Jonathan Zasloff's defense of using budget reconciliation for health care?
First, Ezra's assertion that the reconciliation rules ban health care reform is at best unproven and contrary to the plain language of the law. Those rules bar putting things in a reconciliation bill that have only an "incidental" effect on the budget. But, say, prohibiting discrimination against pre-existing conditions would have more than an incidental effect. Such a move, for example, could save billions from Medicaid, because it would allow people to get insurance in the private market who might otherwise have to go to Medicaid.
As far as I know, Medicaid eligibility is generally restricted to those who are pretty low income. And the waiver-program premia are usually lower than any private entity would charge, even in Europe. With community rating, the prices of private insurance will go up even further. What the heck is Zasloff talking about? How many people does he really think are quiting their jobs and deliberately impoverishing themselves in order to qualify for Medicaid, rather than earning an income which can support the $350 or so per person that gets charged for an HMO in a community-rated state like New York with generous mandatory benefits? I'm sure that there are enough for an enterprising New York Times reporter to write a trend piece, but enough to make a noticeable dent in the budget? The best ways to get Medicaid are to go on welfare, or disability. Both of which imply insufficient income to buy insurance. Or substantial fraud.
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