How the Baucus Plan Screws Older People

As I wrote yesterday, there are aspects of the Baucus health care reform plan that don’t bode well for Medicare recipients. But the people who stand to get screwed most by the plan are those who aren’t old enough to qualify for Medicare, but are still old enough to be discriminated against by insurance companies.

For several months, the Columbia Journalism Review has been publishing analyses of the Massachusetts health care system, which in many ways serves as a model for the current national health care reform–a “canary in the coal mine” for the rest of us. The state mandates that all residents have health insurance or face a tax penalty. And while it does provides some regulation of private insurers, it doesn’t bar them for “age rating”–setting different premium rates based on age. This doesn’t apply to most working people who are covered by group plans through their employers, at group rates. But for the self-employed and early retirees–who numbers are growing since the recession began–the costs can be devastating. CJR cites reporting by Kay Lazar in the Boston Globe, which found:

State law allows insurers to charge older people up to twice as much as younger people for the same coverage. In other states, the disparities can be even greater. One result is that more older people choose less comprehensive plans. Data from the Commonwealth Choice program, which offers state-approved private insurance, show that as enrollees grow older, more choose cheaper and less comprehensive coverage.

The main solution that’s been proposed for this problem is to make it “easier for self-employed people and retirees who are 50 to 64 to be exempted from a stiff tax penalty if they can’t afford insurance.” So rather than force insurance companies to stop discriminating on the basis of age, the state may begin “allowing” 60-year-olds to live without health insurance. So much for the great Massachusetts universal coverage model.

All of the major health reform plans that have been floated in Congress allow age-rating, and the Baucus plan endorses disparities even higher than those in Massachusetts. As the New York Times reports:

Under Senator Baucus’s plan, insurers would be permitted to charge older people five times more for their health insurance premiums than younger people. That proposal, first circulated in a Finance Committee policy options paper last spring, is a significant departure from the approaches put forth by three House committees and the Senate Health, Education, Labor and Pensions Committee. Those bills would only allow insurers to charge older people twice as much as younger ones….

According to AARP, the lobbying organization for older Americans, the number of uninsured adults between 50 and 64 grew to 7.1 million in 2007, an increase of 36 percent over 2000. Among the main reasons for the increase: higher premiums demanded of older, sicker people seeking coverage in the individual insurance market.

Supporters of the Baucus plan and the other half-measure Congressional health reform proposals made a big deal of the fact that insurers won’t be able to turn people away, or charge them more, because they have pre-existing conditions. In other words, they can’t discriminate against sick people. They also, of course, cannot discriminate on the basis of race, ethnicity, gender, and the like. This means that the only form of discrimination that will remain legal is age discrimination.

This is, of course, another sop to the insurance industry, which worries about the effect on its profit margin if it has to insure everyone. As the Times notes:

By allowing insurers to charge so much more for older, often sicker people, “You’re just using age as a proxy for health status,” said Uwe Reinhardt, an economics professor at Princeton University. He estimates that Senator Baucus’s age-rating plan would allow insurers to cover roughly 70 percent of the additional risk they’d take on by being required to accept all comers, regardless of health.

7 responses to “How the Baucus Plan Screws Older People

  1. I am glad you are here to advocate for older Americans in a way that makes sense.

  2. Pingback: Senate Finance Committee Considers Health Care Reform Bill | Our Bodies Our Blog

  3. Thus far President Obama has reneged on every campaign promise he’s made. Gitmo is still open for business – Vouchers for Washington DC kids have been canceled – so much for a Sidwell education, for those who desire to exit deplorable D.C. public schools.

    – NAFTA will NOT be reviewed – (as promised in Ohio) – Mountain Top Removal (500 mts thus far) will continue in West Virginia – with valleys/ rivers being choked with toxic sludge – WAR is ongoing (Billions per month) – in Afghanistan – the graveyard of empires/ Russia spent a decade (was bankrupted) and 240,000 troops in this wasteland of nothingness – no roads, no trains, no utilities , people existing in the 13 century .

    How about our levees, bridges, roads, schools, and closed factories. How insane this ‘nation building of a barren landlocked corrupt country with NO government to speak of –while our nation is imploding with people living in tents like the Afghan people – only our folks aren’t herding goats and sheep! They’ve lost their jobs – and now their homes.

    Recall President Obama, promising citizens on the campaign trail, ‘the same coverage that I and Senators receive’. That ended, upon his arriving in Washington, where he now states “that this (SINGLE PAYER ) would be great if we were starting from scratch”.

