House Committee Chairs Unveil Latest Health Reform Plan

July 14, 2009 (PLANSPONSOR.com) - Employers would be hit with a "play or pay" mandate to either contribute to employees' health care coverage or pay a penalty as a result of a health care reform legislation introduced Tuesday by Democratic leaders in U.S. House of Representatives.

Under America’s Affordable Health Choices Act, H.R. 3200,employers would have to pay 72.5% of the premium for individual coverage and 65% of the premium for family coverage, according to a Business Insurance report.  

Workers with individual coverage could not be required to pay more than $5,000 per year in out-of-pocket expenses, while such expenses would be capped at $10,000 for enrollees with family coverage, the report said. I ndividuals would be required to get coverage, either through their employer or a buying pool, or pay a penalty.

Preventive services would have to be covered without any employee cost-sharing and employers could not restrict new employee coverage because of pre-existing medical conditions, under the bill, according to the Business Insurance report.  

Most employers not meeting the requirements would be hit with a penalty equal to 8% of pay for each employee to whom they did not offer coverage.

For employers with more than $250,000 in annual payroll, the penalty would begin at 2% of payroll, rising to the full 8% penalty for employers with annual payrolls above $400,000. However, employers with an annual payroll of $250,000 or less would be completely exempt from offering coverage or paying an assessment, Business Insurance said.

The reform measure would be funded in part by a new graduated surcharge on annual income of more than $350,000, Business Insurance said.

According to the Business Insurance report, the proposal would reimburse employers providing coverage for pre-Medicare eligible retirees at least age 55. Under that provision, employers would be reimbursed for 80% of the cost of a claim between $15,000 and $90,000.

Introducing the bill Tuesday were   U.S. Representative George Miller,(D-California), chairman of the House Education and Labor Committee, U.S. Representative Charles B. Rangel, (D-New York), chairman of the Ways and Means Committee, and U.S. Representative Henry A. Waxman , (D-California), chairman of the Energy and Commerce Committee. The three panels, which have jurisdiction over health policy, are expected to begin considering the measure as early as this week, according to a Miller news release.

The announcement of the new bill is available here . A bill summary is available here .

More information is also available on the social network site Facebook at http://www.facebook.com/pages/Health-Care-Reform/91591195417 .

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