MaxTax: Working Thread

Fatster found Max Baucus’ health care plan here. Use this thread to post what you find.

I’m about 1/10 of the way through. My favorite detail so far is that the Health Exchanges would take your MaxTax–your mandated payment to shitty insurance companies–as a payroll deduction.

For employed individuals who purchase health insurance through a state exchange, the premium payments would be made through payroll deductions.

This really is a tax to benefit Baucus’ donors.

This is interesting:

Individuals between 300-400 percent of FPL would be eligible for a premium credit based on capping an individual‘s share of the premium at a flat 13 percent of income. For purposes of calculating household size, illegal immigrants will not be included in FPL. Liability for premiums would be capped at 13 percent of income for the purchase of a silver plan. The share of premium enrollees pay would be held constant over time. The premium credit amount would be tied to the second lowest-cost silver plan in the area where the individual resides (by age according to standard age factors defined by the Secretary of Health and Human Services) plan.

This is the cap for premiums for some middle class people, remember. What I’m interested in is that they cap the subsidy to the second lowest-cost plan that qualifies for subsidies. The insurance companies will be gaming that system, to direct consumers into precisely what model they want to pay for, because they know that strapped middle class families will only get what they can get a full subsidy for.

I’m on page 21 now, and already there have been 3 discussions of how to make sure undocumented workers (Baucus calls them illegals) will be prevented from buying into insurance in this program. They may have reprimanded Joe Wilson, but they sure kowtowed to him.

Here’s another way Baucus is incenting employers to pay their employees shit wages:

A qualified small employer for this purpose generally would be an employer with no more than 25 fulltime equivalent employees (FTEs) employed during the employer‘s taxable year, and whose employees have annual fulltime equivalent wages that average no more than $40,000. However, the full amount of the credit would be available only to an employer with ten or fewer FTEs and whose employees have average annual fulltime equivalent wages from the employer of less than $20,000.

McJobs: It’s not just for WalMart anymore.

There’s a whole bunch of language making sure that Uncle Sam doesn’t pay for an abortion–in the mid-20s. But I’m not entirely sure what this means:

The Secretary would be required to estimate, on an average actuarial basis, the basic per enrollee, per month cost of including coverage of abortions beyond those permitted by the most recent appropriation for the Department of Health and Human Services under a basic plan. In making such estimate, the Secretary may take into account the impact of including such coverage on overall costs, but may not consider any cost reduction estimated to result from providing such abortions, such as prenatal care. In making the estimate, the Secretary would also be required to estimate the costs as if coverage were included for the entire covered population, but the costs could not be estimated at less than $1 per enrollee, per month.

I assume that insurers would want to include abortion coverage, since an abortion is cheaper than prenatal care and delivery. Is this Baucus’ way of making sure it gets included?

And this will be hard to administer:

The Secretary would ensure that in each state exchange, at least one plan provides coverage of abortions beyond those for which Federal funds appropriated for the Department of Health and Human Services are permitted. The Secretary would also ensure that in each state exchange, at least one plan does not provide coverage of abortions beyond those for which Federal funds appropriated for the Department of Health and Human Services are permitted.

The God’s Health Care Plan versus the Woman-Friendly Health Care Plan?

Is this a means to extend conscience clauses, via the exchange, to any drug store that wants it?

Current Law
Federal conscience clause laws prohibit recipients of certain Federal funds from discriminating against certain medical personnel and health care entities for engaging in or refusing to engage in specified activities related to abortion.

Chairman’s Mark
Health benefits plans participating in state exchanges would be prohibited from discriminating against any individual health care provider or health care facility because of its willingness or unwillingness to provide, pay for, provide coverage of, or refer for abortions.

Particularly given bogus claims that birth contorl pills and RU486 are abortions.

Lovely. MaxTax prohibits government entities from sponsoring Co-Ops.

It must not be sponsored by a State, county, or local government, or any government instrumentality.

Here’s MaxTax on malpractice "reform:"

The Chairman‘s Mark would express the Sense of the Senate that health care reform presents an opportunity to address issues related to medical malpractice and medical liability insurance. The Mark would further express the Sense of the Senate that states should be encouraged to develop and test alternatives to the current civil litigation system as a way of improving patient safety, reducing medical errors, encouraging the efficient resolution of disputes, increasing the availability of prompt and fair resolution of disputes, and improving access to liability insurance, while preserving an individual‘s right to seek redress in court. The Mark would express the Sense of the Senate that Congress should consider establishing a state demonstration program to evaluate alternatives to the current civil litigation system.

Why even include it if you can’t get even one Republican on board?

16 replies
  1. TheraP says:

    An individual’s “share of the premium” at 13% income. Well, what about the deductibles and co-pays? Probably there’s no limit tied to income. Sounds like indentured servitude to me!

    Reminds me of that song “Sixteen Tons” – Another day older and deeper in debt”.

  2. BoxTurtle says:

    They’d better make sure the illegals aren’t covered, it’s the only GOP point that seems to be making tracks against the bill with the citizenry. The only other “objections” are coming from Pharma & Insurance and outside of their pet congresscritters nobody seems to care.

    I am also frightened at how much support “You Lie” is getting around here. I started a very interesting discussion by asking what they would have thought had Kerry said that to Bush during his go-to-war address. But there was silence for a moment when I first said it. I think true wingnuts heads would have exploded, but these folks seemed to just reboot.

