Biden Lifts Health Care Plan From Insurance Lobbyists

[Soontir C'boath]

The incoming president’s plan mimics an insurance industry letter, instead of pushing a promised public option or Democratic legislation to expand Medicare.

This report was written by Andrew Perez and Julia Rock.

President-elect Joe Biden’s new COVID relief plan does not adopt existing Democratic legislation to expand government sponsored medical coverage nor does it propose a promised public health insurance option. Instead, it adopts proposals from health insurance lobbying groups’ recent letter to lawmakers demanding lucrative new subsidies for insurance companies, at a moment when those corporations have recorded record profits as millions lose coverage and many face claims denials.

Biden’s plan would shovel billions of dollars to private health insurers by providing subsidies for Americans to buy coverage through the Affordable Care Act (ACA) marketplaces, which are far more expensive than government health care programs and have at times been plagued by high rates of claim denials. The plan would also subsidize COBRA continuation coverage through September, allowing workers to keep their employer health insurance plans when they’re laid off.

Those initiatives — which could further boost insurers’ skyrocketing profits — were recently recommended in a letter to lawmakers from America’s Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association, two insurance lobby groups in Washington that have opposed the expansion of government-sponsored health care programs.

A few days after the letter was sent, AHIP said that “health insurance providers are eager to assist the Biden health team.”

Biden’s inaugural committee has received donations from at least two major health insurers, Anthem and Centene, which both offer plans on state marketplace exchanges. Centene’s CEO bundled donations for Biden’s presidential campaign, and Biden’s first major campaign fundraiser was headlined by Independence Blue Cross’s CEO.

During the 2020 primary campaign, Biden repeatedly demonized Medicare for All legislation offered by Rep. Pramila Jayapal and Sen. Bernie Sanders, questioning how the country would pay for it and proposing a public health insurance option people can buy into instead. Democrats previously considered creating a public option during ACA negotiations a decade ago — AHIP secretly bankrolled a successful $100 million advocacy campaign to kill it.

While Medicare for All could actually save the country up to $650 billion annually, according to the nonpartisan Congressional Budget Office, Biden is now proposing some of the most costly and inefficient ways to expand health insurance coverage. The moves could still leave people exposed to substantial out-of-pocket costs — from deductibles, copays, and coinsurance — that act as barriers to care.

Nightmare Deductibles And Widespread Claim Denials
Pushing people onto ACA plans and subsidizing COBRA coverage would be expensive — but not necessarily popular.

Health care coverage purchased through the ACA marketplace costs 83 percent more than Medicaid coverage, and ACA plans leave patients with ten times the amount of out-of-pocket costs, according to a recent study published in the Journal of the American Medical Association.

The researchers concluded that marketplace plans cost so much more than Medicaid because private insurers pay “higher prices for the same services.” Hospitals often bill people with employer health insurance plans, which are maintained under COBRA, more than twice as much as those with Medicare or Medicaid.

The Biden proposal does include a measure to slightly lower the percentage of Americans’ annual incomes that insurers can collect through premiums — from a maximum of 9.86 percent to 8.5 percent. Altogether, the Biden transition says its plan “would reduce premiums for more than ten million people and reduce the ranks of the uninsured by millions more.”

The ACA marketplace was a centerpiece of Democrats’ 2010 health care reform law, but only a small slice of Americans are actually buying insurance plans this way now — often people who are self-employed, independent contractors, or gig workers. The ACA exchanges are only currently “a miniscule part of the health insurance system,” the People’s Policy Project wrote last month.

While the marketplace was billed as allowing people to shop for health insurances, in reality the state exchanges offer few choices, and most are expensive. The average lowest-cost premium for bronze-level plans is $321 this year, though the numbers vary widely by state.

The premiums are pricy, but an even bigger issue is the nightmarish deductibles people with ACA plans are expected to pay before their insurance company actually starts footing their medical bills. The average bronze plan deductible on the individual market was nearly $5,900 in 2019.

Deductibles are lower on silver and gold-tier plans, but the average lowest-cost monthly premiums this year are $436 for silver plans and $482 for gold.

Poorer enrollees may qualify for subsidized premiums or cost-sharing reductions limiting their maximum out-of-pocket expenses — but those reduced out-of-pocket maximums are still substantial.

Making matters worse, health insurers deny nearly one in five claims for in-network care by patients with ACA plans, according to data from the Kaiser Family Foundation for 2017. For some insurers, about 40 percent of claims are rejected.

Moving the uninsured into these plans would be a massively expensive way to expand coverage — and if insurers are still allowed to impose huge out-of-pocket costs and deny claims with regularity, it may not help people much at all.

