In his campaign speeches and recent talk to the AMA, Obama promised that all Americans would “be able to get the same kind of coverage that members of Congress give themselves.”
The proposed Kennedy bill, the Affordable Health Choices Act, however, specifically exempts members of Congress and other employees from being pushed into stingy plans with HMO-type controls (section 3116), notes Betsy McCaughey (Wall Street Journal 6/16/09).
Contrary to what many seem to believe, the Federal Employee Health Benefits Program (FEHBP) is not a public plan. Rather, it offers a wide range of private plans, paid for by the employer—the federal government. Those plans include low-cost, high-deductible plans coupled with health savings accounts.
Ordinary Americans would have to enroll in a “qualified” plan—or else be tracked down and fined (sections 3101 and 6055). We won’t know all the requirements until after the bill gets passed and the Secretary of HHS writes the rules. The language suggests that the plan will require a “medical home” (sections 3101 and 2707). That is likely to be this decade’s version of the HMO gatekeeper, writes McCaughey.
The “payment structure” will be based on “incentives” to “provide the best care, rather than more care.” In other words, an incentive to get paid more by doing less.
Both Obama and Kennedy promise that if you like your plan you can keep it. The question is, how big a fine will you have to pay? The bill sets no limit, but says it will be enough to “accomplish the goal of enhancing participation in qualifying coverage” (section 161).
Obama also promises people that they can keep their doctor. Assuming, of course, that he’s still available on the patient’s plan. Or still in practice at all, after automatic, across-the-board Medicare spending cuts are triggered by failure to meet cost-cutting targets, as proposed by Senator Baucus.
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