Something liberals and conservatives can agree on -- health reform bills won't help keep costs down for middle class families.

The more one learns about the health reform bills the more concern one should become concerned.

A review of the House health care bill finds a massive marriage penalty for middle and upper middle income families. The result? An incentive not to get married in order to obtain health insurance. One observer said this will destroy marriage in the middle class just as welfare did for the poor.

Then there are analyses by a University of Minnesota economist and others that the health bills will not drive costs down for middle income families.

While both bills guarantee access to health insurance regardless of pre-existing conditions, neither one will do much to improve the affordability of health coverage for moderate to middle-income Americans in the individual market, according to wonks and critics across the political spectrum.

In fact, some Americans eligible for proposed federal subsidies may fall into the category of "under-insured" because they would spend more than 10 percent of their income — a widely used affordability standard — for premiums and out-of-pocket costs.

So, despite all the historic efforts to clean up the individual health-insurance market, consumers could continue to be priced out of the market — and they could be penalized for not having insurance, potentially adding insult to injury.

"All that guaranteed issue is, by definition — and people forget this — is you are given a price for the insurance policy," said Stephen Parente, a University of Minnesota health economist who helped develop health policy for Republican Sen. John McCain's presidential campaign. "It doesn't change the fact that you might not be able to afford an insurance policy, at which point you are effectively denied."

Liberal analysts also worry about the question of affordability for moderate to middle-income people.

"Some people will be helped but there are going to be some people that fall just out of the benchmarks," said policy analyst Lynn Blewett, director of the State Health Access Data Assistance Center at the U of M.

Economists, policy analysts and congressional aides are still sorting through the details of the new 2,074-page Senate bill, but bills from the Senate Finance Committee and Health, Education, Labor and Pensions (HELP) Committee were similar in laying out how subsidies or credits would work. Both bills call for subsidies for folks earning up to 400 percent of Federal Poverty Guidelines, although they vary on percentages of cost-sharing.

"Today we're carefully considering the provisions outlined in the bill that was introduced last night [Wednesday]," said Jess McIntosh, a spokeswoman for Sen. Al Franken, D-Minn., who is a member of the HELP committee. "We're pleased that the merged bill has some marked improvements compared to the Senate Finance bill, including coverage for an additional 2 million people and lower premiums for families above 150 percent of the poverty level. Unfortunately, the bill has higher premiums than the Senate Finance bill for families between 133-150 percent of the poverty level."

Subsidies and caps
A Congressional Budget Office's analysis of subsidies [PDF] in the House's Affordable Health Care for America Act breaks down the share of premiums and out-of-pocket costs per income level. Higher-income individuals would pay no more than $5,000 in out-of-pocket costs (in addition to premiums) while families would pay no more than $10,000.

At the low end, a family of four with annual household income of $30,000 would on average spend no more than 4 percent of income on the insurance premium and out-of-pocket costs, and 97 percent of the premium would be subsidized. But once household income for a family of four reaches $54,000, the family's premium and cost-sharing would be 11 percent of income — exceeding the point where many analysts consider a moderate-income family to be under-insured. The total share climbs to as much as 18 percent for families of four making $78,000 to $90,100. (See chart below.)

In fact, what we have is a worsening of the health care crisis. For what purpose? One could say naivete or maybe a desire to create the circumstances where the government steps in and takes over the entire health care system. The push for socialism via the health care system is on.

Reid government run health care bill contains abortion fee option.

The minority leader in the US House John Boehner points out that Reid government run health care bill in the US Senate bill includes an "abortion premium" fee.

Just like the original 2,032-page, government-run health care plan from Speaker Nancy Pelosi’s (D-CA), Senate Majority Leader Harry Reid’s (D-NV) massive, 2,074-page bill would levy a new “abortion premium” fee on Americans in the government-run plan.

Beginning on line 7, p. 118, section 1303 under “Voluntary Choice of Coverage of Abortion Services” the Health and Human Services Secretary is given the authority to determine when abortion is allowed under the government-run health plan. Leader Reid’s plan also requires that at least one insurance plan offered in the Exchange covers abortions (line 13, p. 120).

What is even more alarming is that a monthly abortion premium will be charged of all enrollees in the government-run health plan. It’s right there beginning on line 11, page 122, section 1303, under “Actuarial Value of Optional Service Coverage.” The premium will be paid into a U.S. Treasury account – and these federal funds will be used to pay for the abortion services.