Backing Away From A Public Option
During the 2020 campaign, a health care industry front group called the Partnership for America’s Health Care Future (PAHCF), spent $4.5 million on advertisements attacking Medicare for All. The group launched a late wave of ads in South Carolina — where Biden’s strong performance helped propel him to victories around the country.

PAHCF’s tax return shows it is steered by executives from AHIP and lobbying groups for pharmaceutical companies and investor-owned hospitals. The industry group raised more than $55 million in 2019, and it has made clear that it would fight against a federal public option plan, just as AHIP did in 2009 and 2010. It also spent millions of dollars in 2020 to block a state level public option in Colorado.

Biden consistently campaigned in support of a public health insurance option, and after the primary, a joint task force made up of Biden and Sanders allies negotiated a fairly robust public option plan.

“The public option will provide at least one plan choice without deductibles, will be administered by the traditional Medicare program, not private companies, and will cover all primary care without any copayments and control costs for other treatments by negotiating prices with doctors and hospitals, just like Medicare does on behalf of older people,” the task force wrote.

The Democratic National Committee’s 2020 platform included a similar pledge: “Democrats will also make available on the marketplace a public option administered through the Centers for Medicare and Medicaid Services (CMS) which includes a platinum-level choice, with low fees and no deductibles. Low-income Americans will be automatically enrolled in the public option at zero cost to them, though they may choose to opt out at any time.”

Now, on the eve of his presidency, Biden is proposing a much more conservative health insurance expansion plan proposed by the health insurance industry. If enacted, the plan could head off any talk in Washington of a public option plan down the road.

There are many other options available. Democratic lawmakers could choose to rally around existing legislation to enact an emergency Medicare for All program, or they could press for a public option, as the party and its incoming president promised.

Biden could use his executive authority to expand Medicare during the pandemic, using emergency provisions in the Affordable Care Act. Democrats could also seek to expand Medicaid to cover more people.

Instead, Biden is pushing a health insurance expansion that would further enrich insurers and put people on insurance plans that will be too expensive for many of them to use. Democrats should reject this insurance industry cash grab.

[Vendetta]

What? The corporatist is prioritising the wealth of corporations over the health of people?

I am shocked. SHOCKED!

Well not that shocked.

[Gandalf]

People are about to get that Obama era lesson again; Being better than the Republican doesn't means that he's good.

[Batman]

Nobody claimed Biden is perfect. Far from it. He's probably not even all that good, It's just that the alternative has proven beyond a shadow of a doubt that he's infinitely worse.

[aerius]

Step 1: vote for lesser evil
Step 2: get ass-raped again with no lube
Step 3: repeat step 1

I'm not sure what it's gonna take to break the cycle.

[Batman]

A complete deconstruction of the US political system I suspect. As is I think the lesser evil is the best one can hope for.
And compared to Trump, Biden is one hell of a lot 'lesser'

[Soontir C'boath]

Damn, I can't put my finger on it, but I believe there was someone who ran two Presidential campaigns on tremendous grassroots support, raised a lot of money from people, had huge rallies, had tremendous support for his policies to the point that other candidates decided to copy him, and was not bought by corporations and Wall St.

Oh well, let's vote Biden!

[Gandalf]

Damn, I can't put my finger on it, but I believe there was someone who ran two Presidential campaigns on tremendous grassroots support, raised a lot of money from people, had huge rallies, had tremendous support for his policies to the point that other candidates decided to copy him, and was not bought by corporations and Wall St.

Sounds like radical commie talk to me.

As Pelosi exclaimed a while ago; "We're capitalists!"

[Zaune]

People are about to get that Obama era lesson again; Being better than the Republican doesn't means that he's good.

I don't think anybody with two brain cells to bang together was expecting much beyond "not as bad as the Republicans" from the man who lost out to Obama in the primaries for being too boring.

[bilateralrope]

Yeah, I'm not expecting much from Biden beyond small improvements. And this plan does sound like an improvement over the current healthcare situation in the US.

Question is, how long can democrats continue to patch up the ACA until it falls over and they need to copy the healthcare systems that work elsewhere ?

[Solauren]

Rolling out full scale Health care in the United States is a massive, massive undertaking, and might be a bit of a 'pill' for alot of people to swallow.

It still amazes me that there are people on minimum wage in the United States nearly violently opposed to the idea of free healthcare.

While it's unlikely, it's possible Biden is going with a multi-level introduction. That would give people time to accept the idea, and to get the infrastructure in place.

