The Baucus Plan

Sen. Max Baucus chairs the powerful Senate Finance Committee. As the committee which oversees Medicare and Medicaid, it has a key role in any health reform efforts. Baucus, a moderate, was seen by some as a potential obstacle to reform, but he took a leading position on the issue when he issued the Baucus plan in November.

The Baucus plan is similar in many respects to the proposals offered by Barack Obama during the campaign - it seeks build on the current employer-based system and achieve universal coverage, cost containment and quality improvement.

Unlike the Obama plan, it contains an "individual mandate" - all Americans would be required to buy health insurance once affordable coverage was available. Also unlike Obama, it looks to change the current system under which employers get a tax deduction for buying policies but individuals don't - potentially a serious negative. However, it doesn't specify exactly how the tax code would be changed.

Here's how the Baucus plan addresses CWA's five principles for health reform:

Cover everyone Employers (except for the smallest) would have to offer coverage or pay into a fund. Once affordable coverage is available, all individuals would be required to buy it. Would offer tax breaks to individuals who buy coverage and make less than four times the poverty level (currently $84,800 for a family of four). Would offer tax breaks (varying by size of business and income level of workers) to small businesses who cover their workers. While an insurance exchange is being set up to provide affordable policies, people from 55 to 64 could buy into Medicare. Medicaid would be expanded to cover all Americans below the poverty line.

Control costs Hopes to reduce costs over time by paying doctors more for preventive care and management of chronic conditions. While primary care doctors would be paid more, specialists would be paid less. Would provide more long-term care in the community rather than nursing homes. Recognizes there would be upfront costs to reform, but sets goal that "after ten years, the U.S. would spend no more on health care than is currently projected," but everyone would be covered.

Strong government role A national insurance exchange would provide easier shopping. Participating insurers wouldn't be able to deny coverage to the sick, and would be limited in how much they could raise premiums for older or sicker people. An "independent Health Coverage Council" would set and oversee many of the details of the new system, such as how to define comprehensive and affordable coverage.

Improve quality Create incentives for hospitals and doctors to provide appropriate and effective care. Increase public reporting on quality measures for doctors and hospitals. Monitor quality for private insurers who provide Medicare coverage. Create a new national institute to test effectiveness of drugs, procedures, devices and other treatments. Look at government training subsidies to train more doctors and other clinical staff.

Broad-based financing Would collect fees (size not specified) from companies that don't offer coverage. Would look to generate savings over time through better prevention and elimination of unneeded or ineffective treatments. Would look to change tax treatment of benefits, perhaps tying tax deductibility to a sliding income scale, perhaps capping the amount that workers could receive tax-free. The latter, while not as harsh as John McCain's plan to tax all health benefits, would place a real penalty on workers - such as many CWA members - who receive the best coverage from their employers.

Read the Plan