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- Build on the current employer-based system: The more than 160 million Americans who receive their health insurance through an employer should be able to keep their coverage, if they so choose.
- Strengthen the health care safety net: Medicaid should establish a “clear, simple, transparent income test” where everyone above 100% of the Federal Poverty Level (FPL) is eligible for coverage. The State Children’s Health Insurance Plan (SCHIP) should also be expanded to children in families with incomes up to 300 percent of FPL.
- Helping hand for working families: The federal government would subsidize coverage on a sliding scale up to 400% of the FPL.
- Guaranteed coverage requirement: If every American is required to purchase health insurance coverage — a.k.a. individual mandate requirement — the insurance companies would provide everyone withe coverage.
Any real reform which cuts costs would be far less profitable. So government has, in effect, made a grand bargain with the insurance companies. Force healthy people to pay premiums. Yes, they knew there would be a trade-off; they’d have to take some unhealthy people. But, contrary to the cheerleaders for Obamacare, giving these people insurance via subsidization on the part of the healthy part of the population is not synonymous with paying directly for HEALTH CARE. As anybody who has had regular experience with a health insurance company can attest, read the fine print of the policy. It doesn’t follow that you’ll get the health care provision you assumed you would receive when you were paying those expensive monthly health insurance premiums.
Why the requirement?
It's a pretty obvious way to expand coverage, for one thing. Also, it would help bring in a flood of new customers for health insurers, including healthy young people who might not need much health care.
For insurance companies, those new customers would balance out the losses they would incur by ending the practice of denying coverage to people with pre-existing conditions, something the measure outlaws.
And many people would not be buying coverage purely on their own; Uncle Sam would help them. The bookend to the individual mandate is a federal subsidy to purchase insurance that reaches deep into the middle class.
"We need to look at this as a win for consumers as well. Yes, it'll be a win for the insurance companies, but I don't think we're gonna wind up with the insurance companies walking away [and] winning the whole ball game. If we don't do anything right now, that's what will happen. They'll win everything... I was distraught when I saw what happened, what I saw the Senate voting on. But then I realized - you know, I studied a lot of these efforts over the past many years to get reform - [that] often we've come short because we've tried to get the perfect, and we've never been able to get anything as a consequence... We need to have a foundation, and this may seem to be not an adequate foundation for a lot of people, but there are more than 50 million people in this country who don't have insurance... Wouldn't you rather, and I think wouldn't most Americans rather, that we have something to start from rather than starting from scratch the next time? It's very hard to build up to doing this in the first place... I'm frankly pretty amazed that we're getting this close to passing something."