Section 1303(a)(2)(C) describes the process in which the Health Benefits Commissioner is to assess the monthly premiums that will be used to pay for elective abortions under the government-run health plan and for those who are given an affordability credit to purchase insurance coverage that includes abortion through the Exchange. The Commissioner must charge at a minimum $1 per enrollee per month.

Abortion back in Senate Health Care Bill.

Senate Majority Leader Harry Reid has brought back abortion into the health care debate by opening the door for its coverage in federal health care programs.

Senate Majority Leader Harry Reid (D-Nv.) has rejected the bipartisan Stupak-Pitts Amendment and has substituted completely unacceptable language that would result in coverage of abortion on demand in two big new federal government programs," said Douglas Johnson, legislative director for the National Right to Life Committee. "Reid seeks to cover elective abortions in two big new federal health programs, but tries to conceal that unpopular reality with layers of contrived definitions and hollow bookkeeping
requirements."

The bill grants the secretary of Health and Human Services the authority to determine whether federal money is being used to fund abortions under the public plans, but doesn't ban those plans from offering the coverage. Reid's bill also explicitly requires insurers to separate private premiums from any public subsidies used to pay for that coverage to assure taxpayer dollars aren't used to fund the procedure - which is prohibited by the Hyde Amendment.

One way to understand what's up is the reaction of pro-abortion supporters. They're fine with the Reid language.

California Rep. Lois Capps, who tried to hatch a compromise on the Energy and Commerce Committee, commended Reid's language, saying, “I am pleased that the Senate has adopted a reasonable, common ground approach on this difficult question. It appears that their approach closely mirrors my language which was originally included in the House bill."

So what does the Harvard Medical School Dean think of Obama and Pelosi's health care bill? Disaster.

Of course, all those right wing conservatives dislike what President Obama, Nancy Pelosi and Harry Reid are trying to do to our nation's health care system. What about somebody from the medical establishment? Say Harvard Medical School. Here's what the dean thinks.


Dr. Jeffrey Flier in a Wall Street Journal op/ed piece said the following about the Democrats’ healthcare “reform” legislation.


“...as [the] controversy heads toward a conclusion in Washington, it appears that the people who favor the legislation are engaged in collective denial. …In discussions with dozens of health-care leaders and economists, I find near unanimity of opinion that ... the final legislation ... will markedly accelerate national health-care spending rather than restrain it. Likewise, nearly all agree that the legislation would do little or nothing to improve quality… “Worse, [the] legislation would undermine any potential for real innovation … by overregulating the health-care system… There are important lessons to be learned from recent experience with reform in Massachusetts. Here, insurance mandates similar to those proposed in the federal legislation … increased total spending.”

The most effective advocates for limited government? Surprise. Obama and liberal Congress.

The effects of President Obama and the liberal Congress' push towards socialism is showing up in a significant shift in the public's attitude towards more government. The most recent evidence is a Gallup Poll showing that less than 50% of Americans don't think it's the responsibility of the federal government to guarantee healthcare coverage for all Americans nor is it the federal government's responsibility. 47% of Americans say it is. The significant fact is how much support has dropped for government involvement in health care.
More Americans now say it is not the federal government's responsibility to make sure all Americans have healthcare coverage (50%) than say it is (47%). This is a first since Gallup began tracking this question, and a significant shift from as recently as three years ago, when two-thirds said ensuring healthcare coverage was the government's responsibility.

What's significant is support for the federal government's involvement in health care has dropped 22 percentage points from a high of 69% in the fall of 2006 to now 47% in the fall of 2009. The shift has accelerated in the last year from 54% support to now 47%.

With polls, it's always hard to know what's driving people's attitudes and whether they will last. I wonder if Americans are having second thoughts about the move towards socialism, European style. If so that's a very hopeful sign because we lose lots with socialized medicine. Costs and taxes rise and the overall quality of health care under socialized health care declines.

The bottom line?

The wording of the healthcare bill the House passed last Saturday explicitly states that one of the bill's purposes is to provide "affordable, quality healthcare for all Americans."

The current poll results indicate that, with the renewed healthcare debate since Obama took office, Americans have become less convinced that it is an appropriate goal for the federal government to take on the responsibility of ensuring that all Americans have healthcare coverage. It is possible that the current debate has increased the average American's awareness as to the nuances of the various roles the government could play in the healthcare system, helping make the generic "make sure all Americans have healthcare coverage" sound less appealing. Plus, the current debate may have produced more skepticism among Americans that the government's role in healthcare could or should be this broad.