Health Reform: How will it impact you?

Posted on December 1, 2009

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A Brief Breakdown of the Current House and Senate Bills

The two health reform bills moving through the U.S. Congress differ in a number of ways but attempt to achieve the same goal: a dramatic reduction in the number of uninsured Americans.

Legislation approved by the House of Representatives earlier this month would expand coverage to 96 percent of Americans. The Senate is preparing to debate a proposal to expand coverage to 94 percent of Americans.

The bills require most Americans to have health insurance or pay penalties for failing to comply. The House imposes a fine of 2.5 percent of adjusted income. The Senate phases in penalties, which rise to $750 a year starting in 2016 and are adjusted annually for cost of living.

People of modest means who don’t have health insurance may qualify for coverage under Mediaid. The House bill expands Medicaid eligibility to 150 percent of the federal poverty level. In 2009, that’s $16,245 for an individual or $33,075 for a family of four. The Senate bill is slightly less generous, boosting Medicaid eligibility to people with incomes at or below 133 percent of the federal poverty level, or $14,403 for an individual and $29,326 for a family of four.

The bills also benefit people who lose health insurance because their employers no longer offer coverage or go out of business who would be eligible to purchase health insurance through an insurance exchange.

Under both bills, individuals and families with incomes up to 400 percent of the federal poverty level would be eligible for help paying for plan premiums and other cost-sharing through national or state-based exchanges.

Under the House version, employers with annual payrolls exceeding $750,000 would be required to offer coverage to their employees. The Senate doesn’t mandate coverage, but employers with more than 50 employees that fail to offer coverage would be fined $750 annually per worker when an employee obtains federally subsidized health insurance through an exchange.

Each bill offers an array of differing financing mechanisms. The House bill includes a 5.4 percent tax on individuals making more than $500,000 and families earning more than $1 million. The Senate proposes increasing the Medicare payroll tax on individuals earning more than $200,000 and couples making more than $250,000. It would also impose a 5 percent tax on cosmetic medical and surgical procedures.

To implement these health reform changes, the Senate must pass the current legislation, then the House and Senate would appoint a conference committee to work out differences between their two bills. Both chambers would vote on the compromise version. And if each passes the bill, it would go to the president for his signature.

Legislators must first come to consensus and debate a variety of hot issues. One current issue of contention among legislators is whether or not the government should offer a public plan to compete alongside private health-plan options. The House bill creates such a plan, while the Senate has proposed allowing states to opt out of offering a public plan.

The House and Senate bills also support research to compare the clinical effectiveness of various medical treatments.

More information

For help comparing the House and Senate versions, visit the Kaiser Family Foundation.
Information for this post was obtained from a report on HealthDay News.

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Posted in: Health Reform