FixHealthCarePolicy

The Public Option Threat Still Buried in the Senate Bill

Most Americans now believe that major health care legislation will not pass this year. But as Heritage Vice President Stuart Butler explains in The New England Journal Medicine one seemingly minor proposal in the Senate health care bill could end up having huge repercussions for our entire health care system:

“The Senate legislation contains strong directives to the OPM, requiring it to negotiate medical-loss ratios (the percentage of premiums that insurers actually spend on medical care for enrollees), minimum benefits, profit margins, premiums, and “such other terms and conditions of coverage as are in the interests of enrollees in such plans.” Crucially, the legislation also specifies that the OPM-administered plans would automatically be deemed to meet all the requirements for plans to be offered through the health exchanges created by the legislation.1 This means that OPM-administered plans could in practice operate free of many of the financial regulations that exchanges might impose on other plans, allowing the plans to operate under their own OPM-designed regulations.” (more…)

Tags: New England Journal of Medicine, OPM, public option, Senate Bill, Stuart Butler

OPM: The Public Option in Disguise

In order to secure the votes to pass a health care bill, Senate Democrats were forced to scrap the widely unpopular public option. But before chalking this up as a victory for opponents of government-run health care, though, its replacement deserves a closer look. As described in Sec 1334 of the Senate bill, the Director of the Office for Personnel Management (OPM) would now be charged with sponsoring a set of multi-state health plans to compete with private insurers. As a recently published detailed analysis by Heritage’s Bob Moffit and Kathryn Nix shows, this new program is simply a placeholder for the public option.

On January 20, The Heritage Foundation hosted three former OPM directors to explore the ramifications of the new proposal. Former Director Linda Springer opened by questioning the role of OPM in the proposal. OPM currently administers the successful Federal Employee Health Benefits Program, and it is due to this expertise that the agency was chosen to run the new multi-state plans. However, Springer warned that overstretching OPM beyond its traditional role could result in the cannibalization of the existing FEHB program.

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Tags: Federal Employee Health Benefits Program, OPM, public option