As political pressure has reduced the price tag of expanding coverage to below $1 trillion over ten years, many observers assumed Democrats would react by trimming financial assistance for the middle class--that is, people making between twice and four times the poverty line, or between $44,000 to $88,000 for a family of four.
The assumption was that if Democrats had to make tough choices about what to cut, they'd protect the the poor and most vulnerable. After all, they're Democrats.
But now it appears that assumption may be wrong--or, at least, not entirely right.
As recent work from the Center on the Budget and Policy Priorites has shown, the bill that the Senate Finance Committee approved actually offers substantially less protection for people making less than twice the poverty line. If the bill were to pass, the result could be significant financial hardship for people least equipped to deal with it:
The greatest concern relates to people with incomes below 200 percent of the poverty line (below $36,620 for a family of three in 2009). The amounts that families between 133 percent of the poverty line (where Medicaid eligibility generally would end) and 200 percent of poverty would have to pay for insurance purchased through the health insurance exchanges would be as much as two to four times higher as under the Senate HELP Committee or House bills and would constitute a substantial burden for many of these households.
The good news is that the bill from the Senate Health, Education, Labor, and Pensions Committee (HELP) is considerably more generous. And the Senate leadership must combine the two. (In fact, that process is supposed to wrap up today.)
But providing assistance to the poor and middle class that's on a part with the Senate HELP bill would likely require allocating more money than the Finance bill sets aside. And that's something Senate leadership is already struggling to do, since much of the Democratic caucus seems more interested in scaling back the revenue measures already on the table, starting with the tax on high-benefit insurance plans.
Indeed, the really scary part of this story is that, under pressure to make more out of less, the Senate Finance Committee has apparently put on the table a proposal that would scale back subsidies for the poor even farther.
I say "apparently" because one reliable source, close to the process, tells me the idea isn't really under consideration. But two other sources (also very reliable) swear the proposal is very much in the mix. In fact, they say, the Finance Committee has actually sent the measure to the Congressional Budget Office for an estimate of how it will affect reform's bottom line.
It seems to be serious enough that Center on Budget--which has gotten wind of this story, as well--has studied what the proposal would mean in practice.
A family of three earning $27,465 a year before taxes — that is, at 150 percent of the poverty line--would have to pay $1,318 a year for health coverage under a proposal that Senate negotiators are considering for a merged health reform bill that they would bring to the Senate floor. This is more than such a family would pay under either the Senate Finance Committee health bill or the bill that the Senate Health, Labor, Education, and Pensions (HELP) Committee approved, and represents a large amount for families that often have difficulty paying the rent and utilities and putting food on the table.
This $1,318 premium charge, which would represent 4.8 percent of the family’s income, is nearly five times the $275 that the family would pay under the Senate HELP bill and $82 more than the $1,236 it would pay under the Finance bill.
Those amounts may not seem like a lot of money, but keep in mind those are only the premiums. Co-payments and such are separate. More important, when you're supporting a family of four on $29,000, a few extra hundred dollars makes a huge difference.
To be clear, the apparent purpose of this latest shift is to boost assistance for the middle class, in order to make sure people sign up for the insurance. That's a worthy goal--and a necessary one, most likely, with the Senate simultaneously reducing the penalties for people who don't comply with the requirement to get insurance.
But the way to help the middle class is to allocate more money for reform--not to take money away from the poor. Democrats don't do that. Or, at least, they shouldn't.
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COMMENTS (7)
Being poor in America is to be an untouchable.
They say the moral worth of a nation is reflected [and can be measured] in the manner in which it treats its most vulnerable, least fortunate citizens.
In that respect, Obama and the Democrats are far worse than the Republicans.
But then, like the Republicans, many of them really don't give a shit at all about those who contribute nothing towards their reelections.
In other words, the ethics of expediency in a world that has made poverty virtually disappear from the media altogether. Out of sight, out of mind.
And there is always Sunday to confess their sins into oblivion.
george
Being poor in America is to be an untouchable.
