In order to draw the Republicans to the table, he has offered a nominal budget that offends a swath of his own party. It probably offends him, as well. But it gets the ball rolling.
That said, I expect this much of the budget will not change a lot: I expect that the final budget will cause high income couples to pay more for doctors’ visits and medicine, from their own pockets — instead of from government subsidies. Even so, high income families are far more likely to have private insurance, and thus will be less likely to see these increases in deductibles and co-pays appear in their private plans.
So, as the New York Times reports this morning, HHS Secretary Sebelius still expects between $1.5 billion and $2 billion to be available in 2013-2014 for the state health care exchanges; and that number will likely rise to closer to $4 billion by early 2015.
Much of the increase in the cost of these exchanges (as we’ve earlier noted) is directly attributable to the small-minded, provincial decision-making underway in the southern states led by Republican governors — Tennessee, Florida, Texas and Ohio (not truly a southern state, but you get the idea, here) among them.
A bit from The New York Times — do go read it all, then:
. . . .Kathleen Sebelius, the secretary of health and human services, said Wednesday that the president was requesting $1.5 billion to operate health insurance supermarkets, known as exchanges, in 2014. In addition, the administration plans to raise $450 million by charging insurance companies fees to sell their products to consumers and small businesses in the exchanges. The federal government will have the primary responsibility for operating the exchanges in more than 30 states.
The largest share of the new payments by Medicare beneficiaries, $50 billion over 10 years, would come from additional premiums paid by high-income people for coverage of doctors’ services and prescription drugs. . . .
We will keep you — as ever — posted. I applaud the way the President is using the budget negotiation process to deftly pin these recalcitrant Republicans to the mat, on their refusal to pass legislation that would plainly be good for their constituents — but would also violate the ludicrous campaign promises many of the Tea Party influenced politicians made — while running for office. Smart. Smart. Smart.