WASHINGTON BUREAU — The Concord Coalition is urging Senate Majority Leader Harry Reid to use real budget cuts and real sources of revenue to pay for any health coverage expansion.
Senate leaders should keep the proposed 40% excise tax on high-premium insurance plans that is included in the Senate Finance Committee’s America’s Healthy Future Act bill draft when combining that draft with the Senate Health, Education, Labor and Pensions Committee’s health bill, leaders of the Arlington, Va., coalition write in a letter addressed to Senate Majority Leader Harry Reid, D-Nev.
“It is a lot easier to come up with new ways to expand health care coverage than it is to find politically acceptable ways of paying for it,” coalition leaders warn.
The Concord Coalition promotes discipline in federal budgeting.
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The coalition leaders who signed the letter are the co-chairman- former Sen. Warren Rudman, R-N.H., and former Sen. Robert Kerrey, D-Neb. – and the president, former U.S. Commerce Secretary Peter Peterson.
Several key Democratic senators, including Senate Finance Committee Chairman Max Baucus, D-Mont., have been saying they will vote for a health bill only if it either will decrease the federal budget deficit over 10 years or have no effect on the deficit.
The Senate Finance Committee recently sent the AHFA bill draft to the Congressional Budget Office and the congressional Joint Committee on Taxation for an analysis of its possible effects on the federal budget deficit.
The CBO says the bill, as implemented, could cut the federal budget deficit by $81 billion over a 10-year period starting in 2010, but that achieving those results would depend in making cuts in Medicare provider reimbursement increases stick.
In the past, Congress has been unable to implement plans to cut provider reimbursement increases, CBO Director Douglas Elmendorf has warned.
Concord Coalition leaders write in their letter that using “scoring gimmicks” to make a health reform “deficit neutral” could keep the U.S. health care system on an “unsustainable track.”
“Medicare is already facing a $38 trillion unfunded obligation over the next 75 years,” the coalition says in a memo accompanying the letter. “Using savings from this program, which we strongly support, to pay for new commitments would not leave overall health care spending on a more sustainable track.”
The Joint Committee on Taxation says the proposed excise tax on “Cadillac plans” could raise $201 billion over 10 years, and “it would also serve as a constraint on plan premiums — thereby encouraging insurers to exert downward pressure on provider costs,” the coalition says.
The coalition also recommends shifting toward paying for bundles of health care services, and away from fee-for-service arrangements; tailoring subsidies carefully, to avoid encouraging families incentives to drop coverage; getting serious about slowing Medicare physician reimbursement increases; cutting Medicare Part D prescription drug program subsidies; and avoiding creation of any kind of “Medicare for all plan.”