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BaucusCare: FUBAR

Viewable here (PDF). Here's the part that I focused on:

Excise Tax. The consequence for not maintaining insurance would be an excise tax. If a taxpayer‘s MAGI [Adjusted Gross Income] is between 100-300 percent of FPL [Federal Poverty Level], the excise tax for failing to obtain coverage for an individual in a taxpayer unit (either as a taxpayer or an individual claimed as a dependent) is $750 per year. However, the maximum penalty for the taxpayer unit is $1,500. If a taxpayer‘s MAGI is above 300 percent of FPL the penalty for failing to obtain coverage for an individual in a taxpayer unit (either as a taxpayer or as an individual claimed as a dependent) is $950 year. However, the maximum penalty amount a family above 300 percent of FPL would pay is $3,800.

[More . . .

The excise tax would apply for any period for which the individual is not covered by a health insurance plan with the minimum required benefit but would be prorated for partial years of noncompliance. The excise tax would be assessed through the tax code and applied as an additional amount of Federal tax owed. No excise tax will be assessed for individuals not maintaining health insurance for a period less than or equal to three months in the tax year. However, assessed excise taxes for those not insured for more than three months include the entire duration the individual was uninsured during the tax year.

Exemptions from the excise tax will be made for individuals where the full premium of the lowest cost option available to them (net of subsidies and employer contribution, if any) exceeds ten percent of their AGI. Available policies are defined as an employer policy in the case of an individual who works for an employer who offers coverage and an individual policy in the case of an individual who does not have access to an employer sponsored plan. Exemptions from the excise tax will also be made for individuals below 100 percent of FPL, any health arrangement provided by established religious organizations comprised of individuals with sincerely held beliefs (e.g., such as those participating in Health Sharing Ministries), those experiencing hardship situations (as determined by the Secretary of Health and Human Services) and an individual who is an Indian as defined in Sec. 4 of the Indian Health Care Improvement Act. Additionally, in 2013, individuals at or below 133 percent of FPL will be exempt from the excise tax. When making these determinations, income from individuals not subject to the mandate should not be considered.

Here's the thing, why not instead of taxing people, just automatically enroll them in a public option insurance program? Say, Medicare? Hell, how about auto-enrollment into one of Conrad's cockamamie co-ops? Oh BTW, here is the co-op provision:

The Chairman‘s Mark authorizes $6 billion in funding the Consumer Operated and Oriented Plan (CO-OP) program to foster the creation of non-profit, member-run health insurance companies that serve individuals in one or more states. CO-OP grantees would compete in the reformed individual and small group insurance markets. Federal funds would be distributed as loans and grants. Loans would be provided to assist with start-up costs, and grants would be provided to meet state solvency requirements.

In order to be eligible for Federal funds under the CO-OP program, an organization must meet the following requirements.

1. It must be organized as a non-profit, member corporation under State law.

2. It must not be an existing organization that provides insurance as of July 16, 2009, and must not be an affiliate or successor of any such organization.

3. Its governing documents incorporate ethics and conflict of interest standards protecting against insurance industry involvement and interference.4. It must not be sponsored by a State, county, or local government, or any government instrumentality.

5. Substantially all of its activities must consist of the issuance of qualified health benefit plans in the individual and small group markets in each State in which it is licensed to issue such plans.

6. Governance of the organization must be subject to a majority vote of its members (i.e., beneficiaries).

7. As provided in regulations promulgated by the Secretary of Health and Human Services (HHS), it must be required to operate with a strong consumer focus, including timeliness, responsiveness, and accountability to members.

8. Any profits made would be required to be used to lower premiums, improve benefits, or for other programs intended to improve the quality of health care delivered to members.

[. . . ]

Six billion dollars to create, from scratch, co-ops FOR THE ENTIRE COUNTRY but no government entities can be involved. Yep, that will work. Sheesh. They are not even trying to fool us anymore.

Needless to say, BaucusCare is a bad joke.

Speaking for me only

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  • Display: Sort:
    Memories... (5.00 / 8) (#1)
    by Steve M on Wed Sep 16, 2009 at 10:05:51 AM EST
    The [Obama] advertisement also claims that that Hillary's plan would make people who fail to enroll "pay a penalty." Sen. Obama's own plan would fine parents who fail to enroll their children and he has said he will consider imposing penalties on people who don't enroll.

    Hillary would consider a range of ideas, including automatic enrollment, to ensure everyone is covered. Sen. Obama's plan, would, experts agree, leave 15 million people out.