    Instead big pharma – the insurance companies etc have met secretly with White House health advisers (including Dr. Ezekiel Emanuel – Rahm’s brother) to set up their great scam of fleecing the citizens (nothing has changed).

    They (insurance) are salivating at the prospect of Mandated new millions of customers, for a Medicaid plan on steroids. If you want REAL coverage you’re going to have to pay a HEFTY price – real hefty! As it is today – many doctors WILL NOT take Medicade patients and forget any specialized treatment .

    We are, amongst those, who provide the BEST health care in the world – FOR A PRICE. Try going to the Mayo Clinic with a Medicaid card for specialized surgery.

    Meantime, Washington shills have voted AGAINST having the SAME coverage they want to dump on the rest of us/ God forbid our EMPLOYEES have the same coverage as we their EMPLOYERS are being mandated to have or face a FINE.

    This is called a POLL tax . Washington politicians/ Supreme Court have CADILLAC coverage. For us they are voting Yugo coverage.

    WE pay 72% of their premium costs – They have life time coverage on into retirement – They can choose from dozens and dozens of plans —costing them from 100 to a maxium 300 per month (entire family) which includes prescriptions -dental – eyeglasses – no co-pay or minimal – NO problem with any pre-existing condition.

    You’re on the roll as soon as you take office (no waiting period). YOU can never have your policy canceled. As you can see be you Ruth Gingsberg (Supreme Court )- Senator Dodd etc, it’s Sloan Kettering for that cancer operation.

    No sick days for them – they get paid, like Senator Kennedy – (best of care) their full salaries no matter how long they’re sick.

    THOUSANDS of doctors/nurses have petitioned – gone to Washington, to demand SINGLE PAYER ( see HR 676 – worked on for years) which is Medicare expanded – everybody in – nobody out (including Washington honchos). Guess what? President Obama (March) promised everybody would be at the table. NOT —when the doctors/nurses try to speak (who would know better) BAUCUS had them arrested!

    This gang of six (finance committee) are not representatives of the people but SHILLS for industry. This gang of thieves are making decisions for millions —They who amongst themselves have received almost ONE BILLION in campaign monies etc from corporate hucksters.

    And we’re represented? I think not. An Advisory Panel (non medical) WILL decide who will receive treatment/surgery/ medications. Too bad if you’re 65+ or are disabled – neurologically impaired etc —-Sorry Charlie your treatment is
    NOT COST EFFECTIVE.

    We want what President (candidate ) Obama promised. People voted for change / not a third term for Bush. Soaring rhetoric is fine but ya can’t pay the doctor – the rent – or light bill with YES WE CAN –

  4. David Marshall

    A trust betrayed?

    The Chief Judge of Congress’s Court of Veterans Appeals stated that the, “Constitution, Statutes and Regulations” are “policy freely ignored” by both “The Veterans Health Administration” and the Secretary of the Department of Veterans Affairs (DVA), i.e., the “STATE OF COURT” transcript PARAGRAPH 9 with Congress’s law of the land U.S. CODE, TITLE 38, SECTIONS (§) 511 and § 7252. Decisions of the Secretary; finality; REFERENCES [1], [2] & [3]. This is a no teeth Congressional LEGISLATIVE vs an independent from Congress and the DVA, Judicial Branch Court. The DVA Health Care laymen, “initial adjudicators” still are not held responsible for their “freely ignored” and medically ignorant “Schedule of Ratings for Disabilities” decisions. Thereby, lost are those rights that so many have died for!

    An example of the “initial adjudicators” to date “freely ignored” is this veterans 1957 DVA Physician’s resultant, “MPerR PERMANENT” “SURGEON HQ ARRC JUN 25 ‘58 MEDICALLY DISQUALIFIED FOR MILITARY SERVICE”!

    It is now 15 years later without the Chief Judge’s 1994 advised Congressional oversight. Please hold your U.S. House and Senate members accountable for Congress’s perverted Veteran Care.

