders have yet to nail down the votes they'll need to pass their sweeping bill. They're aiming for floor action to begin as early as Friday and finish before Veterans Day, Nov. 11.

"The public wants incremental change," he said.

The change to the insurance system being proposed would be a fundamental shift, Guthrie said. This is something that has been talked about for several months. It impacts everyone. People who want to make their voices heard need to contact thier representatives this week.

Associated Press reports contributed to this article.

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