    Ohhhh, those evil mandates! Good thing we kept THAT idea off the table.

    Auto enrollment (5.00 / 7) (#2)
    by Big Tent Democrat on Wed Sep 16, 2009 at 10:08:52 AM EST
    is MUCH easier to defend than an "excise tax."

    After all, social security and medicare are auto enrollment programs.

    Parent

    The big difference (5.00 / 3) (#7)
    by Steve M on Wed Sep 16, 2009 at 10:16:31 AM EST
    is that while you get forced to pay either way, in the automatic enrollment scenario you at least wind up with health coverage in return!

    Axelrod & Co. are still advising the President.  During the campaign, they advised him quite rightly that fines and penalties are dangerous political territory.  Unless they've forgotten their own advice, they need to shoot down this ugly proposal right now.  There's a perfectly acceptable solution at the point where good politics and good policy intersect.

    Parent

    True (5.00 / 2) (#9)
    by Big Tent Democrat on Wed Sep 16, 2009 at 10:17:57 AM EST
    but the thing to do is to make it look as much like Medicare as possible.

    Parent
    AND you get something for your money! (5.00 / 4) (#15)
    by inclusiveheart on Wed Sep 16, 2009 at 10:20:50 AM EST
    If you are auto-enrolled, you get access to care for your money.  If you are penalized after-the-fact, you get nothing but agro and resentment.

    The different between a "penalty" and a "benefit" is significant.

    Parent

    Well . . . (5.00 / 1) (#19)
    by nycstray on Wed Sep 16, 2009 at 10:25:57 AM EST
    there is a slight benefit to the penalty. . .

    It's more affordable than junk insurance!

    Parent

    Funny, I thought the same thing (5.00 / 4) (#24)
    by inclusiveheart on Wed Sep 16, 2009 at 10:40:13 AM EST
    actually.  Seems to me, a lot of people may well opt for the penalty.

    Parent
    like (none / 0) (#3)
    by Capt Howdy on Wed Sep 16, 2009 at 10:12:48 AM EST
    we didnt see that comin

    Parent
    No? ;) n/t (none / 0) (#16)
    by inclusiveheart on Wed Sep 16, 2009 at 10:21:14 AM EST
    A recipe for disaster (5.00 / 9) (#4)
    by eric on Wed Sep 16, 2009 at 10:13:12 AM EST
    taxing people for failing to purchase insurance.  It outrages me, and I am totally on-board with universal coverage.  Can you imagine the reaction of anyone with an aversion to government in general?  WOW, what a ridiculous idea.  It is like he is TRYING to become the most hated man in America.

    Aversion to government in general... (5.00 / 1) (#17)
    by kdog on Wed Sep 16, 2009 at 10:24:45 AM EST
    that would be me, and like I've said before an excise tax aka fine is so outrageous to me I've got half a mind to cancel my coverage over its inclusion in any plan.

    If anything auto-enrollment is far better...just add it to the vig and tell us what we owe...forget the fine nonsense.

     

    Parent

    Cancelling (5.00 / 3) (#21)
    by eric on Wed Sep 16, 2009 at 10:29:02 AM EST
    that would be my gut reaction, too.  But I have auto-enrollment at my work and quite frankly, I would be too lazy to even bother.

    Which, by the way, demonstrates another point.  What about all those slackers out there like me that procrastinate and don't sign up for things as they should?  Just another thing to fine us for?

    I already get fined for failing to renew my drivers license and failing to move my car from an expired meter and failing to pay my tax bill on time, now they are going to fine me for failing to buy something?

    Parent

    Normally... (5.00 / 1) (#23)
    by kdog on Wed Sep 16, 2009 at 10:36:17 AM EST
    I'd be too averse to the hassle off any paperwork to cancel mine either...but the fine proposal, as well as the recent paycut, might be the right cocktail for me to save 25 bones a week and roll the dice on staying healthy and see if such fines are even constitutional.  Might bring me out of under the radar duck and cover mode.

    The constitution gives government the right to tax, I'm not so sure it gives 'em the right to force a purchase from a private company whose goal is to rip you off.  Just tax us all...or better yet, disband the DEA, cut the CIA/DOD budget in half, and cancel the occupations... there might be enough left over for a tax cut.

    Parent

    Does New York State required mandatory (none / 0) (#27)
    by oculus on Wed Sep 16, 2009 at 10:53:24 AM EST
    minimum auto insurance to register a vehicle?

