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house Bill H.R. 265

Is There a Need for a Public Health Insurance Option?

Argument in favor

A public option would help control the cost of health insurance premiums while offering consumers an affordable, high-quality alternative to private insurance. Plus it could shave about $15 billion per year off the federal deficit, which isn’t too shabby.

Mindful's Opinion
···
07/28/2016
My right to health like..."...life, liberty..." Should be protected/enforced with health insurance guaranteed as a public choice and not determined by For Profit entities which have only their own profit as the principal focus. Which they can only achieve by our not using the insurance. This make sense to you?
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07/28/2016
People who sit on their pedestals and bemoan "failed" "havoc causing" ACA are people who never would have supported any kind of low cost healthcare to begin with. ACA has insured millions of people. WE ARE A DEVELOPED, RICH COUNTRY, and BEING IN GOOD HEALTH SHOULD NOT BE A LUXURY. Public Option takes ACA to where it should have already gone to begin with. I am saddened by those who would prefer we live in a society where working class people ignore health concerns out of inability to pay. This is how people die.
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Adam's Opinion
···
07/28/2016
Yes, we absolutely need a public option. It really is the only way to add competition to the private health organizations. If you seriously believe that exclusive niche businesses like health care are competing to lower prices your believing that two pyrotechnics are competing to make the smallest fire. A public option is the only way to really stimulate competition in available health care. Of course if you have a private practice that you prefer then you can keep that, but for the many that can't afford that level of healthcare need a viable option to be treated and not go bankrupt for choosing to be healthy.
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Argument opposed

A public option would reduce competition by using HHS’ power to set payment rates for Medicare and Medicaid plans to undercut private insurers, leaving consumers with fewer choices and giving the federal government more control of healthcare.

operaman's Opinion
···
07/28/2016
After ObamaCare and it's failed promises we are now being promised a New ObamaCare with better bells and whistles. I believe we've heard of better health care, lower cost and expanded coverage. Therefore I say "how did it work out for you." More empty words on another future failure. HHS wants healthcare to work because Socialism always works. Well, just slapping another coat of paint on ObamaCare won't coverup dry rot or stop the stinking fish head who wants to control America by his visions of grandeur to ensure his legacy of HOPE.
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Andy's Opinion
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07/28/2016
Before Obamacare healthcare costs were quite stable, now costs are through the roof with no sign of slowing down. Adding more government to fix a government disaster is like treating cancer with more cancer.
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SherryTX's Opinion
···
07/28/2016
Absolutely not! Obamacare and Medicare before it is reason enough for the govt to stay out of the health insurance business. Obamacare and all its mandates of coverage that people don't need has driven the cost of healthcare through the roof. More importantly, Obama-don't-care is NOT about healthcare, but about the insurance. Please explain to me how someone that requires a subsidy to purchase this abomination can afford the $10k deductible? Medicaid reimbursements are less than what is cost to deliver the service. Instead of spending all this money on insurance that doesn't allow one to afford being sick, they need to focus on making insurance affordable. They way to do that is to allow insurance sales across state lines and allow people to purchase the insurance they NEED. All the govt has achieved is raising the cost of insurance, reducing Medicare reimbursements to the point that one cannot even find doctors that accept Medicare anymore, and burdening people with out of pocket expenses they can't afford. I was a medical practice administrator for 30 years. I left because of Obama-don't-care. There is now more focus on the paperwork and making sure all the boxes are checked on the mandatory electronic medical record than on the patient. The entire ACA is an atrocity. The answer to the uninsured and under insured are out there. Clinics manned with providers that want/need loans to be forgiven are cheaper and more effective than the ACA. A sliding scale fee based on one's ability to pay allows for people to receive care and makes sure they have skin in the game. Anything given free will be abused. Lastly, the ACA was set up to fail to force a one payer system. Ask England how that is working for them. My dear friend died at home from the flu because there was no more money in the budget for the flu. When the transplant budget is depleted they do no more transplants. There is NOTHING in the Constitution that says anything about healthcare. Bottom line WE THE PEOPLE are responsible for ourselves. We need to make the hard choices and those that are ABLE need to get off their butts and work. There are plenty of things that can be done so we have workfare not welfare.
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What is House Bill H.R. 265?

