OK...they call the amount spent on claims "medical loss ratios". Nice.
They will be have that ratio be 80 or 85%, much lower than it is now for all but big employers. If the 85% premiums is not spent on medical care the difference must be refunded to members of the plan.
Currently guidelines from the National Association of Insurance Commissioners says MLRs must be minimum 50-60%
Some states have established MLRs but not as high as these bills. (House bill has 85%)

There are so many regulations and they needed more without the simpler check of a strong public option. Revised Senate bill has over 400 pages of regulations, including on price increases.
They will all depend on oversight and enforcement

Then the comment
"We voted for single payer." Really? We voted for Dennis Kucinich? He was the only advocate of single payer.

Who is this "we" that wants no part of it?
The millions who can't get insurance now because of preexisting conditions? The insured and uninsured forced into bankruptcy by medical debt? Those who have reached the lifetime limit in treatment for their condition?

So we are very unlikely to get the public option now. That sucks. The weak po of the senate sucked too.
But people with incomes up to 400% of poverty level will get some help. That is
$43,320 for single
$58,280 couple
$73,240 family of 3
and so on)
There is a cap on what people pay in premiums and subsidies cover the rest.
At lowest end (after those who go on Medicaid) their share is 2.8%
At the top it is 9.8%
It's 4 or 6% at levels between.
Which also sucks but is an improvement for most.

Another help is the out of pocket cap. Still too much but will avoid medical bankruptcy. Those earning less than 22K (single) will pay no more than 2,000 out of pocket, at 33 K it is 3K, at 44 K it is 4K and so on, maxing out at 5,900

Might not help much for most who don't see doctor often or have some big crisis. It will be a huge help for those who do need some expensive care for accident or illness.

One thing this bill will do right away is stop bias against children with preexisting conditions... and set up some federal pool for adults with conditions to use until exchange kicks in. Banning rescinding policies will be almost immediate
Hoping the exclusion is eliminated for everyone sooner.

There will be no copay on many preventative services/tests or for well baby care. If you find out for free you have cancer, diabetes, heart disease then probably you will find you can afford the 20 or 30% copay to get treatment. (That only goes until you reach your pout of pocket cap and then there is no copay)

The exchange won't be a mish mash of crap policies, they will have to meet standards, at least one choice will be non-profit. There will be standard for basic benefit packages, labeling of products based on comprehensiveness, standardized definitions between plans of product services.
Reid is/has been working with Consumers Watchdog, American Cancer Society and other patient advocacy groups to close loopholes.
This is so much better than what is available now, so much better for so many. It isn't close to what we want.
We'd better change Senate rules if we ever want that and I wasn't thinking of that 60 vote thing. I was thinking of how much money they can take from lobbyists. They outnumber congress 5 to 1 and average daily spending by health lobby over last 2 years is $860,000 per day and lobbyists become senate staffers and vice versa. How is that even legal? But we just have to accept "It doesn't affect my vote/bill amendment". We could write a far better bill...but we also have to pass it. Yes bush got bill through with smaller majority but his policies were on the side of big money! Not a big challenge.
That will haunt us and stop real reform on every major issue we face.

So we could have done so much better and we keep fighting to make it better...but there is so much to be glad for now. I've been reading how other countries got to their current coverage and it was not in one step, not even close. Anyone who doesn't think this is a huge step forward may bot have actually read what this contains.