In its place will be many of the alternatives we've been hearing about, including a Medicare expansion and a triggered, federally-based public option, the aide said.
As has been widely reported, one of the trade-offs will be to extend a version of the Federal Employees Health Benefits Plan to consumers in the exchanges. Insurance companies will have the option of creating nationally-based non-profit insurance plans that would offered on the exchanges in every state. However, according to the aide, if insurance companies don't step up to the plate to offer such plans, that will trigger a national public option.
Beyond that, the group agreed--contingent upon CBO analysis--to a Medicare buy in.
That buy-in option would initially be made available to uninsured people aged 55-64 in 2011, three years before the exchanges open. For the period between 2011 and 2014, when the exchanges do open, the Medicare option will not be subsidized--people will have to pay in without federal premium assistance--and so will likely be quite expensive, the aide noted. However, after the exchanges launch, the Medicare option would be offered in the exchanges, where people could pay into it with their subsidies.
It appears as if liberals lost out on a Medicaid expansion that would have opened the program up to everybody under 150 percent of the poverty line. That ceiling will likely remain at 133 percent, as is called for in the current bill.
And, while the Democrats were in closed-door meetings trying to do something good for everyone, Republicans were on the Senate floor declaring in a colloquy that the sky would fall it these plans were adopted. No help for the country there.
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