    Parent
    Auto insurance (5.00 / 1) (#33)
    by eric on Wed Sep 16, 2009 at 11:09:53 AM EST
    is completely different because it is only required if you are driving.  It makes sense for the government to put restrictions on things that are voluntary, like driving.  Driving, as they say, is a privilege that can be restricted.  Taxing me for being born here and walking around without insurance on my own body is repugnant to me.

    Parent
    It is completely different. But doesn't (5.00 / 1) (#34)
    by oculus on Wed Sep 16, 2009 at 11:14:46 AM EST
    seem to me mandated health insurance will fly unless there is a penalty similar to the vehicle registration penalty, which, of course, many people get around by getting mandatory min. insur. and promptly cancelling policy once registration obtained.  Haven't figured out what such a penalty could be re health insur. though.  No ER?  Kids can't enroll in public school w/o proof of insurance?  

    Parent
    Its (5.00 / 1) (#38)
    by eric on Wed Sep 16, 2009 at 11:30:10 AM EST
    a good question.  How will they fine you if you aren't in the system?  Track you with your income tax?  Do a national registration of everyone in the country?

    Parent
    National id with chip showing insurance? (none / 0) (#40)
    by oculus on Wed Sep 16, 2009 at 11:36:18 AM EST
    How much will they charge me (5.00 / 1) (#41)
    by Spamlet on Wed Sep 16, 2009 at 12:07:45 PM EST
    to implant the chip?

    Parent
    Gimme a chip-laden ID... (5.00 / 1) (#44)
    by kdog on Wed Sep 16, 2009 at 01:12:03 PM EST
    I take out my hammer, microwave it, whatever it takes:)

    Parent
    Yes... (none / 0) (#31)
    by kdog on Wed Sep 16, 2009 at 10:56:40 AM EST
    and I don't like that any better.

    You've made me wonder if getting around this (if it passes) will be as easy as getting around the auto insurance mandate....just sign a policy and never make the payments and the insurance company cancels it, but you have a card.  Rinse and repeat when it come time to register your car again....I know a lot of people tight on cash do this.

    Parent

    Is it really (none / 0) (#36)
    by Steve M on Wed Sep 16, 2009 at 11:23:33 AM EST
    that easy to buy auto insurance when you defaulted on last year's policy?  Where I come from, companies won't even cover you if you come to them without paid-up insurance.

    Parent
    They're not calling Geico... (none / 0) (#39)
    by kdog on Wed Sep 16, 2009 at 11:32:18 AM EST
    the fly-by-night joints, shady independent agents, the kind that sell bailbonds as well...and they have to make the first monthly payment to get the card.  The agent and the ins. co. they go through make out, one payment in none ever going out.

    Parent
    Seems like they are trying to prevent (5.00 / 2) (#5)
    by MO Blue on Wed Sep 16, 2009 at 10:14:26 AM EST
    the non-profit entities of Blue Cross/Blue Shield etc. from taking over the co-op business.

    2. It must not be an existing organization that provides insurance as of July 16, 2009, and must not be an affiliate or successor of any such organization.

    If co-ops are part of the exchange, wonder what creative mechanism the industry will use to get around that provision. I'd be willing to bet that they will find a way around it.

    Probably not important, because as BTD pointed out, due to start up costs, co-ops may never get off the ground.

    Your last sentence is the explanation (5.00 / 3) (#8)
    by Big Tent Democrat on Wed Sep 16, 2009 at 10:16:58 AM EST
    You can't start up nationwide co-ops with 6 billion dollars. This is absurd.

    Parent
    Perhaps they just want it to (5.00 / 1) (#11)
    by nycstray on Wed Sep 16, 2009 at 10:18:45 AM EST
    look that way. If the co-ops don't get funded and there is no public option in the Exchange . . .

    I suspect the big insurance companies already have a way around it. Some form of 'insurance washing' similar to green washing :)

    Parent

    Actually, they are trying to facilitate (5.00 / 1) (#22)
    by scribe on Wed Sep 16, 2009 at 10:31:13 AM EST
    BC/BS into being the co-ops.  Remember, the whole Co-op thing was the brainchild of Sen. Conrad, of N.Dak. OVer 90 percent of all health insurance dollars in N.D go to BC/BS, and they have a string on him like one would not like to believe.

    Moreover, you need to remember that this plan was drafted by former insurance company lobbyists (who joined Baucus' staff early this year) and shared around with a few of the Blue Dogs and K Street to make sure that the insurance industry was happy.  From what I've read by people who unmasked the .pdf info, it was drafted this spring and has been getting passed around since then.  BC/BS has had over a month and a half to set up the framework of such co-ops and surely already has them in existence.  As of July 17, 2009 or so.

