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We now know what the president wants in a health care bill. For the first time in the year-long debate, Mr. Obama released his own vision of what a health overhaul would look like. The White House called the presidents blueprint, unveiled yesterday, an opening bid for a summit meeting this week with Congressional Republicans and Democrats. It largely follows the health care bill passed in the Senate, as NPRs Scott Horsley reports.
SCOTT HORSLEY: Much of the money in the presidents $950 billion health care plan would pay to extend health insurance to those who dont have it now. But President Obama is also trying to sell his plan to the majority of Americans who do have coverage.
President BARACK OBAMA: Even if youve got health insurance, whats happened to your premiums lately?
HORSLEY: At a town hall meeting in Nevada last week, Mr. Obama hammered away at the example of a California insurer, Anthem Blue Cross, that threatened to raise premiums by up to 39 percent this year. The White House says that kind of rate hike is just the tip of the iceberg.
Pres. OBAMA: No matter what your situation, I guarantee you your costs have gone up at least double digits over the last year.
(Soundbite of applause)
Pres. OBAMA: They have doubled over the last decade. And theyre going to more than double over the next decade if we dont do anything.
HORSLEY: What the presidents plan would do is give the Health and Human Services secretary power to review insurance premiums and reject those deemed unreasonable. The idea was first proposed by California Senator Dianne Feinstein, who complains profits at the five biggest private insurers jumped more than 50 percent last year.
Senator DIANNE FEINSTEIN (Democrat, California): The big publicly owned medical insurance companies have gotten very greedy, and their profit margins are enormous.
HORSLEY: The health insurance industry argues that its profits represent a tiny fraction of overall health care spending. Karen Ignani, who heads the trade group, Americas Health Insurance Plans, says it would be wrong to regulate insurance premiums without addressing the underlying costs of doctors, hospitals and pharmaceuticals.
Ms. KAREN IGNAGNI (President and CEO, Americas Health Insurance Plans): This would be like capping the price automakers can charge consumers but letting the steel, rubber and technology manufacturers charge the automakers whatever they want.
HORSLEY: Many states already exercise some control over insurance premiums, but enforcement varies. Insurance Commissioner Sandy Praeger of Kansas says adding federal oversight could bring some helpful standardization. But, she doubts it would put a big dent in the average insurance bill.
Ms. IGNAGNI: Probably not, I think were chasing the wrong tail here. Its really about health care costs.
HORSLEY: Praeger, who is past president of the National Association of Insurance Commissioners, says her state already takes a close look at insurance premiums anytime there is a big increase.
Ms. SANDY PRAEGER (Former President, National Association of Insurance Commissioners): In most cases, the companies have been able to justify them because of the economic situation. The book of business is probably getting sicker because healthier people are just dropping out.
HORSLEY: Thats the explanation that Californias Anthem offered for its proposed increase. During the recession more healthy people decide they can skip insurance, raising the average cost for insured customers who remain. Thats where other parts of the proposed overhaul come in.
The presidents plan, like the Senate bill, would require nearly everyone to carry health insurance. Health care analyst Elizabeth McGlynn, of the Rand Corporation, says young healthy customers would effectively subsidize insurance for everyone else.
Ms. ELIZABETH MCGLYNN (Health Analyst, Rand Corporation): If you add into the mix, a fair number of people who have quite a bit lower expected health expenses, youre spreading across more people.
HORSLEY: The proposed overhaul would also create statewide exchanges, where McGlynn says individuals and small businesses could buy standardized health insurance policies.
Ms. MCGLYNN: In a way, because you can - you have a better sense of, you know, the price youre paying for insurance.
HORSLEY: Rand estimates these and other provisions of the overhaul could lower health care premiums by two to four percent over the next decade, reducing the need for the federal government to police those premiums. The governments power to regulate premiums will be most important in the next few years, before those other provisions take effect.
Scott Horsley, NPR News, Washington.
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