Monday, August 10, 2009

Senator Wyden's Plan: An IRA/401K for Health Care

Senator's Wyden's plan for Health Care provisioning is a simple one, and in many ways a very viable and attractive plan. He states as follows:

1. It Creates Exchanges; State Wide or National

"The Free Choice Proposal gives every American the ability to either choose to keep the coverage they have or pick a plan that works better for them and their family. It guarantees both choice and portability by creating a path for employers to insure their workers through a national or state-based insurance marketplace known as the “Exchange.”"

The operative phrase is marketplace exchange. In many ways we have that in 401 K plans, one goes to a marketplace provider. The key underlying elements of the Wyden plan he implies appears to be:

a. Universal
b. Portable
c. No pre-existing condition limits
d. Competitive prices
e. Reasonable set of required coverage for catastrophic diseases

2. It is paid for the most part by Employers and then Transitioned to the Individual. He makes the statement as to how this is covered. It is done as follows:

"Under this proposal:

1) Employers that offer group health coverage must offer the equivalent of a minimum benefit plan, contribute at least 70% of the premium, and offer at least one other health plan of greater actuarial value; or

2) Employers that do not offer the choice of a low cost option must offer workers a voucher worth at least 70% of the average of the three lowest cost plans in the exchange; or

3) With an adequate transition, employers can take their entire group to the exchange where they would receive a group discount so long as they provide at least 70% of the cost of average of the three lowest cost plans in the exchange; or

4) Employers that do not offer health insurance choices, a voucher, or go to the exchange, would have to pay a “fair share” fee which would be a percent of the national average of the three lowest cost plans in each state."

This is a great idea because it transitions the relationship between the coverage from the insurer and the employer to the insurer and the insured. Our analysis sees this as the most efficient manner. The devil is always in the detail,l and in this case the mandatory coverage issue. But this is a great idea and Senator Wyden deserves praise for trying it. Unfortunately Senator Baucus has dismissed it out of hand, for reasons one in Washington alone can fathom.