The Good, the Bad, and the Ugly of ObamaCare

Everything you need to know about President Obama's just-unveiled health care plan

President Obama unveiled his health care reform plan Monday morning. Forged as a compromise between the Senate and the House, and to a lesser extent between Democrats and Republicans, it will be debated at Thursday's bipartisan summit. We explored the mostly-positive reaction to one high-profile proposal for insurance regulation. Here are quick takes on the nitty-gritty of ObamaCare.

The Good

• Covers 31 Million Americans  As many pundits note approvingly, Obama's plan will provide health insurance coverage to an additional 31 million Americans.

• Tougher Anti-Fraud Measures  The Atlantic's Marc Ambinder says it's bipartisan. "Includes significantly ramped up efforts to crack down on waste and fraud within the Medicare/Medicaid systems -- this is a nod to Republicans (Peter Roskam and Mark Kirk are behind proposals to do just this)."

• Better Coverage For Poor  The New Republic's Jonathan Cohn writes, "The House bill offered more assistance to low-income people buying coverage through the insurance exchanges. Obama is proposing to improve the Senate's financial assistance, so that it more closely approximates the House's numbers."

• No More Cornhusker Kickback  The Washington Post's Ezra Klein notes that no one supported the special deal cut by a Nebraska Senator to give his state extra funding. The provision was a "distraction" that hurt the politics of reform.

• Medicare Cost Controls  The New Republic's Jonathan Cohn says Medicare Advantage "famously pays private insurers serving beneficiaries too much money, at least in eyes of most experts." Obama's plan will reduce those payments substantially, as the House plan proposed.

• Good Publicity  The Washington Monthly's Steve Benen notes that, according to poll data, the more that Americans know about health care reform, the more they like it. So every high-profile unveiling like today's or even like Thursday's is a step forward for the politics of reform.
  

The Bad

• 2014 Start Date  Most reforms won't kick in until then, leaving Democrats politically vulnerable in the meantime, as many pundits note. After all, how can you campaign on reform that hasn't done anything yet?

• No CBO Score  When the Congressional Budget Office "scores" a bill it determines its cost. The CBO scored earlier proposals as bringing in more money than they spent, greatly aiding reform's political prospects. But as Chris Bowers at OpenLeft writes, Obama's proposal has not yet been scored so lacks the CBO seal of approval.

• 'No Big New Concessions to Republicans'  So evaluate The New York Times' Herszenhorn and Stolberg. If this becomes political conventional wisdom, it could make it tough for Obama to sell the plan as truly bipartisan.

• Mandate Penalty Increase  Consumers who refuse to buy health insurance would be penalized under all the plans. But Obama has raised the penalty from 2% of annual income to 2.5%. Liberal blogger Jane Hamsher warns, "But for months now, polling has shown that a mandate with no public option is an extremely unpopular combination. The annual penalty for failure to comply makes it even more unpopular in swing districts."

The Ugly

• No Public Option  The much-debated provision championed by liberals is out. Think Progress's Igor Volsky worries this could cause some House Democrats to drop their support.

• Senate to Use Reconciliation?  Democrats are planning to use the parliamentary procedure to lower the necessary vote threshold from 60 to 50. "This means that the entire Democratic leadership is now on board with the reconciliation process," writes Open Left's Chris Bowers. But so far only 34 Senators support using reconciliation.

• Closes Medicare Part D 'Donut Hole Gap'  The controversial policy implemented under Bush requires seniors to pay for medications out of pocket above a certain amount. The Atlantic's Marc Ambinder suggests this is "something seniors should notice before the November 2010 elections if this gets through Congress." That is, this provision could finally secure the support of seniors, although it will drive up costs for everyone else.

• Excise Tax in 2018  The tax on the most expensive tier of health care plans has been especially controversial among labor unions, which say it will disproportionally effect workers with dangerous jobs. Obama's plan "keeps excise tax, but does not implement it until 2018.  Labor is still studying the proposal, and has not endorsed it yet," writes Open Left's Chris Bowers.

• $1B To Federal Govt  The Atlantic's Marc Ambinder finds "the bill gives the executive branch $1 billion to help efficiently implement the plan." It may be necessary, but how will it look?