Questions raised on health bills' affordability, cost savings

 The Wall Street Journal: "The health-care bills moving through Congress contain little to reward consumers for lowering their health costs, an omission prompting some lawmakers to press for more such incentives.  Sen. Ron Wyden (D., Ore.) is proposing amendments to the Senate bill that would give people who are eligible for coverage through their employer the option of buying cheaper coverage from the new insurance exchanges -- and pocketing the difference."

The proposal, which has support from prominent moderates in both parties as well as a business group that opposes the overall bill, would mean allow far more people to join the exchanges than the pending legislation would.  "There are virtually no provisions in the Senate or House health bills that directly reward consumers for choosing cost-efficient care or lowering their medical costs through healthy behavior. ... Despite getting bipartisan support, Mr. Wyden's amendments don't appear to have enough votes to pass, and may not even come to a vote on the floor. The White House and top Democrats want to keep people in employer plans if they are affordable " (Adamy, 12/15).

It's not clear whether the legislation will make health care affordable to all of the people Democrats are hoping to cover, The Buffalo News reports. "Moderate-income families could get caught with a choice of paying for a health plan they can't afford, paying a penalty to avoid the even greater cost of insurance or, if eligible, seeking an exemption to the requirement to buy coverage."

The News continues, "Some experts say the subsidy levels for middle-income earners are too low and risk a backlash of disappointment if health reform forces people to cut back significantly to buy insurance or to pay a penalty to go without coverage" (Harris, 12/13).

Related previous KHN story: Chasm In Congress Over How Much Individuals Should Pay For Health Care (Rau, 9/17).

The Salt Lake Tribune answers a reader's question on whether expanding coverage would lead to cost savings. The Tribune reports that the bills' pricetags of about $850 billion over 10 years accounts only for federal dollars going out, not money saved through cuts and efficiencies, such as fewer emergency room visits. Cuts to programs and new taxes also save money, it reports. "The CBO has an estimate on that, too. Its analysts predict the House bill would raise more money than it spends, saving $139 billion by 2019, while the Senate version would save $130 billion" (Canham, 12/14).