    And, finally, as someone who has wrestled repeatedly with what is called in the law as "successor liability", I can tell you that that seeming obstacle is in reality a gateway you can drive a pair of trucks through with room to spare.  In the state where I do my practicing, in products liability cases we have something called "corporate successor liability" or "product line liability" which, in short, says that if a person buys someone else's line of machinery (say food choppers), if a plaintiff is hurt you can reach back and get the company which got all the money out, and not have to worry about the empty shell which owns the product line now.  The problem is that you have to first get an idea on how the corporate line went from A to Z, and then you have to get discovery to find out whether, in fact, Z really is a successor of A.  And then you have to deal with seriously arcane rules which have the effect of determining whether or not Z is a successor of A.  These deals, FWIW, are set up by lawyers who know very well how to avoid making Z a successor of A - if that's the desired result - and thus to get all the money into A and leave all the liability in the empty shell of Z.

    In short - this part of the bill, like most of the rest, is bullcrap.  It does nothing to protect people and everything to benefit insurance companies at peoples' expense.

    Parent

    I keep wondering how the hell (5.00 / 2) (#6)
    by Radiowalla on Wed Sep 16, 2009 at 10:15:21 AM EST
    this 'gang of six" got selected to be the death panel for HCR.   Who picked these weak-kneed marshmallows masquerading as Democrats?  Was it Harry Reid?    Imagine if we had some proper Dems on board, like Shumer, Rockefeller, Boxer, Brown, Feingold, etc.

    What a pathetic show.

    probably Baucus, right? (none / 0) (#13)
    by Capt Howdy on Wed Sep 16, 2009 at 10:19:20 AM EST
    thats what all those millions the health care industry have given him bought.


    Parent
    $856 billion (5.00 / 1) (#10)
    by lilburro on Wed Sep 16, 2009 at 10:18:04 AM EST
    glad we were all jumping up and down about how awesome it was Baucus' had a 900 billion plan.

    Heh (none / 0) (#12)
    by Big Tent Democrat on Wed Sep 16, 2009 at 10:19:00 AM EST
    Well, at least the battle lines are fully drawn (5.00 / 4) (#14)
    by steviez314 on Wed Sep 16, 2009 at 10:19:55 AM EST
    now.

    If might have been easy for some Blue Dogs in the House and Senate to oppose the House bill/public option, when the alternative was some out there amorphous Baucus plan/compromise/alternative/bipartisan thingie.

    Now the crap sandwich is on full display and the choice is clear and stark.

    So the only remaining question (5.00 / 3) (#18)
    by eric on Wed Sep 16, 2009 at 10:25:05 AM EST
    that I have is:  Will those fines be dischargeable in bankruptcy?

    Excise tax: isn't that for cognac, yachts, (5.00 / 2) (#20)
    by oculus on Wed Sep 16, 2009 at 10:27:54 AM EST
    and cigars?

    The junk insurance provision (5.00 / 2) (#29)
    by TeresaInSnow2 on Wed Sep 16, 2009 at 10:53:49 AM EST
    Exemptions from the excise tax will be made for individuals where the full premium of the lowest cost option available to them (net of subsidies and employer contribution, if any) exceeds ten percent of their AGI.

    LOL.  This is just nuts.

    If no employer insurance available, (5.00 / 3) (#35)
    by oculus on Wed Sep 16, 2009 at 11:16:47 AM EST
    prove you tried to get a reasonable health insurance policy and escape the penalty.  Should create an extensive government investigative system followed by full employment in administrative law.  

    Oh for gawd's sake (5.00 / 5) (#42)
    by MyLeftMind on Wed Sep 16, 2009 at 12:13:18 PM EST
    We could simply increase funding for our current single payer systems (Medicaid, Medicare, VA, Native American programs, native Hawaiian healthcare, etc), then offer any one of those programs to public employees at 70-80% of their current costs, and offer the same deal to businesses and individuals. The savings to public agencies and companies would be enormous. It would stimulate the economy and the extra funding in our current "socialized medicine" systems could be used to cover the poor.

    Instead we're building a huge, complicated system that we won't even be able to monitor, never mind assess or improve. Obama's claiming we won't cover illegal immigrants, while it's clear that we have to in order to effectively reduce costs. We'll be spending billions just setting this thing up even though we already have multiple single payer systems. Worse, we won't know for years that it's actually costing us much more than they said it would, and by then it's too late to use the simpler, more effective method of expanding what we already have.

