In summary, the bill provides quality affordable health care for all Americans and controls health care cost growth. The key provisions of the House of Representatives Health Care Reform Bill follow below:
1. Coverage and Choice. This bill protects current coverage allowing individuals to keep the insurance they have if they like it. It creates a Health Insurance Exchange allowing individuals and small employers to comparison shop among private and public insurers. It administers affordability credits to help low-and middle-income individuals and families purchase insurance. There will also be a public health insurance option guaranteeing coverage and providing insurance reforms. It limits the ability of insurance companies to charge higher rates due to health status, gender, or other factors. A new independent Advisory Committee chaired by the Surgeon General will recommend a benefit package based on standards set in the law. This essential benefit package will become the minimum quality standard for employer plans which will include preventive services with no co-pays, mental health services, and oral and vision care for children.
2. Affordability. In order to insure all Americans have affordable health coverage, the bill provides sliding scale credits available to low and moderate income individuals and families. All new policies will cap annual out of pocket spending to prevent bankruptcies due to medical expenses happening under our current system. The bill will expand the Medicaid program for low income children, individuals with disabilities, and people with mental illnesses. Medicare will be improved by filling of the donut hole in the current Medicare D drug program, eliminating co-pays for preventive services, and will extend the solvency of the Medicare Trust Fund.
3. Shared Responsibility. Once market reforms and affordability credits are in place, individuals will be responsible for obtaining and maintaining health insurance coverage. Those who choose to not obtain coverage will pay a penalty of 2.5 % of AGI (adjusted gross income). Employers will have the option of providing health insurance coverage for their workers or contributing funds on their behalf. There will be assistance for small employers (payroll that does not exceed $250,000) who will be exempt from the employer responsibility requirement. A payroll penalty will phase in starting at 2% for firms with annual payrolls of over $250,000. A new small business tax credit will be available for those firms who want to provide health coverage to their workers.
4. Controlling costs. Modernization and improvement of Medicare will be implemented to reward efficient provision of health care and aim to decrease preventable hospital readmissions, create new consumer protectons for Medicare Advantage Plans, eliminate the "donut hole", and will improve low-income subsidy programs so that Medicare is affordable for all seniors and other eligible individuals. The public health insurance option will be empowered to be the purchaser of health care to get more value for each health care dollar spent. New tools will be provided to combat waste, fraud and abuse within the entire health care system. The bill will simplify the paperwork burden that adds tremendous costs and hassles for patients, providers, and businesses.
5. Prevention and Wellness will be expanded by the use of Community Health Centers.
6. Workforce Investments will be made by increasing funding for the National Health Service Corp; increase training of primary care doctors; increasing an expansion to promote individuals going into health professions (primary care, nursing, and public health); expansion of scholarships and loans for individuals in needed professions and shortage areas; and redistribution of unfilled graduate medical education residency slots in order to train more primary care physicians.
In listening to the President's remarks about the new emphasis on programs that contribute to health and wellness, I couldn't help but wonder about Medicare's Hospice Program. I would hate to see the much needed non for profit and for profit Hospice programs be cut back in funding as the pre- baby boomer population continues to age. More about Hospice in Part II.
We wish to thank Francine Hardaway of Arizona Health Futures.org for her very concise blog posted on July 14th explaining the proposed House of Representatives Health Care Reform Bill which even I could understand.
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#3 is what really scares me. It may be what puts small businesses out of business. Unless the government has a magical way to provide health insurance that small businesses can afford, then it's sticky. I like to employ older people. They have a great work ethic. Insuring just one of my current employees is $1200 per month for coverage that is the same as what our family has through my husband's work. Also, are they going to make spouses get insurance if they're already covered by a spouse? What if your employees are all spouses already covered, like I currently have? I want healthcare to be available but there has to be options that a small business can afford or there's no reason to hire people and build a larger business. $14,400 a year per employee. Our product pricing will go up substantially if this happens."
ReplyDeleteI also worry as I currently have someone on my payroll and her husband is currently unemployed. Would I be responsible for both under the new reform bill?
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