The House Bill appears to mandate:

1. public option
2. 85% payout of premiums
3. regulator approval of premium increases

However it's not all bad news and the devil is in the detail.

So the rub is:

1. The public option is only available to members buying on the exchange which is only available for uninsured individuals or employees of companies under 100 employees. This is less than 25% of the entire market. In theory the firm size threshold could be progressively increased or even decreased growing or shrinking the market.

2. The public option is based on negotiated rates and a level playing field. If the gov't manages to procure better then the larger HMO's will also enjoy these same rates based on industry standard MFN clauses.

3. Reading the legislation the purported 85% mandated payout appears to only be a transition arrangement until the insurance exchange starts when it sunsets.

4. Approval for premium increases is unfortunately exactly what it is but I am unsure whether it applies to the entire market or just the insurance pools purchased on the exchange.

If I have my wires crossed then happy to stand corrected...if someone else can confirm or deny this I would be delighted to hear.

And this is meant to be a bill that will kill HMO's...don't think so...and it's only going to drift to the right.