To those routinely slamming Obama's efforts and the public option and declaring the bill dead,

HEALTH REFORM AT A GLANCE:THE HEALTH INSURANCE EXCHANGE

• Give people the ability to choose from a variety of plans — including a new public health insurance option.
  
  
• Provide standardized benefit packages so that people will be able to comparison shop and make informed choices based on cost and quality.
  
  
• Plans compete locally—so small plans and national plans have an equal opportunity to offer coverage.

• To ensure that health care is affordable to people of all incomes, new affordability credits will be available for people purchasing through the Exchange. They will assist people with incomes up to 400% of the federal poverty level ($43,000 for individuals or $88,000 for families of four) and phase-out on a sliding scale basis.
  
  
• Includes a cap on premiums and out-of-pocket spending. Regardless of income, everyone will be protected, so no one will face bankruptcy due to medical expenses.

• Bring transparency to the health care marketplace, so that families know what benefits their plan covers and what it will cost them.
  
  
• Require plans to explain their coverage in plain language, so that consumers can make informed choices about their medical care.

• Allow consumers to choose coverage among several standard benefit packages.
  
  
• Provide comprehensive health care services with different levels of cost sharing.
  
  
• Include a Premium Plus plan through which people will have options to purchase coverage for additional health care benefits that are not included in the core benefit standards.

• Health Insurance Exchange is opened to small employers first (those with 10 or fewer employees in the first year, and 20 or fewer in the second year) and to larger employers over time.
  
  
• Offers opportunity to small employers through the Exchange to provide their employees with broad choices for coverage and to be able to eliminate the administrative costs of maintaining their own health plan contracts.

A Strong Public Option

• HHS-based plan: The Community Health Insurance Option would be run by the Department of Health and Human Services. The government would pay for the first three months of claims as a way to capitalize it; this would be a loan to be repaid over time. For the first two years and longer if necessary, this strong public option would also qualify for “risk corridor protections” which offset or reclaim excessive losses and gains which could result during the start-up period (identical to those in Medicare Part D). Subsequently, its premiums would be set to make it self sufficient. This would make the public health insurance option quickly available in all areas of the country.
  
  
• Plays by the same rules: The public option would be one of the Gateway choices. It would follow the same rules as private plans for defining benefits, protecting consumers, and setting premiums that are fair and based on local costs.
  
  
• Provider payments and participation:
  
  
  • Negotiated rates within limits: The payment rates paid by the public option would be no more than the local average private rates – but could be less. The Secretary would negotiate these rates.
    
    
  • Input from Advisory Councils: Each State would create a Council of provider and consumers to recommend strategies for quality improvement and affordability. States would share in the savings that result.
    
    
  • Purely voluntary: Health care providers would have the choice of participating in the public option; there would be no obligation to do so.

• Pooled purchasing power: This public option can pool the purchasing power of its enrollees nationwide to leverage lower prices to compete with private plans. Similar negotiation power has been used by states to get drug rebates in Medicaid beyond the statutory minimum. It has been used by large businesses to drive delivery system change. This negotiation would be backed by a ceiling of paying no more than average local rates.
  
  
• Flexibility and incentives to innovate Unlike administered pricing, the negotiation for payment rates gives the Secretary the ability to quickly and aggressively promote payment policies that promote quality and best practices. In addition, the State Advisory Councils would tailor delivery system reform for the public option, with a financial bonus for success.
  
  
• Lower administrative overhead: The public option would not need to raise premiums to support shareholder profits, extensive marketing, and extra risk reserves required by require to protect enrollees from plan insolvency or mismanagement of funds.