They say the moral worth of a nation is reflected [and can be measured] in the manner in which it treats its most vulnerable, least fortunate citizens.
In that respect, Obama and the Democrats are far worse than the Republicans.
But then, like the Republicans, many of them really don't give a shit at all about those who contribute nothing towards their reelections.
In other words, the ethics of expediency in a world that has made poverty virtually disappear from the media altogether. Out of sight, out of mind.
And there is always Sunday to confess their sins into oblivion.
george
Poor people are much less likely to vote than those in the middle class.
Poor people are much less likely to vote than those in the middle class.
More nonsense from loony tunes George:
"Being poor in America is to be an untouchable."
This is bullshit both gramatically and factually.
The poor in America are not, well, well off. But in what country are they well off? However, they are not untouchables, not by a long shot.
Does he know what being an untouchable means? Has he ever been around "the poor" in this country? Has he ever been poor?
What planet is George living on?
"They say the moral worth of a nation is reflected [and can be measured] in the manner in which it treats its most vulnerable, least fortunate citizens."
Every thing George post could start with the phrase, 'The say...."
"In that respect, Obama and the Democrats are f ... view full comment
More nonsense from loony tunes George:
"Being poor in America is to be an untouchable."
This is bullshit both gramatically and factually.
The poor in America are not, well, well off. But in what country are they well off? However, they are not untouchables, not by a long shot.
Does he know what being an untouchable means? Has he ever been around "the poor" in this country? Has he ever been poor?
What planet is George living on?
"They say the moral worth of a nation is reflected [and can be measured] in the manner in which it treats its most vulnerable, least fortunate citizens."
Every thing George post could start with the phrase, 'The say...."
"In that respect, Obama and the Democrats are far worse than the Republicans."
If his above comment was nonsense, this phrase is obscene.
Does George even now about New Orleans which was the most visible sign of a cavalier attitude towards poor people that led to despair and hopelessness?
Taxes on the poor (and middle class and rich) are how other countries pay for socialized medicine.
Someone making $27K in the US pays an effective tax rate of 4.3%, or $1161 in taxes.
Someone making $27K in the UK (16,600 pounds) pays an effective tax rate of 18%, or $4860 in taxes.
Yes, the poor person in the UK pays 4X more taxes compared to the poor person in the US
Johnathan Cohn, isn't this "free" medical care what you wanted? After watching you bang this drum for months, I'm surprised you are just now looking into how this is paid for. Why don't you do your readers a favor and explain to them how much the middle class pays for "free" health care in other countries? They will be shocked.
Taxes on the poor (and middle class and rich) are how other countries pay for socialized medicine.
Someone making $27K in the US pays an effective tax rate of 4.3%, or $1161 in taxes.
Someone making $27K in the UK (16,600 pounds) pays an effective tax rate of 18%, or $4860 in taxes.
Yes, the poor person in the UK pays 4X more taxes compared to the poor person in the US
Johnathan Cohn, isn't this "free" medical care what you wanted? After watching you bang this drum for months, I'm surprised you are just now looking into how this is paid for. Why don't you do your readers a favor and explain to them how much the middle class pays for "free" health care in other countries? They will be shocked.
