Imagine my surprise to see that 3 major compromises being worked out in health care reform all actually improve reform as it stands at the moment.
1. The excellent Federal Employees Health Benefits Program (FEHBP) will be used as the exchange model so that well-regulated private insurance in a FEHBP-like exchange with community rating will bring the far-superior Federal Employees types of insurance to the individual and small group market. This is a much better alternative than less-regulated exchanges with very weak public options.
2. The "health benefits ratio", aka "medical loss ratio" -- the portion of annual health insurance premium income insurers pay out for actual health care -- sounds like it will be regulated to be 90%. This is an excellent number. Vastly better than the 80% we heard only a week or so ago. Compare this ratio to the current average of 80% in the private market (and less in the individual market), and compare to average payout ratios that were above 90% during the 1990s.
3. Perhaps one of the most dramatic improvements possible: Instead of expanding the stigmatized Medicaid so broadly (as previously proposed to everyone up to 150% of poverty level), Medicare itself would be opened up for buy-in to everyone 55 and older (instead of only available at age 65 as now). Individuals age 55 to 64 could pay premiums to buy-in to Medicare coverage (with low-income people still receiving the previously proposed premium subsidies.) The significance? Medicare is highly cost-efficient, with a "health benefits ratio" between 94-97%. This means reform gets more bang for the buck, and thus the premium subsidies can be more sustainable.
These are just simply very, very good outcomes.
I would not have dared to hope for such good compromises.
Those who like to write Congress might find it a good moment to say "Yes!" to their representative and Senators on this compromise.