Back to Baucus: Marginally Less Awful

Reviews roll in for the Baucus version of health reform, released yesterday.

Michael F. Cannon of the Cato Institute divides the outline into good, bad and ugly. The good is that the plan takes a step toward regional or national sales of health insurance and calls for co-ops rather than an outright government corporation that sells insurance. The bad is composed of Medicaid expansion, cuts to Medicare Advantage, and an employer mandate. The ugly includes a “heavily punitive individual mandate” and new regulations that may — the language of the outline is unclear — require changes to what people already have in insurance. (So much for “if you like your insurance you can keep it.”)

Linda Halderman, MD, points to some perverse incentives in the measure:

Forcing individuals to buy coverage regardless of its cost would be made simpler, he claimed, by another provision of the plan: no insurance company could offer lower premiums to applicants with good health (Rating Rules in the Individual Market, page 4).

For example, a healthy woman who exercises regularly and doesn’t abuse drugs could not pay less for the same plan offered to a morbidly obese, sedentary man with liver disease from chronic alcohol use.

The editors of National Review call it “marginally less awful than the bills produced by the other committees.” “Perhaps the worst element of the Baucus package,” they say, “is the Medicare Commission,” which “would hasten the march down the price-control road that leads inevitably to government-enforced rationing of health care.”

The Wall Street Journal editorial board says: “The political irony here is rich. If liberal health-care reform is going to make people better off, why does it require ‘a very harsh, stiff penalty’ to make everyone buy it? That’s what Senator Obama called it in his Presidential campaign when he opposed the individual mandate supported by Hillary Clinton.”

The Heritage Foundation says, “While it drops explicit endorsement of a public option, the legislation creates a CO-OP which is literally an acronym for a new federal program — not the empowerment of existing co-ops — and it is in reality a thinly disguised public option.”

Cross-posted from State House Call.

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