• Embed Doc
  • Copy Link
  • Readcast
  • Collections
  • CommentGo Back
Download
 
Side-by-Side CompariSon of major HealtH Care reform propoSalS — ls m: oc 8, 2009

Health Reform
on

This side-by-side compares the leading comprehensive reform proposals across a number of key characteristics and plan components. Included in this side-by-side are proposals for moving toward universal coverage that have been put forward by the President and Members of Congress. In an effort to capture the mostimportant proposals, we have included those that have been formally introduced as legislation as well as those that have been offered as principles or in WhitePaper form. This side-by-side will be regularly updated to reect changes in the proposals and to incorporate major new proposals as they are announced.The House Tri-Committee summary incorporates the major amendments to the legislation adopted by the three committees of jurisdiction during their mark-upsof the bill. These amendments are identied using an abbreviation for the House panel that approved it — “E&C” for the Committee on Energy and Commerce;“E&L” for the Committee on Education and Labor; and “W&M” for the Committee on Ways and Means.
Senate Finance CommitteeAmerica’s Healthy Future Actof 2009Senate HELP CommitteeAffordable Health Choices ActHouse Tri-CommitteeAmerica’s Affordable HealthChoices Act of 2009 (H.R. 3200)President ObamaPrinciples for Health Reform
Date plan announced
September 16, 2009(as amended by Committeeduring mark-up)June 9, 2009(passed by Committee July, 15, 2009)June 19, 2009February 26, 2009
Overall approachto expanding accessto coverage
Require most U.S. citizens and legalresidents to have health insurance.Create state-based health insuranceexchanges through which individualscan purchase coverage, with premiumand cost-sharing credits availableto individuals/families with incomebetween 100-400% of the federalpoverty level (the poverty level is$18,310 for a family of three in 2009)and create separate exchanges throughwhich small businesses can purchasecoverage. Assess a fee on certainemployers that do not offer coveragefor each employee who receives a taxcredit for health insurance throughan exchange, with exceptions forsmall employers. Impose newregulations on health plans in theexchange and in the individualand small group markets. ExpandMedicaid to all individuals with incomesup to 133% of the federal poverty level.Require individuals to have healthinsurance. Create state-basedAmerican Health Benet Gatewaysthrough which individuals and smallbusinesses can purchase healthcoverage, with subsidies available toindividuals/families with incomes upto 400% of the federal poverty level(or $73,240 for a family of three in2009). Require employers to providecoverage to their employees orpay an annual fee, with exceptionsfor small employers, and providecertain small employers a creditto offset the costs of providingcoverage. Impose new regulationson the individual and small groupinsurance markets. ExpandMedicaid to all individuals withincomes up to 150% of the federalpoverty level.Require all individuals to havehealth insurance. Create a HealthInsurance Exchange through whichindividuals and smaller employerscan purchase health coverage, withpremium and cost-sharing creditsavailable to individuals/familieswith incomes up to 400% of thefederal poverty level (or $73,240 fora family of three in 2009). Requireemployers to provide coverage toemployees or pay into a HealthInsurance Exchange Trust Fund,with exceptions for certain smallemployers, and provide certainsmall employers a credit to offsetthe costs of providing coverage.Impose new regulations on plansparticipating in the Exchange and inthe small group insurance market.Expand Medicaid to 133% of thepoverty level.President Obama outlined eightprinciples for health care reformin his FY 2010 Budget overview.The President has indicated thatcomprehensive health reform should:•Reduce long-term growth ofhealth care costs for businessesand government.•Protect families from bankruptcy ordebt because of health care costs.•Guarantee choice of doctors andhealth plans.•Invest in prevention and wellness.•Improve patient safety and qualitycare.•Assure affordable, quality healthcoverage for all Americans.•Maintain coverage when youchange or lose your job.•End barriers to coverage forpeople with pre-existing medicalconditions.
 