At least it's more then the Republicans have done towards it. Hell, Trump scrapped the Affordable Healthcare act, and didn't he cut medicade?

[Ace Pace]

Damn, I can't put my finger on it, but I believe there was someone who ran two Presidential campaigns on tremendous grassroots support, raised a lot of money from people, had huge rallies, had tremendous support for his policies to the point that other candidates decided to copy him, and was not bought by corporations and Wall St.

Oh well, let's vote Biden!

Yep, he was an amazing candidate except he ran two campaigns and didn't win.

[Soontir C'boath]

Damn, I can't put my finger on it, but I believe there was someone who ran two Presidential campaigns on tremendous grassroots support, raised a lot of money from people, had huge rallies, had tremendous support for his policies to the point that other candidates decided to copy him, and was not bought by corporations and Wall St.

Oh well, let's vote Biden!

Yep, he was an amazing candidate except he ran two campaigns and didn't win.

You know, the fact that you rather be snarky, rather than acknowledge the once in a lifetime chance we actually had to actually improve the state of American and world politics as whole, just shows you're just a piece of shit.

You want to be smug that the political atmosphere we live in is hot garbage and we shouldn't expect any better? Go right ahead and play in the pile of shit.

[Ace Pace]

Damn, I can't put my finger on it, but I believe there was someone who ran two Presidential campaigns on tremendous grassroots support, raised a lot of money from people, had huge rallies, had tremendous support for his policies to the point that other candidates decided to copy him, and was not bought by corporations and Wall St.

Oh well, let's vote Biden!

Yep, he was an amazing candidate except he ran two campaigns and didn't win.

You know, the fact that you rather be snarky, rather than acknowledge the once in a lifetime chance we actually had to actually improve the state of American and world politics as whole, just shows you're just a piece of shit.

You want to be smug that the political atmosphere we live in is hot garbage and we shouldn't expect any better? Go right ahead and play in the pile of shit.

You'll have this chance in 4 years and you had them 8 years ago. Good candidates exist, some of them are also electable.

I live in a country that has an endless list of impressive candidates with good backgrounds who just can't get elected and I'm basically sick of amazing people who just can't get stuff done in a democracy that has a specific structure. They can have nice policy papers, they be charismatic to specific audiences. But change in a FPTP system happens if you can convince a mass of people to vote for you.

And as much as I can agree with Bernies policies, it seems that he did not manage to convince the population of those policies.

[Soontir C'boath]

Yep, he was an amazing candidate except he ran two campaigns and didn't win.

You know, the fact that you rather be snarky, rather than acknowledge the once in a lifetime chance we actually had to actually improve the state of American and world politics as whole, just shows you're just a piece of shit.

You want to be smug that the political atmosphere we live in is hot garbage and we shouldn't expect any better? Go right ahead and play in the pile of shit.

You'll have this chance in 4 years and you had them 8 years ago. Good candidates exist, some of them are also electable.

I live in a country that has an endless list of impressive candidates with good backgrounds who just can't get elected and I'm basically sick of amazing people who just can't get stuff done in a democracy that has a specific structure. They can have nice policy papers, they be charismatic to specific audiences. But change in a FPTP system happens if you can convince a mass of people to vote for you.

I have two questions for you then.
1. Do you vote, donate, organize, and/or canvass for those impressive candidates?
2. If you don't do one of those, how will you ever, EVER, expect anyone else to vote for them then if even you won't?

I donated and voted for Bernie Sanders in the primaries, because at least it was betting on a chance to get something new and better and he was hardly someone who didn't have a chance in hell like Kamala Harris or Klobuchar. Of course, Biden winning the primary ends that, but it was at least an opportunity to try and grab hold. Your stance is one of cynicism and that you might as well vote for Biden, and I do not accept that.

And as much as I can agree with Bernies policies, it seems that he did not manage to convince the population of those policies.

You seem to like to state the obvious. Yes, Bernie clearly lost twice as I pretty much lamented in that post.

However, I am not going to prescribe his campaigns as a total loss either given the change in the political landscape among Democrats/leftist leaning Americans and the tools and down the ballot victories harnessed. So much has changed since 2015 here for the better.

[Soontir C'boath]

And as much as I can agree with Bernies policies, it seems that he did not manage to convince the population of those policies.

By the way, by your logic, Hillary didn't manage to convince the population back in 2016 either, so are you saying we should have actually voted for Trump this time around then instead of taking a chance and vote for Biden?

After all, he was the incumbent and therefore more likely to win in a FPTP.

But that's clearly foolish right? You would be nuts to not vote for Biden. So how would that be any different for Bernie? Just shift that mindset to the primary.

