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Health Reform Comparison

Health Reform Comparison

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Albert Wu made a chart of how the different health care plans stack up against each other.
Albert Wu made a chart of how the different health care plans stack up against each other.

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Published by: Michael Robert Hussey on Jun 07, 2011
Copyright:Attribution Non-commercial

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06/07/2011

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SwissHealthcareAffordableCareActRyanPlanPre-ACACanadianHealthcare(Medicare)BritishHealthcare(NHS)MassachusettsHealthReformHealthySanFranciscoCoverage
Universal(99%)Near-universal(90+%)Unknown,similartopre-ACA?18.6%UninsuredUniversalUniversalUniversal(98%)89%ofUninsured(99%insuredorHSF-covered)
IndividualMandate
YesTaxpenaltyfornotpurchasinghealthcareFlatrefundabletaxcreditforpurchasinghealthcareNoN/AN/ATaxpenaltyfornotpurchasinghealthcareNo
EmployerMandate
NoTaxcreditstosmallbusinessesforprovidinghealthcareNoNoNoNoYesEmployersmustprovidehealthcareorpayintoHSF
GuaranteedIssue
YesYesNoNoN/AN/AYesN/A
InsuranceCompanyProfitsCapped
0%(fornon-supplementaryplans)15-20%(80-85%MedicalLossRatio)NoNoN/AN/ANoN/A
RiskPooling
ByCanton(state)ByStateorbyemployerByEmployer/IndividualByEmployer/IndividualNationwide(N/A)Nationwide(N/A)ByStateorbyemployerByCity
PremiumVariationfactorsallowed
ByLocationOnlyByLocationandage(3:1max)UnregulatedUnregulatedN/AN/AByage(2:1max)N/A
Requiredbenefits
Definedbylaw,comprehensive"Bronze,"(60%)"Silver,"(70%)"Gold,"(80%)and"Platinum"(90%)actuariallevelsdefinedNoneNoneComprehensiveComprehensiveNotdefinedforemployerplans,definedbyCommonwealthHealthInsuranceConnectorAuthorityforConnectorplansMostservicesbutonlywithinSanFrancisco
Low-incomeSubsidies
Directgovernmentrebateafter8%ofincomespentonhealthcareMedicaidforallpersons≤133%FPL,refundabletaxcreditsbasedonBronzeplanandincomeupto400%FPLNoguaranteeofMedicaidCoverageMedicaidcoveragevariesbystate(usuallyonlywomenwithchildrenandtheirspouses)N/AN/ANopremiumsfor≤150%FPL,slidingscaleupto300%FPLPremiumsvaryfrom$0to$150amonthdependingonincome,upto500%FPL
Cost-sharing
Yearlydeductible(varieswithpremium)andpercentagecostsharinguptoamaximumout-of-pocketcostPreventativemedicinefree,yearlydeductible(varieswithactuarialcoverage)andflatcostsharing(copay)uptoamaximumoutofpocketcost.DefinedbyprivateinsuranceDefinedbyprivateInsuranceN/AN/ADefinedbyprivateinsuranceFlatcopaydependingonincome($0for≤100%FPL)
CostControlMeasures
Universalcoverage,percentage-basedcostsharing,prescriptiondrugcostsregulated,labtestandmedicaldevicecostsregulatedUniversalcoverage,flat-feecostsharing,excisetaxonmedicaldevices,taxon"Cadillacplans,"MedicarefeesdirectlysetbyCongressCostsshiftedontoconsumer.FederalgovernmentcostsareflatforbothMedicareandMedicaidMedicarefeesdirectlysetbyCongressUniversalcoverage,MedicarereimbursementratessetbygovernmentUniversalcoverage,AllhealthprovidersaregovernmentemployeesUniversalcoverageReimbursementratessetbycitycouncil

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