    This stupid plan is going to sink us economically and politically.


    Yes, it is sensical. What is not, (none / 0) (#43)
    by KeysDan on Wed Sep 16, 2009 at 01:02:42 PM EST
    is its avoidance contortions. Medicare-for-all is off the table, since it "would disrupt the health care system", but  certainly the public health care option is a no-brainer from several perspectives.   Indeed, we already have that "sliver" wherein individuals of any and all ages  are eligible for Medicare, and have been, since 1973 (signed into law by President Nixon).  It is a disease-specific sliver (end-stage kidney disease, with primary causes of hypertension, glomerular nephritis and diabetes mellitus) but it demonstrates the administrative ease and treatment effectiveness of extending Medicare.

    Parent
    Blocking States (none / 0) (#25)
    by waldenpond on Wed Sep 16, 2009 at 10:46:43 AM EST
    From Co-ops but will that be interpreted to include States trying to implement single payer?  What a giveaway to the insurers.  I will be happy if this bill is killed.

    Do American Indians have socialized medicine? (none / 0) (#26)
    by Manuel on Wed Sep 16, 2009 at 10:48:18 AM EST
    They are exempt in this bill.  I read recently that health care is paid for by the government on the reservations.  Are there any details on reservation health plans?

    new plan: (none / 0) (#28)
    by lilburro on Wed Sep 16, 2009 at 10:53:37 AM EST
    expand government insurance to anyone with 1/100,000,000 of a drop of Native American blood in their bodies.  I am in (actually I would slide in safely with my 1/16th).

    Parent
    Sure, but is this health care you would want? (none / 0) (#32)
    by Manuel on Wed Sep 16, 2009 at 11:06:50 AM EST
    Be careful what you wish for.

    I just did an Internet search and this came up.

    About one-third more is spent per capita on health care for felons in federal prison, according to 2005 data from the health service.


    Parent
    Really? (none / 0) (#45)
    by Militarytracy on Wed Sep 16, 2009 at 05:59:11 PM EST
    Cuz I'm on the same whatever teenth that you are.  Is this really true?

    Parent
    Here (none / 0) (#30)
    by TeresaInSnow2 on Wed Sep 16, 2009 at 10:56:22 AM EST
    This site probably has what you want to know:

    Link

    Parent

    Thanks, it is confusing (none / 0) (#37)
    by Manuel on Wed Sep 16, 2009 at 11:25:40 AM EST
    It seems that the Indian Health Service is underfunded.  However, Native Americans are eligible for Medicare/Medicaid in which many fail to enroll.  If a Public Option became the law it seems that the U.S. would be obligated to pay the premiums by treaty.

    Is a low quality public option preferable to no public option at all?  Probably but a lot of pressure would have to be brought to bear to improve quality and lower costs.  Unfortunately, a lot of the MSM(TV) discussion of HCR don't address these issues.

    Parent

    Help me with the math (none / 0) (#46)
    by DFLer on Wed Sep 16, 2009 at 06:04:24 PM EST
    The FPL is $10,830 for one individual.

    What is 100% of that? $10,830? or 100 x $10,830?

    or what?

    100% (none / 0) (#47)
    by TeresaInSnow2 on Wed Sep 16, 2009 at 09:07:10 PM EST
    is $10,830

    Parent
    thanks (none / 0) (#50)
    by DFLer on Thu Sep 17, 2009 at 01:08:40 PM EST
    yikes!

    Parent
    NBC (none / 0) (#48)
    by TeresaInSnow2 on Wed Sep 16, 2009 at 09:12:01 PM EST
    tonight first covered Baucuscare, pointing out, that gee, he's standing there all by hisself.  No supporters!

    They then went immediately, without really any transition, into Jimmy Carter's statement, that of course if you disagree with Obama you're a racist.  They pointed out that only 43% of whites voted for Obama in 2008....WOW....then I looked it up on CNN.  Only 41% of whites voted for Kerry in 2004....I guess more whites are racist against whites than blacks.

    And if fewer whites voted for Obama per state, shoot, maybe it was the bitter knitters like me who held on to their guns and gawd and sat the presidential election out.

    I'm not saying that racism doesn't exist against Obama.  I'm only saying that the media is going to try and sell interference with Baucuscare as racism.  I pray to Gawd, it doesn't work.

    Here's a link (none / 0) (#49)
    by TeresaInSnow2 on Wed Sep 16, 2009 at 09:13:16 PM EST
    to the 2004 stat:

    Link

    Parent