While there’s been a lot of concern in federal health reform about the public health insurance option, I am more concerned with the possible scaling back of affordability subsidies. Partially because of concern for the size of the number, and partially because some don’t want to have to raise the needed revenues, there is talk in the Senate and even in the White House about to make the bill cost less, from about $1 trillion over 10 years to about $700 million.
The cost of the bill is for the subsidies and assistance to low- and moderate-income families to afford health coverage. Do they do enough? Former LA Times Sacramento reporter Jordan Rau at Kaiser Health News reports on this issue with some real examples, no doubt informed by his experience reporting on the California attempt at health reform in 2007-8, as that was the core issue here: what is affordable?
However appealing it sounds, scaling the cost of the bill back is to make low- and moderate-income families pay more in premiums and/or out-of-pocket costs, or get less in terms of benefits. For many, it will still be an improvement over the current status quo, where people struggle to makes ends meet, or simply go uninsured and fully exposed to medical debt and bankruptcy. But as Ezra Klein at the Washington Post indicates, if the bill is scaled back too much, the reform collapses.
Affordability was the issue in *the* key issue in the California debate, it is *the* issue now.