[Ace Pace]

You know, the fact that you rather be snarky, rather than acknowledge the once in a lifetime chance we actually had to actually improve the state of American and world politics as whole, just shows you're just a piece of shit.

You want to be smug that the political atmosphere we live in is hot garbage and we shouldn't expect any better? Go right ahead and play in the pile of shit.

You'll have this chance in 4 years and you had them 8 years ago. Good candidates exist, some of them are also electable.

I live in a country that has an endless list of impressive candidates with good backgrounds who just can't get elected and I'm basically sick of amazing people who just can't get stuff done in a democracy that has a specific structure. They can have nice policy papers, they be charismatic to specific audiences. But change in a FPTP system happens if you can convince a mass of people to vote for you.

I have two questions for you then.
1. Do you vote, donate, organize, and/or canvass for those impressive candidates?
2. If you don't do one of those, how will you ever, EVER, expect anyone else to vote for them then if even you won't?

I donated and voted for Bernie Sanders in the primaries, because at least it was betting on a chance to get something new and better and he was hardly someone who didn't have a chance in hell like Kamala Harris or Klobuchar. Of course, Biden winning the primary ends that, but it was at least an opportunity to try and grab hold. Your stance is one of cynicism and that you might as well vote for Biden, and I do not accept that.

And as much as I can agree with Bernies policies, it seems that he did not manage to convince the population of those policies.

You seem to like to state the obvious. Yes, Bernie clearly lost twice as I pretty much lamented in that post.

However, I am not going to prescribe his campaigns as a total loss either given the change in the political landscape among Democrats/leftist leaning Americans and the tools and down the ballot victories harnessed. So much has changed since 2015 here for the better.

Yes and yet I plainly understand my opinions are far from the mainstream and don't whine about everyone is stupid except those who support my views.

[Soontir C'boath]

Yes and yet I plainly understand my opinions are far from the mainstream and don't whine about everyone is stupid except those who support my views.

Isn't that what Democrats do all the time though? Whine about Republicans and how stupid they are voting against their interests and how my liberal views are better?

Given the back and forth we've had with each other, are you sure you're not projecting? After all, you have incessantly felt the need to explain things to me as if I hadn't the slightest clue and that includes your second post in this thread. Did really you think I don't understand FPTP systems? Did you really have to point out that Bernie lost?

Please, look at yourself in the mirror.

[His Divine Shadow]

People are about to get that Obama era lesson again; Being better than the Republican doesn't means that he's good.

I don't think anybody with two brain cells to bang together was expecting much beyond "not as bad as the Republicans" from the man who lost out to Obama in the primaries for being too boring.

Most of the journalists are giving me extreme vibes of "finally everything's back to to normal, the way it should be and forever will be". No ideas or reflection on why populism and trump got to power.

[Gandalf]

Most of the journalists are giving me extreme vibes of "finally everything's back to to normal, the way it should be and forever will be". No ideas or reflection on why populism and trump got to power.

That's why we'll see a strong Trump like candidate in 2020. What I'm not seeing on the news is a lot of acknowledgement of the fact that in order to prevent another Trump, they need to address the root causes of how he got there in the first place.

It's like the country was in a car crash, got out of the ER, but can't decide whether or not to go to a long and difficult PT course.

[His Divine Shadow]

I like to think of it like the country was driving drunk. But has no plans to stop drinking.

[Beowulf]

People are about to get that Obama era lesson again; Being better than the Republican doesn't means that he's good.

I don't think anybody with two brain cells to bang together was expecting much beyond "not as bad as the Republicans" from the man who lost out to Obama in the primaries for being too boring.

Most of the journalists are giving me extreme vibes of "finally everything's back to to normal, the way it should be and forever will be". No ideas or reflection on why populism and trump got to power.

Journalists are generally showing an extreme disinterest in why trust in the media is going down. This distrust of the media is also feeding into the populist problem.

[Solauren]

I like to think of it like the country was driving drunk. But has no plans to stop drinking.

How about 'drunk and under the influence of narcotics. They've tossed the narcotics, but have no plans to stop drinking'

[montypython]

I like to think of it like the country was driving drunk. But has no plans to stop drinking.

How about 'drunk and under the influence of narcotics. They've tossed the narcotics, but have no plans to stop drinking'

Like I always try to remind folks, "if one doesn't understand the nature of a problem, then one has no means of resolving it".

[LaCroix]

As expected.

Tb, my hopes for this ticket were that he would have to step down after a year or so and Harris might steer a bit further left than he would...
Yeah, I know...
But it is more plausible than Biden even leaning slightly to the left.