The idea is that the Office of Personnel Management would choose nonprofit plans that met national standards and offer them on every state exchange (unless states opted out). These plans would be private, but the OPM would act as an aggressive purchaser, ensuring that they met high standards and conducted themselves properly. It's a private option with a public filter, essentially. [. . .] But the fact remains that private plans are not public options, no matter how much extra scrutiny they're subjected to.
I agree. And for the delivery of non-mandated health insurance premium subsidies, it is an acceptable vehicle imo.
It is, of course, NOT reform. It is not sufficient to support an individual mandate, which should be stripped from the bill if this is the end result.
The last important question - the public option question has now been answered (the Obama Administration is tired of it, it wants it to go away) - is how this health insurance premium assistance bill will be funded. There is of course the fact that this will involve a transfer of money for individuals to the health insurance companies. This is inevitable when the goal is to get more people insured without adding a public option (the increase in Medicaid eligibility is the exception here.) So who should pay for that? Ezra writes:
The House and Senate need to figure out their revenue measures [. . .]
Indeed. I favor the well off paying for this. The House bill provides the most progressive funding mechanism, charging a surtax on incomes above $500,000 a year to fund the health insurance premium assistance act. The Senate bill has one provision that I can support - increasing the Medicare tax for incomes above $200,000 a year. but it also contains an unacceptable regressive tax - the excise tax.
The excise tax should be a deal breaker on the funding side. It is sold as "cost containment" when in fact it is "coverage containment." It will fall on people of all incomes who have been provided good health insurance benefits in lieu of higher pay. No progressive in good conscience should support it. I do not oppose an excise tax that applies to PERSONS who make at least 300,000 a year. I would strongly oppose an excise tax that will apply to all income groups. That is a regressive tax.
The endgame is upon us and reform efforts are over. There will be no reform in this bill. There is not a single reform worth an individual mandate that will survive in this bill.
Without meaningful reform, an individual mandate is too high a price to pay.
And even with meaningful reform, a progressive financing arrangement is essential to a good bill. The House bill's financing mechanisms are clearly what progressives should support.
Speaking for me only