The federal reform push starts…

Senator Max Baucus of Montana, Chair of the Senate Finance Committee, is slated to release a concept paper around health reform today

Laura Meckler at The Wall Street Journal, Jonathan Cohn at The New Republic, and Robert Pear of the New York Times have some of the outline. We should see more of the details tomorrow.

If the articles (and our sources of information) are right, we start from a vastly improved place from the Clinton era. The then-Chair of the Senate Finance Committee, Daniel Patrick Moynihan, wass openly dismissive of the need for health reform, much less the framework. In contrast, Senator Baucus is proposing a framework very similar to the plan that President Obama ran on, and poured well over $100 million in campaign TV ads promoting.

Both Obama and Baucus plans appropriately focus on expanding group coverage, including expanding public programs for lower-income children and adults, and employer-based coverage in general. It would offer purchasing pools and public coverage options. Both would institute a variety of cost-control measures, and new regulations on insurers–particular preventing them to deny people for “pre-existing conditions.” That’s good stuff, and a strong platform to start.

Much will be made about the notion of an individual mandate, which was a debating point between Senator Clinton and Senator Obama during the primaries. Clinton was for it; Obama said he wanted to ensure affordability before considering the requirement for adults as well (his plan includes a requirement for children, ). Many have argued that the issue was overblown.

We at Health Access have been skeptical of the individual mandate, but not opposed to the notion that we all–sick and healthy–should contribute to health coverage (as many health reforms, including single-payer, include). Rather, our issues were more about the problems in the inefficient and inequitable individual insurance market that some may be forced into. It was only in the context of expanding group coverage, shrinking the individual market, and placing new subsidies and restrictions, that we and other consumer groups supported AB x1 1, the negotiated deal between Governor Schwarzenegger and Speaker Nunez.

So the real question, in the Baucus plans and others that may come out, is: what help does it provide? Will it leave consumers are the mercy of the private insurers, of the individual insurance market?

In addition to supporting the concept and urgency of health reform, we as consumer advocates can push to ensure that we institute new rules for the private insurers, especially with regard to allowing them to pick and choose who they cover; that we offer new purchasing pools so individuals and employers can better negotiate for the best deal; and provide new public coverage options, as a competitive choice.

Let’s look at the details when they come out, but that’s what I will be looking for.

Health Access California promotes quality, affordable health care for all Californians.
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