Health Care Experiments

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The DLC just sent out an email highlighting some of the recent healthcare initiatives being proposed in Montana, the sort of thing that could possibly serve as a model for the nation at large:

Montana’s new small-business program… will provide direct financial assistance for health care insurance premiums to offset the high insurance costs facing smaller businesses and the large number of low-wage workers in smaller firms. The assistance will be targeted at very small businesses (under 10 employees) and will be more generous for low to moderate-income employees.

These businesses will be able to purchase the coverage through a purchasing pool that can negotiate a lower price with insurance companies, a proposal advanced by Governor Brian Schweitzer. Insurance companies may be willing to offer a lower price because the premium assistance will make coverage affordable to most employees, and in turn, will help solve one big problem in today’s small group insurance market: the tendency of small businesses to buy insurance when they have workers who are sicker and need the coverage. Insurance companies charge extra when they are likely to enroll sicker workers….

In Montana’s purchasing pool, employees and dependents who are eligible for Medicaid or the Children’s Health Insurance Program will be automatically enrolled as part of their job-based coverage in order to maximize federally matched funding.

Finally, Montana will offer a tax credit to small businesses who currently provide coverage but who are struggling to afford it. This tax credit will send those businesses an important message to keep up the good work.

Now I have doubts that some of these proposals will work, especially that purchasing pool. (Studies have shown that similar programs, known as Association Health Plans, either have a very small impact on covering the uninsured or, paradoxically, increase the number of uninsured. Read this for the gory details.) Nevertheless, this is precisely the sort of thing that should be tried out on a state level, to see what works and what doesn’t, so that when this current batch of Republicans get kicked out of office and we can finally get serious about health care reform, we have some models to examine. Another “laboratory of health care” to watch will be Gov. Christina Gregoire’s proposal in Washington to restrain costs by eliminating waste. Again, I’m skeptical that in practice you can really eke that many health savings out of “information technology,” but why not give it a shot?

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SIX TRUTHS

Reclaiming power from those who abuse it often starts with telling the truth. And in "This Is How Authoritarians Get Defeated," MoJo's Monika Bauerlein unpacks six truths to remember during the homestretch of an election where democracy, truth, and decency are on the line.

Truth #1: The chaos is the point.

Truth #2: Team Reality is bigger than it seems.

Truth #3: Facebook owns this.

Truth #4: When we go to work, we're in the fight.

Truth #5: It's about minority rule.

Truth #6: The only thing that can save us is…us.

Please take a moment to see how all these truths add up, because what happens in the weeks and months ahead will reverberate for at least a generation and we better be prepared.

And if you think journalism like Mother Jones'—that calls it like it is, that will never acquiesce to power, that looks where others don't—can help guide us through this historic, high-stakes moment, and you're able to right now, please help us reach our $350,000 goal by October 31 with a donation today. It's all hands on deck for democracy.

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