There should be health insurance choices offered to everyone


Only three categories of people under any of the Democratic plans — the eligible uninsured, the self-employed and small businesses — will have access to state insurance exchanges, and therefore, if there is one, a public option. That is estimated to be about 25 million people or less.

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And why is this the case? Democratic Sen. Charles Schumer of New York, a strong supporter of a “level playing field” version of the public option, was asked on a Sunday talk show why so few people will have any access to the public exchanges or a public option. His answer was unclear — something about the public option leading to greater competition and a reduction of health insurance costs by employers.

Huh? How does that explain why 150 million insured workers shouldn’t have the same multiple choices for insurance as everyone else?

Democratic Sen. Ron Wyden of Oregon has a simple answer and, for the life of me, I do not understand why Democrats have not embraced it — as well as Republicans who value maximizing individual choices (and who oppose a public option).

Wyden’s Free Choice Amendment could be attractive with or without the public option. He would require employers either to offer their employees a lower-cost, high-value policy along with the current policy in place, or allow them to “cash out” on the value of their employer-provided policy and go to the state public exchange and buy a policy of their choosing. If that policy is less expensive than the one the employer had been providing, the employee gets to pocket the difference.

This is a good idea whether or not there is a public option. If there is one, then insured employees will be guaranteed a lower-cost choice offered by their employers or could go to the exchange and purchase the public option. (Thus it would create incentives for employers to shop for lower-cost insurance as a second choice for all employees.) But if the public option doesn’t succeed in getting 60 votes in the Senate to end the filibuster, it seems to me that the Wyden Free Choice Amendment becomes even more important, because it guarantees that employees lacking a lower-cost choice that meets their particular individual or family needs from their employers could go to the exchanges to purchase a better plan of their choosing. And one of those choices could be a requirement that every state exchange offer the equivalent of the lower-cost, higher-value Blue Cross health insurance plan available to all members of Congress and federal employees.

For reasons that have never been fully explained, when Wyden introduced his Free Choice Amendment, which he wasn’t able to do until 1 a.m. on the morning after the day of the markup of Sen. Max Baucus’s (D-Mont.) Finance Committee bill, Baucus ruled it “out of order” and would not let a vote to occur. He was under the erroneous conclusion that Wyden’s proposal had not been “scored” by the Congressional Budget Office. In fact, it had — on Sept. 22, the CBO had issued a scoring that found Wyden’s Free Choice Amendment would have the effect of reducing the federal deficit by $1 billion over 10 years.

Assuming an honest mistake was made thwarting a vote on Wyden’s amendment, it is not too late for Senate leaders to include his proposal in the merged bill to be debated on the Senate floor — assuming there are 60 votes allowing that to happen — or at least allow Wyden to get an up-or-down vote on the Senate floor.

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The only explanation I’ve read so far as to why Wyden’s proposal has received so little support is that, as Jay Stevens wrote on Oct. 7 in his Left in the West blog, “the proposal was doomed by the joint opposition of businesses and labor. Businesses didn’t like it because they lose control over their employees’ health benefits. Labor groups didn’t like it because they lose control over their members’ health benefits.”

If both business and labor don’t want their workers to have multiple choices for health insurance, then that may be one reason why this is a good idea. At the very least, Wyden’s Free Choice proposal should be debated and voted on, and not shunted aside as “out of order.” Who could disagree with that?

Davis, a Washington lawyer and former special counsel to President Clinton from 1996-98, served as a member of President George W. Bush’s Privacy and Civil Liberties Oversight Board in 2005-06. He is the author of Scandal: How ‘Gotcha’ Politics is Destroying America.

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