Side-by-Side CompariSon of major HealtH Care reform propoSalS — ls m: oc 8, 2009 2
Senate Finance CommitteeAmerica’s Healthy Future Actof 2009Senate HELP CommitteeAffordable Health Choices ActHouse Tri-CommitteeAmerica’s Affordable HealthChoices Act of 2009 (H.R. 3200)President ObamaPrinciples for Health Reform
Individual mandate
•Require U.S. citizens and legalresidents to have qualifying healthcoverage. Enforced through a taxpenalty of $750 per adult per year.The penalty will be phased-inaccording to the following schedule:$0 in 2013; $200 in 2014; $400 in2015; $600 in 2016; and $750 in2017. Exemptions will be grantedfor nancial hardship, religiousobjections, American Indians, and ifthe lowest cost plan option exceeds8% of an individual’s income or ifthe individual has income below133% of the poverty level.•Require individuals to havequalifying health coverage.Enforced through a minimum taxpenalty of $750 per individualper year (maximum penalty perfamily of 4 times the individualpenalty). Exemptions to theindividual mandate will be grantedto residents of states that do notestablish an American HealthBenet Gateway, members ofIndian tribes, those for whomaffordable coverage is notavailable, those without coveragefor fewer than 90 days, and thosewith incomes below 150% FPL.•Require all individuals to have“acceptable health coverage”.Those without coverage paya penalty of 2.5% of modiedadjusted gross income up tothe cost of the average nationalpremium for self-only orfamily coverage under a basicplan in the Health InsuranceExchange. Exceptions granted fordependents, religious objections,and nancial hardship.•The plan must put the countryon a clear path to cover allAmericans.
Employer requirements
•Assess employers with more than50 employees that do not offercoverage a fee for each employeewho receives a tax credit forhealth insurance through anexchange. The penalty is thelesser of a at dollar amountequal to the average national taxcredit for each full-time employeereceiving a tax credit or $400times the total number of full-time employees in the rm.•Exempt employers with 50 orfewer employees from the penalty.•Require employers with 200 ormore employees to automaticallyenroll employees into healthinsurance plans offered by theemployer. Employees may opt outof coverage if they have coveragefrom another source.•Require employers to offer healthcoverage to their employees andcontribute at least 60% of thepremium cost or pay $750 foreach uninsured full-timeemployee and $375 for eachuninsured part-time employeewho is not offered coverage. Foremployers subject to theassessment, the rst 25 workersare exempted.•Exempt employers with 25 orfewer employees from therequirement to provide coverage.•Require employers to offercoverage to their employees andcontribute at least 72.5% of thepremium cost for single coverageand 65% of the premium cost forfamily coverage of the lowest costplan that meets the essentialbenets package requirements orpay 8% of payroll into the HealthInsurance Exchange Trust Fund.[
E&L Committee amendment:Provide hardship exemptions for employers that would be negatively affected by job losses as a result of requirement.
]•Eliminate or reduce the payor play assessment for smallemployers with annual payroll ofless than $400,000:
–
Annual payroll less than$250,000: exempt
–
Annual payroll between$250,000 and $300,000: 2% ofpayroll;
–
Annual payroll between$300,000 and $350,000: 4% ofpayroll;Not specied.
 
Side-by-Side CompariSon of major HealtH Care reform propoSalS — ls m: oc 8, 2009
Senate Finance CommitteeAmerica’s Healthy Future Actof 2009Senate HELP CommitteeAffordable Health Choices ActHouse Tri-CommitteeAmerica’s Affordable HealthChoices Act of 2009 (H.R. 3200)President ObamaPrinciples for Health Reform
Employer requirements
(continued)
–
Annual payroll between$350,000 and $400,000: 6% ofpayroll.[
E&C Committee amendment:Extend the reduction in the pay or play assessment for smallemployers with annual payroll of less than $750,000 and replace the above schedule with the following:– Annual payroll less than$500,000: exempt – Annual payroll between$500,000 and $585,000: 2% of payroll;– Annual payroll between$585,000 and $670,000: 4% of payroll;– Annual payroll between$670,000 and $750,000: 6% of payroll
.]•Require employers that offercoverage to automatically enrollinto the employer’s lowest costpremium plan any individual whodoes not elect coverage under theemployer plan or does not opt outof such coverage.
Expansion of publicprograms
•Expand Medicaid to all individuals(children, pregnant women,parents, and adults withoutdependent children) withincomes up to 133% FPL (to beimplemented in 2014). Adults withincomes between 100-133% FPLwill have the option of obtainingcoverage through Medicaid orwith federal subsidies through theexchange. All newly eligible adultswill be guaranteed a benchmarkbenet package that at leastmeets the minimum creditablecoverage standards.•Expand Medicaid to all individuals(children, pregnant women,parents, and adults withoutdependent children) with incomesup to 150% FPL. Individualseligible for Medicaid will becovered through state Medicaidprograms and will not be eligiblefor credits to purchase coveragethrough American Health BenetGateways.•Expand Medicaid to all individuals(children, pregnant women,parents, and adults withoutdependent children) with incomesup to 133% FPL. Newly eligible,non-traditional (childless adults)Medicaid beneciaries mayenroll in coverage through theExchange if they were enrolled inqualied health coverage duringthe six months before becomingMedicaid eligible. Provide Medicaidcoverage for all newborns who lackacceptable coverage and provideoptional Medicaid coverage to•As a foundation for healthreform, the President signedthe Children’s Health InsuranceProgram ReauthorizationAct (CHIPRA), which providescoverage to 11 million children.
of 00

Leave a Comment

You must be to leave a comment.
Submit
Characters: ...
You must be to leave a comment.
Submit
Characters: ...