    Boxturtle (These are my neighbors, not GOP hacks, btw)

  3. klynn says:

    6 month wait for getting coverage with a preexisting once you have been denied?

    Nothing like timely administration of care.

    I second the indentured servitude.

  4. Peterr says:

    That “payroll deduction” clause is a real gift to the insurance industry. I wonder how the banks and credit card companies will feel about insurers getting to the front of the line when it comes to getting their money?

    I’m not a lawyer nor an accountant, but I believe that *required* deductions from payroll at present come only for taxes to be paid to the government and to enforce court-ordered claims like past due child support, for instance.

    Big Insurance: Breaking New Ground in Breaking into Your Wallet.

  5. bobash says:

    O/T: I received my Atlantic monthly in the mail yesterday and read Andrew Sullivan’s open letter to President Bush “who is the only one who can repair the moral damage caused by torture.” It’s well worth reading and is up online at Would be very interested in reading this community’s reaction to it.

    • BoxTurtle says:

      Anyone who says that the national “polity” is too important for Bush to be personally prosecuted for torture is a concern troll.

      Prosecutions should go where the evidence leads. An apology from Bush and an acceptance of responsability should be considered at sentancing, it is NOT a reason to “move on”. If the person who killed a small child were to accept responsability and apologize, we’d still prosecute, right?

      Boxturtle (Bush will one day answer to God. Bush won’t like it)

      • bobash says:

        I agree with you and disagree with Sullivan’s position on prosecutions, which is admittedly central to his letter. But the rest of his plea to Bush is pretty good summary language, fodder for opening arguments from the prosecution I would think.

        The only acceptable solution for those who bow to national polity (still?–after this summer?) is a presidential pardon, to be issued only after an admission of guilt and enough media exposure from the trials for all reasonable Americans to know just how criminal these perps were.

        bobash (hoping you’re right about the hereafter)

      • bobschacht says:

        Anyone who says that the national “polity” is too important for Bush to be personally prosecuted for torture is a concern troll.

        And that would be who? Obama? I don’t see it in what bobash wrote.

        Bob in AZ

  6. earlofhuntingdon says:

    The GOP position on not insuring aliens is typically self-destructive. Like all of us, they are still prone to life-threatening accident, they still “walk among us” capable of being afflicted with communicable disease, they still provide the agricultural, construction, and yard care workers, the cleaners, landscapers, dry wallers and home care workers upon which a considerable portion of our economy depends. Even the Germans treated their Turks better.

    Undocumented workers live and drive more safely than average, to avoid being seen, yet work at filthier, more dangerous jobs. They are a boon to the public economy in many ways, but one achieved by outsourcing the risks onto them. I thought the GOP’s beloved Chicago School was all about properly internalizing the costs of one’s behavior, not externalizing it, so that actors can make correct economic choices? Never mind. I forgot that inconsistency and hypocrisy to them are features, not a flaws.

    Insuring undocumented workers would be smart public health policy and smart economics, despite the short-term cost. That’s too much to ask of Republicans. It would be an admission that it is often the wealthy who take advantage of their undocumented status, an advantage that would go away if they admitted they were here. It’s all rather like a script from the X-Files, isn’t it?

  7. earlofhuntingdon says:

    Expect that payroll deduction clause to be in the next No Credit Card Left Behind bankruptcy reform legislation. Heaven knows they’ll need it to stave off bankruptcies themselves, having sold so much credit to the destitute and have depleted their meager resources with planned ”penalty” fees and interest rates that would make Al Capone blush. So much for wanting to keep Big Brother out of our homes and pocketbooks, eh?

    As with Social Security and income taxes, mandated payroll deductions should be restricted to those funds that go directly to the government, to fund government administered programs. As you point out, allowing them to be redirected to private enterprises would be going for the nuclear option and the start of a financial war to be the first to grab the increasingly limited resources of increasingly more desperate middle class payers.

    If the Dems had a spine, they would kick Baucus out of the party. Instead, he’s seen as carrying Blue Dog ’Bama’s water on this bill.

  8. TheraP says:

    Between social security deductions and the 13% for medical insurance, that’s over 20% going to the govt BEFORE income tax is deducted! And if the poor soul happens to be self-employed (and not pulling in a whole lot), the hit is 28%! (15% for Social Security and 13% for medical) How nice!

    The injustice here is beyond belief! Especially if you have any medical bills, which result in deductibles and co-pays.

  9. cinnamonape says:

    Marcy- Great Job…but I’m beginning to wonder if the illegal immigrants aren’t getting the better deal here by not being covered at all.

  10. TarheelDem says:

    The Secretary would be required to estimate, on an average actuarial basis, the basic per enrollee, per month cost of including coverage of abortions beyond those permitted by the most recent appropriation for the Department of Health and Human Services under a basic plan.

    Is this one of the Republican parts so that they can scream about the plan paying for abortions?

  11. ScoutFinch says:

    I read recently that Mexico is in the middle stages of establishing their own NHS. Maybe we can all go down there for care – it would be cheaper, I’m sure!

    I did inform my Senator of this fact and how very tragic it would be for America to be surrounded on all sides by countries that actually care about their people while the wingnuts dither in WA.

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