BAUCUS BILL (2009):
- No public option.
- Estimated 94% of Americans will be covered.
- No government benefits for illegal immigrants.
- Plan funded by fees from insurance companies, drug makers, device manufacturers, addtional taxes on the insurance companies, cuts to medicare and medicaid, and fines for individuals who do not sign-up for insurance.
- Everyone must get coverage on their own or through their government plan, employer. With some exceptions for economic hardship individuals must have covership as long as it costs less than eight percent of your income.
- Employers are not required to offer coverage (benefits to those that do)
- Tax credits for individuals and families who make up to 400 percent of the federal poverty level.
- Forty percent tax on "Cadillac" health plans.
- No denial of coverage based on pre-existing conditions.
- State-based purchasing pool for small businesses and self-employed.
HOUSE BILL (2009):
Overall Mandate:
Require most individuals to have health insurance. Create a Health Insurance Exchange through which individuals and smaller employers can purchase health coverage, with premium and cost-sharing credits available to individuals/families with incomes up to 400% of the federal poverty level (the poverty level is $18,310 for a family of three in 2009). Require employers to provide coverage to employees or pay into a Health Insurance Exchange Trust Fund, with exceptions for certain small employers, and provide certain small employers a credit to offset the costs of providing coverage. Impose new regulations on plans participating in the Exchange and in the small group insurance market. Expand Medicaid to 150% of the poverty level. ("Side-by-Side Comparison of Major Health Care Reform Proposals Share," 2009, Kaiser Family Foundation)
SENATE BILL (2009):
Overall Mandate:
Require most U.S. citizens and legal residents to have health insurance. Create state-based American Health Benefit Exchanges through which individuals can purchase coverage, with premium and cost-sharing credits available to individuals/families with income between 100-400% of the federal poverty level (the poverty level is $18,310 for a family of three in 2009) and create separate Exchanges through which small businesses can purchase coverage. Require employers to pay penalties for employees who receive tax credits for health insurance through an Exchange, with exceptions for small employers. Impose new regulations on health plans in the Exchanges and in the individual and small group markets. Expand Medicaid to 133% of the federal poverty level. ("Side-by-Side Comparison of Major Health Care Reform Proposals Share," 2009, Kaiser Family Foundation)
WHITE HOUSE BILL (2010)
New York Times writers David Herszenhor and Sheryl Stolberg state that the "the new plan is largely a compromise proposal aimed at bridging some of the extremely thorny policy disputes that kept Congressional Democrats from finalizing their legislation before the victory by Senator Scott Brown in the Massachusetts special election in January upended the vote count in the Senate" (Herszenhor & Stolberg, 22 Feb. 2010).
Mr. Obama’s proposal — the first time the president has provided a detailed road map for what he wants a health overhaul to look like — is the opening act to a week of high drama that will culminate on Thursday [25 Feb. 2010], when the president convenes Democrats and Republicans at an all-day televised health care “summit” at Blair House. The White House is hoping the session can jump start the stalled health bill. (Stolberg & Herszenhor, 22 Feb. 2010).Plan Summary (Reuters)
- State-based insurance exchanges (similar to Senate-passed bill)
- No call for government controlled health insurance program (public option/included in House bill)
- Maintains Senate version: OPM negotiates with private insurers to provide multi-state health plans.
- Raises the Medicare tax on high-income earners to 2.9 percent (from 2.35 percent) (adopts Senate approach)
- "Cadillac" tax for plans costing $10,200 for individuals and $27,500 for families, beginning in 2018 (rather than 2013, the original date on the Senate bill).
- Higher tax thresholds for companies that employ mostly women or older workers. Higher thresholds for high-risk professions such as firefighters.
- Increases new assessments on brand-name pharmaceuticals to raise $23 billion over 10 years.
- Closes tax loophole on a cellulosic biofuels credit to prevent it from being used for a paper processing byproduct.
- Improves affordability to help both low- and moderate-income families. A family of four earning as much as $88,000 a year would receive federal assistance in paying for healthcare costs.
- Closes "doughnut" hole in Medicare prescription drug coverage. Current Medicare plan: stops paying for drugs after $2,830 is spent; coverage reinstated only after out-of-pocket spending reaches $4,550. Obama plan will close the covergate gap by 2020.
- Young adults up to the age of 26 can stay on a parent's health insurance plan. Within months of enactment, insurers will be barred from dropping people from their health plans.
- In 2014, insurers will be barred from excluding people for pre-existing conditions and setting annual and lifetime coverage limits.
- The Department of Health and Human Services will get new authority to help states review annual premium rate increases.
- Individuals are required to purchase health insurance (accords with Senate and House bills).
- No employer mandate and assessment fees on uninsured companies with employees receiving subsidized health policies on the exchange - fees modified (sides with the Senate bill).
- Small firms (fewer than 50 employees) will be exempted from above requirements. Tax credit available to encourage small companies to offer health coverage to workers.
(Reuters, 22 Feb. 2010)
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