Public Plan Dead After Senate Committee Vote? Not by a Long Shot.

The public is proving to be a fickle bunch when it comes to their support for healthcare reform. The latest Kaiser Health Tracking Poll shows the public support for health reform ended its summer slide, reversed course and moved modestly upwards in September.

The survey showed that fifty-seven percent of Americans now believe that tackling health care reform is more important than ever — up from 53 percent in August. The proportion of Americans who think their families would be better off if health reform passes is up six percentage points (42% versus 36% in August), and the percentage who think that the country would be better off is up eight points (to 53% from 45% in August).

Changes occurring among Republicans and Independents

What’s even more interesting is the upswing in support has been driven by changes among Republicans and Independents. While these groups were markedly more pessimistic about health reform in August, their viewpoints had softened by September. While 49 percent of Republicans say their family would be worse off if health reform passes, this is down from 61 percent in August. The percentage of independents saying they would be worse off fell from 36 percent in August to 26 percent this month

While the survey seems to indicate that support for some kind of reform is growing, it also shows no sense of urgency to get it done. Forty-seven percent favors taking longer to work out a bipartisan approach to health reform, compared to 42 percent who would prefer to see Democrats move faster on their own. Meanwhile, the public continues to view the action in Washington with mixed feelings: The largest share (68%) said they were “hopeful” about reform, but 50% are “anxious” and 31% “angry.

Perhaps what is causing this “hopefulness” about healthcare reform, is that Americans continue to struggle with the affordability of health care. One third of Americans (33%) say they or someone in their household has had problems paying medical bills over the past year. That is up nine percentage points from August and represents the highest level this measure has reached in nearly a year, according to Kaiser.

A majority of Americans (56%) also say they have put off care over the last 12 months because of cost reasons, with many saying that they had relied on home remedies or over the counter drugs instead of seeing a doctor (44%), skipped dental care or other checkups (35%), or skipped a recommended medical test or treatment (28%).

Because of these coverage gaps it is not surprising that the reform component that draws the srongest support across the political spectrum is requiring that health insurance companies cover anyone who applies, even if they are sick or have a pre-existing condition. Overall, 8 in 10 people support that idea, including 67 percent of Republicans, 80 percent of independents and 88 percent of Democrats.

Discussion always comes back to who will pay?

As always, these discussions inevitably lead to the question of how to pay for this additional coverage. Two ideas now under discussion among policymakers garner initial majority support among those surveyed. Fifty-seven percent of the public say they would support “having health insurance companies pay a fee based on how much business they have” and 59 percent would support “having health insurance companies pay a tax for offering very expensive policies.” In both cases, Republicans are evenly divided while Democrats and political independents tilt in favor

What this seems to imply is that the public thinks we should all pay a little more for our insurance coverage, so more can be covered and we will. The Baucus bill now being marked-up by the Senate Finance committee includes a 40% excise tax on insurance plans that exceed $8,000 for a single and $21,000 for a family plan. While these may seem like “Cadillac” plans today, by 2013 when the tax kicks in a majority of plans will probably qualify. The Kaiser Family Foundation said that family coverage reached an average of $13,375 in 2009 — a hike of 5%, or $695 — while single coverage premiums increased by $120 to reach an average of $4,824 annually, an increase of less than 0.3%.

In another six years, plans that are projected, with inflation, to cost $25,000 a year will run $35,000 after the tax is tacked on. If these prices do not send employer plan sponsors running for the exits, they will be looking to cut back on benefits or wages, or both. So the average plan today will soon become tomorrow’s “gold plated” plan. When this happens expect a renewed cry for a public option or single payer system – the ole’ government bailout.

So while yesterday’s vote in the Senate Finance Committee to not include  a Public Option was received as a repudiation of the idea, it was really just a delaying tactic to lull the public onto the inevitable path to a single payer system.

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