    REFERENCES:

    [1] The complete 16 paragraph “STATE OF COURT” transcript is available on request. Previously at, and now missing from the Chief Judges and state_of_court sites: http://www.goodnet.com/~heads/nebeker and http://www.firebase.net/state_of_court_brief.htm

    “STATE OF COURT

    CHIEF JUDGE FRANK Q. NEBEKER

    STATE OF THE COURT

    FOR PRESENTATION TO THE

    UNITED STATES COURT OF VETERANS APPEALS

    THIRD JUDICIAL CONFERENCE

    OCTOBER 17-18, 1994

    {as it appears in Veterans Appeals Reporter}”

    ——————–PARAGRAPH 9 of 16 in “STATE OF COURT” TRANSCRIPT records DVA laymen ignoring medical opinion without veteran recourse.—————————–

    “I believe my message is clear. There is, I suggest, no system with judicial review which has within it a component part free to function in its own way, in its own time and with one message to those it disappoints — take an appeal. That is, I am afraid, what we have today in many of the Department’s Agencies of Original Jurisdiction — that is AOJs — around the country. Neither the Court, through the Board, the Board, nor the General Counsel has direct and meaningful control over the Agencies of Original Jurisdiction. Indeed, it is also clear that the VHA — the Veterans Health Administration — ignores specific directives to provide medical opinions as directed. And this is resulting in unconscionable delays. Let us examine judicial review. Remember, the Court and the Board do not make policy, the Secretary and Congress do. The Court simply identifies error made below by a failure to adhere, in individual cases, to the Constitution, statutes, and regulations which themselves reflect policy — policy freely ignored by many initial adjudicators whose attitude is, “I haven’t been told by my boss to change. If you don’t like it — appeal it.” (Emphasis added)

    The top medically ignorant “boss” is Congress’s confirmed “Secretary” of the DVA.

    AND THE CONGRESS’S “policy freely ignored” UNITED STATES CODE law of the land, Health Care take away from Veterans:

    [2] UNITED STATES CODE, TITLE 38 > PART I > CHAPTER 5 > SUBCHAPTER I >
    § 511. Decisions of the Secretary; finality

    http://www.law.cornell.edu/uscode/html/usc…11—-000-.html

    “(a) The Secretary shall decide all questions of law and fact necessary to a decision by the Secretary under a law that affects the provision of benefits by the Secretary to veterans or the dependents or survivors of veterans. Subject to subsection (b), THE DECISION OF THE SECRETARY AS TO ANY SUCH QUESTION SHALL BE FINAL AND CONCLUSIVE AND MAY NOT BE REVIEWED BY ANY OTHER OFFICIAL OR BY ANY COURT, whether by an action in the nature of mandamus or otherwise.” (Emphasis added)

    THEREFORE, NO COURT REVIEW OF THE MEDICALLY UNTRAINED DVA laymen and “Secretary” “schedule of ratings for disabilities” decisions as proven by:

    [3] UNITED STATES CODE, TITLE 38 PART V > CHAPTER 72 > SUBCHAPTER I >
    § 7252. Jurisdiction; finality of decisions

    “(b) Review in the Court shall be on the record of proceedings before the Secretary and the Board. The extent of the review shall be limited to the scope provided in section 7261 of this title. THE COURT MAY NOT REVIEW THE SCHEDULE OF RATINGS FOR DISABILITIES adopted under section 1155 of this title or any action of the Secretary in adopting or revising that schedule.” (Emphasis added.)

  5. If you are an older American that has been forced to cancel your health insurance premiums do to high cost, here’s our solution
    My wife and I are in our 60’s
    We are self employed
    My wife has a pacemaker
    I am in good health
    We have Blue Shield
    The most affordable policy we could find at our age was their PPO 4000/8000 plan
    Our monthly premiums are $915 per month..
    Our deductible is $4000 per year per person.
    So basically we are “self insured” since we pay at least $15,000 per person per year for insurance premiums and health care before we can get a dime of help from Blue Shield.
    I’ve tried everything I can think of to get our premiums down. Even looked into a small group plan.

    It’s gotten to the point that we’ve started going abroad for medical care
    For the past 4 years we’ve been saving up all our medical and dental problems and making a 3 week visit to a Thai hospital where the care is excellent and the cost…just a fraction of what I would have to pay out of pocket in the US. For example, last November I had an Endoscopic balloon dilation for a condition known as dysphagia. The specialist in the US said the operation would cost me $2500. (His bill for the 15 minute consultation was $250.) I decided to wait until I got to Thailand and had it done in at Chulalonkorn public hospital…cost $100 including biopsy, (all I needed for ID was my US passport. No questions asked!!)

    This solution isn’t going to help us if we get hit by a car in the US.

    But it goes a long way towards solving the heath care cost problem we were having here in the Us

  6. Pingback: RN web » generation america vs aarp rates

  7. Pingback: AAPR webs » generation america vs aarp rates

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s