This bill would require the Dept. of Health and Human Services (HHS) to offer a public health insurance option that would be available nationwide to consumers through health insurance exchanges. The public health insurance plan would seek to provide another choice for consumers, in addition to offering competitive, stable, and high-quality healthcare coverage. HHS’ responsibility under the bill would be to create a low-cost plan that doesn’t compromise on quality or access to care.

This legislation would also require the public health insurance option to conform to certain characteristics, including that it:

  • Would only be available through health insurance exchanges;

  • Must comply with requirements that apply to other health insurance plans, such as those related to benefits, benefit levels, provider networks, notices, consumer protections, and cost sharing;

  • Must offer bronze, silver, and gold plans.

HHS would have to collect data needed to set premiums and payment rates for the public health insurance option and adjust premiums for regional differences to cover administrative costs. It also would have the ability to use innovative methods to determine how payments for items and services are paid out by the public health insurance option.

In its first three years of operation, HHS would also be required to set payment rates for the public option while also providing for greater payments during that time period.

All startup costs for the public health insurance option would be required to be repaid over a 10-year period.

Impact

People purchasing health insurance plans; entities offering health insurance plans; and HHS.

Cost of House Bill H.R. 265

A CBO cost estimate is unavailable.

More Information

In-Depth: Sponsoring Rep. Jan Schakowsky (D-IL) has been introducing legislation to establish a public health insurance option since 2009 when the debate surrounding the Affordable Care Act (ACA) was in full swing. She was unsuccessful at getting language mandating the creation of a public option into the ACA, but she believes giving consumers that choice now would improve on the law by making the health insurance market more competitive:

“It’s time to pursue legislation that builds upon Obamacare. The Public Option Deficit Reduction Act is just that type of legislation. It would save consumers even more money, offering premiums that are 5 to 7 percent lower than private insurance plans and decreasing our deficit by $158 billion over 10 years. The public option means more transparent, lower-cost health care for Americans.”

Not everyone is so optimistic about the impact a public option would have on America’s health insurance market. Some believe that it would eventually lead to a federally-run, single-payer healthcare system (including Rep. Schakowsky herself on multiple occasions). Opponents of a public option and single-payer system like the Heritage Foundation’s Robert Moffit believe that would be problematic:

“While private plans must negotiate market rates with doctors and hospitals, a Medicare-like “public option would fix payment rates by fiat, well below the rates that would otherwise prevail in a real market… Backed by the full power of the government, and fixing payment rates below normal market levels, the “public option” would crowd out private coverage, resulting in greater concentration in the market, less  choice for patients, and less competition among plans, until only the government health plan would remain.”

This legislation has 35 cosponsors, all of whom are Democrats, and it should be noted that the Democratic Party’s official 2016 platform supports the creation of a public health insurance option.


Media:

Summary by Eric Revell
(Photo Credit: Flickr user Andrew Aliferis)

AKA

Public Option Deficit Reduction Act

Official Title

To amend the Patient Protection and Affordable Care Act to establish a public health insurance option.

bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
  • The house has not voted
      house Committees
      Committee on Energy and Commerce
      Health
    IntroducedJanuary 9th, 2015
    My right to health like..."...life, liberty..." Should be protected/enforced with health insurance guaranteed as a public choice and not determined by For Profit entities which have only their own profit as the principal focus. Which they can only achieve by our not using the insurance. This make sense to you?
    Like (25)
    Follow
    Share
    After ObamaCare and it's failed promises we are now being promised a New ObamaCare with better bells and whistles. I believe we've heard of better health care, lower cost and expanded coverage. Therefore I say "how did it work out for you." More empty words on another future failure. HHS wants healthcare to work because Socialism always works. Well, just slapping another coat of paint on ObamaCare won't coverup dry rot or stop the stinking fish head who wants to control America by his visions of grandeur to ensure his legacy of HOPE.
    Like (46)
    Follow
    Share
    Healthcare is a basic human right. We, as citizens, should not be dependent upon For-Profit organizations.
    Like (61)
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    Before Obamacare healthcare costs were quite stable, now costs are through the roof with no sign of slowing down. Adding more government to fix a government disaster is like treating cancer with more cancer.
    Like (37)
    Follow
    Share
    Absolutely not! Obamacare and Medicare before it is reason enough for the govt to stay out of the health insurance business. Obamacare and all its mandates of coverage that people don't need has driven the cost of healthcare through the roof. More importantly, Obama-don't-care is NOT about healthcare, but about the insurance. Please explain to me how someone that requires a subsidy to purchase this abomination can afford the $10k deductible? Medicaid reimbursements are less than what is cost to deliver the service. Instead of spending all this money on insurance that doesn't allow one to afford being sick, they need to focus on making insurance affordable. They way to do that is to allow insurance sales across state lines and allow people to purchase the insurance they NEED. All the govt has achieved is raising the cost of insurance, reducing Medicare reimbursements to the point that one cannot even find doctors that accept Medicare anymore, and burdening people with out of pocket expenses they can't afford. I was a medical practice administrator for 30 years. I left because of Obama-don't-care. There is now more focus on the paperwork and making sure all the boxes are checked on the mandatory electronic medical record than on the patient. The entire ACA is an atrocity. The answer to the uninsured and under insured are out there. Clinics manned with providers that want/need loans to be forgiven are cheaper and more effective than the ACA. A sliding scale fee based on one's ability to pay allows for people to receive care and makes sure they have skin in the game. Anything given free will be abused. Lastly, the ACA was set up to fail to force a one payer system. Ask England how that is working for them. My dear friend died at home from the flu because there was no more money in the budget for the flu. When the transplant budget is depleted they do no more transplants. There is NOTHING in the Constitution that says anything about healthcare. Bottom line WE THE PEOPLE are responsible for ourselves. We need to make the hard choices and those that are ABLE need to get off their butts and work. There are plenty of things that can be done so we have workfare not welfare.
    Like (27)
    Follow
    Share
    I agree with what Countable member SherryTX said: "Absolutely not! Obamacare and Medicare before it is reason enough for the govt to stay out of the health insurance business. Obamacare and all its mandates of coverage that people don't need has driven the cost of healthcare through the roof. More importantly, Obama-don't-care is NOT about healthcare, but about the insurance. Please explain to me how someone that requires a subsidy to purchase this abomination can afford the $10k deductible? Medicaid reimbursements are less than what is cost to deliver the service. Instead of spending all this money on insurance that doesn't allow one to afford being sick, they need to focus on making insurance affordable. They way to do that is to allow insurance sales across state lines and allow people to purchase the insurance they NEED. All the govt has achieved is raising the cost of insurance, reducing Medicare reimbursements to the point that one cannot even find doctors that accept Medicare anymore, and burdening people with out of pocket expenses they can't afford. I was a medical practice administrator for 30 years. I left because of Obama-don't-care. There is now more focus on the paperwork and making sure all the boxes are checked on the mandatory electronic medical record than on the patient. The entire ACA is an atrocity. The answer to the uninsured and under insured are out there. Clinics manned with providers that want/need loans to be forgiven are cheaper and more effective than the ACA. A sliding scale fee based on one's ability to pay allows for people to receive care and makes sure they have skin in the game. Anything given free will be abused. Lastly, the ACA was set up to fail to force a one payer system. Ask England how that is working for them. My dear friend died at home from the flu because there was no more money in the budget for the flu. When the transplant budget is depleted they do no more transplants. There is NOTHING in the Constitution that says anything about healthcare. Bottom line WE THE PEOPLE are responsible for ourselves. We need to make the hard choices and those that are ABLE need to get off their butts and work. There are plenty of things that can be done so we have workfare not welfare."
    Like (23)
    Follow
    Share
