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Tucked deep inside the Senate health reform bill - beginning on page 1,926 - is a plan for a new federal insurance program. Average premiums could be as high as $180 per month and could be automatically deducted from the paychecks of some American workers. The nonpartisan Congressional Budget Office (CBO) predicts this new program would "add to budget deficits ... by amounts on the order of tens of billions of dollars." This is not, however, the so-called public option that is the focus of much heated debate on Capitol Hill. It's an entirely different Democratic plan...
...ripe for mischaracterization. For instance, to prevent people from purchasing long-term-care coverage when they are already in need, the CLASS Act requires that enrollees be employed and pay into the system for five years before becoming eligible to collect benefits. But because the CBO evaluates the costs of legislation - like the Senate reform bill - based on 10-year periods, the CLASS Act - which would begin collecting premiums in 2011 but wouldn't begin payouts until 2016 - appears to generate $72.5 billion in savings between 2010 and 2019. On paper, these savings are used to offset spending...
...opponents are just as guilty of fiscal shenanigans. It's true, as Thune pointed out, that the CBO says the CLASS Act will increase budget deficits in the long term, but that's only because of the peculiar way the deficit is calculated. Premiums collected would be invested in federal securities, and when the interest earned is transferred back to the CLASS Act trust fund, the transaction would be recorded as an increase in the deficit. The Senate bill also requires that the CLASS Act trust fund be solvent over a 75-year period, and the bill would give...
...already authorized $1.1 billion for the field.) And yet as Diana Buist, a researcher at Group Health in Seattle who received some of the stimulus funding, says, "[Comparative-effectiveness research is] a hard sell. It always has been." According to a 2007 Congressional Budget Office (CBO) report on the topic, "Some experts believed that less than half of all medical care is based on or supported by adequate evidence about its effectiveness." Instead, said the CBO, health care in the U.S. is often motivated by factors like "enthusiasm for the newest technology" and a fee-for-service payment system that...
...CBO says both the House and Senate versions of the bill would cut the deficit in the long run. But even the CBO acknowledges that its predictions are highly uncertain and based on forecasting models that assume that most of the bill's untested reforms will actually work. To skeptics, that seems too good to be true, especially with millions of new patients coming into the system. While families' health bills may go down, they say, costs for the government - and ultimately taxpayers - are sure to rise. "I find near unanimity of opinion that, whatever its shape, the final legislation...