So Max Baucus is preparing to announce his own plan, along these lines:

  • Mandate
  • Some penalty for employers who don't buy health insurance for low-wage workers
  • Medicaid up to 133% of the poverty line
  • Tax credits for buying insurance up to 300% of the poverty line
  • Taxes on cadillac coverage that greatly exceeds the national average
  • Guaranteed issue
  • Something close to community rating

His price tag is somewhere in the $900 billion range.

I'm not seeing it.  The unions hate taxes on cadillac coverage, and it's not going to be exactly popular in high-cost states like New York and California, where there are a lot of Democratic house members who have to vote for this thing.  Cutting off the subsidy at an income of $66,000 for a family of four is also going to be worrisome for high cost states, since in the New York Metro area, that's less than the combined income of a small firm secretary and a moderately well paid delivery truck driver.

Meanwhile, $900 billion sounds a lot like $1 trillion--and it will be hard to do through reconciliation, because the deficits explode after the ten year window.  The need to keep it in the window is why the Bush tax cuts sunset next year.  I'm not sure Democrats want a plan that runs for six years and then abruptly stops unless someone finds the money to pay for it.

But I'm sure that to reform proponents, I just sound like one of the nattering nabobs of negativism.