jackass Walton has never heard of the eitc, or s-chip, or afdc, the moron speaks in absolutes, how cavalier, how ignorant to compare the untouchables of India with the poor in the states. I know poverty, I live in rural Oaxaca, and have lived on a remote island in Micronesia, and a remote village in China. I know the difference between being poor in China and being poor in America. Clueless Walton doesn't. He holds the poor in contempt, and uses the world untouchable to explain their condition. America is generous to the poor, far beyond what most of the world's poor can fathom. And to a large degree this is due to the hard work of Democrats (and yes, many Republicans, just not the Club for ... view full comment
jackass Walton has never heard of the eitc, or s-chip, or afdc, the moron speaks in absolutes, how cavalier, how ignorant to compare the untouchables of India with the poor in the states. I know poverty, I live in rural Oaxaca, and have lived on a remote island in Micronesia, and a remote village in China. I know the difference between being poor in China and being poor in America. Clueless Walton doesn't. He holds the poor in contempt, and uses the world untouchable to explain their condition. America is generous to the poor, far beyond what most of the world's poor can fathom. And to a large degree this is due to the hard work of Democrats (and yes, many Republicans, just not the Club for growth kind)
jeez, Seattle, you and your numbers fetish. It means far, far less than you think it means. You have zero appreciation of quality of life issues. As I have said before, for Republicans there are only 3 countries in the world, Britain, Canada, and the US. God forbid Seattle compare the US to Japan, or Taiwan, or Germany and their health care systems. He doesn't because he knows their socialized systems have better outcomes at much less the cost. The point is to learn from systems that are best, not cherry pick stats from England (quick, look around in your house, find something that says "made in England")
I think I've had this comparative tax rate discussion with seattleengineer before. Look at the OECD charts on disposable income (after taxes) fo families earning comparable US$ paychecks and you will see that Canadians paying 4-5 % more in taxes end up with much more diposable income to spend on non healthcare related consumer goods. They pay 1/3 less for drugs, no co-pays, no medical bankruptcies, no confusing paperwork. They can access preventive care without fear of deductibles. In certain provinces there is a modest premium paid at tax time. It's not a perfect system--They need to add dental coverage and a few more family docs and orthopedic surgeons--as do we.
But consider the q ... view full comment
I think I've had this comparative tax rate discussion with seattleengineer before. Look at the OECD charts on disposable income (after taxes) fo families earning comparable US$ paychecks and you will see that Canadians paying 4-5 % more in taxes end up with much more diposable income to spend on non healthcare related consumer goods. They pay 1/3 less for drugs, no co-pays, no medical bankruptcies, no confusing paperwork. They can access preventive care without fear of deductibles. In certain provinces there is a modest premium paid at tax time. It's not a perfect system--They need to add dental coverage and a few more family docs and orthopedic surgeons--as do we.
But consider the quality of life and dignity issues, freedom from worry, shared risk and cost, high quality care for you and your neighbor.
Go to www.healthcare-NOW.org to get active with the single payer proponents in your region. Time to advocate for Medicare for All. One nation, one plan.
hmseil01, I'd love to see this data if you can provide a link.
PS. Married Canadians with kids aren't paying 4-5% more in taxes. It's 10% more in taxes a median earner is paying compared to their US counterparts.
Blackton, let's make a bet. You state "He doesn't because he knows their socialized systems have better outcomes at much less the cost. "
Are you asserting that our costs will fall dramatically with a public option? Funny, medicare hasn't achieved that. Medicare costs rise more quickly than private costs in the US.
Are you asserting that our longevity will increase under a public option? Funny, white european Americans live as long in the US as they do in the EU. And Asian Americans in ... view full comment
hmseil01, I'd love to see this data if you can provide a link.
PS. Married Canadians with kids aren't paying 4-5% more in taxes. It's 10% more in taxes a median earner is paying compared to their US counterparts.
Blackton, let's make a bet. You state "He doesn't because he knows their socialized systems have better outcomes at much less the cost. "
Are you asserting that our costs will fall dramatically with a public option? Funny, medicare hasn't achieved that. Medicare costs rise more quickly than private costs in the US.
Are you asserting that our longevity will increase under a public option? Funny, white european Americans live as long in the US as they do in the EU. And Asian Americans in the US live as long as they do in Asia. And African American's live longer in the US than they do in Africa. A public plan will not improve this further.
Are you suggesting that we'll have more doctors under a public option? Funny, but doctors are leaving medicare precisely because medicare pays them pennies on the dollar. And the changes congress is proposing will pay doctors even less.
Why do you think a public plan will fix all these ills you point out today? If medicare had been kicking a$$ the last 50 years, I might be inclined to believe you.
I'll bet you that 5 years after a public plan is implemented we will have doctor shortages, the program will have seen massive overruns, waiting times will have increased and longevity increases will be on the same pace that they were before it was implemented.