    People who sit on their pedestals and bemoan "failed" "havoc causing" ACA are people who never would have supported any kind of low cost healthcare to begin with. ACA has insured millions of people. WE ARE A DEVELOPED, RICH COUNTRY, and BEING IN GOOD HEALTH SHOULD NOT BE A LUXURY. Public Option takes ACA to where it should have already gone to begin with. I am saddened by those who would prefer we live in a society where working class people ignore health concerns out of inability to pay. This is how people die.
    Like (19)
    Follow
    Share
    Yes, we absolutely need a public option. It really is the only way to add competition to the private health organizations. If you seriously believe that exclusive niche businesses like health care are competing to lower prices your believing that two pyrotechnics are competing to make the smallest fire. A public option is the only way to really stimulate competition in available health care. Of course if you have a private practice that you prefer then you can keep that, but for the many that can't afford that level of healthcare need a viable option to be treated and not go bankrupt for choosing to be healthy.
    Like (17)
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    Healthcare is a basic human right, rich or poor, working or unemployed. People seem to forget that not all that are unemployed are lazy, and not everyone can afford to have private health coverage and in a split second your life could change and you could be in that position. Private companies have abused the system and taken advantage so it is time for the government (the people) to step in. THE CYCLE IS THIS: because some people do not pay, hospitals raise the cost of services. Because hospitals raise the cost of services, insurance prices go up. Because insurance prices go up, people cannot afford insurance. Because people cannot afford insurance, they either ignore health issues, or don't pay for services. This will make a significant dent in this issue and help people stay healthy.
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    Obama care made my private insurance expensive enough, no thank you
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    Public options undercut private competition. This inevitably leads to very expensive private options which only the rich can afford. Everyone else will be forced to have health insurance through the public option. This will inevitably lead to total control of the health industry by the government. Health care is an important industry and it needs to stay privatized in order to continue to develop and stay affordable.
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    The public option is needed to allow for affordable health care for everyone. Private insurance can only do so much. The larger pool will drive down the price so that everyone will
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    Inside friends of politicians will never have the same desire to cut costs as business owners with their necks on the line.
    Like (9)
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    The government needs to not try add more bureaucracy to what is already a struggling healthcare system.
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    We do need it, absolutely, but I hope we get alongside a fixed progressive system, where everyone pays their fair share. Not just increased taxes solely on the poor and middle class. That would greatly negate the good the plan intends to produce.
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    Make healthcare a true free market where people can shop around for the best care at a price they can afford. Stop subsidies of all health insurance providers, open the competition to cross state providers, list all cost of all procedures, and make not only healthcare providers, but insurance providers show transparency of cost. Let the people decide what they can afford and allow the costs to come down to a real affordable level.
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    If anything we need universal single payer healthcare
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    Yes! Medicare for all.
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    My employer provided free health insurance for his employees before obamacare changed the rules, now my employer, who cares very deeply for those who work for him can no longer afford to provide insurance, the government can not be trusted with this task, you can keep your doctor, and assorted other lies along with the price increases that came with the obamacare fiasco should be ample evidence that the government doesn't have our interest at heart.
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    As someone who works in healthcare, believe me when I say health insurers are not raking in the wealth like their detractors would have you believe. It is a very difficult business. The government would absolutely fail at it. The program would be a money pit. It would be the most expensive plan in the country - not to its users, but to all the rest of the taxpayers who are funding it without partaking. What's more, it would bankrupt almost every hospital in the country. How do I know? Medicare. Medicare pays doctors and hospitals and clinics and centers about 70-80% of the actual cost of care in most cases. Providers lose money on just about everything they do for every Medicare patient. The only reason health care provider organizations stay afloat at all is that commercial insurers pay providers a lot better and the private organizations literally subsidize the government. If those commercially-insured patients were replaced by more government-insured patients, hospitals would collapse. They're not raking in the wealth either. Their margins are usually razor thin. This is a terrible idea. Government needs to get out of health care. They have "helped" enough already, and if they "help" any more we may all suffer greatly.
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