House Dems Roll Out Health Care Proposal

June 19, 2009 (PLANSPONSOR.com) - The chairmen of the three committees with jurisdiction over health policy in the U.S. House of Representatives - all Democrats - have unveiled what they called a "discussion draft for health care reform."

Employers will be impacted by the terms of the new proposal.   Under a provision that claims to “…ensure that individuals, employers and the federal government all share responsibility for a quality and affordable health care system”.   Specifically, the  proposal states that:  

  • Employers who currently offer coverage would be able to continue offering coverage to workers. Employers who don’t currently offer coverage could choose to pay for their workers to gain health care coverage through the exchange or pay a penalty.  Under the House proposal, employers that fail to meet the requirements would have to pay a penalty equal to 8% of pay for each employee not offered coverage.This requirement would go into effect in 2013.
  • All individuals would be required to get coverage, either through their employer or the exchange, or pay a penalty.
  • The federal government would provide what the draft calls “affordability credits”, available on a sliding scale for low- and middle-income individuals and families to make premiums affordable and reduce cost-sharing.

According to the Congressmen, their proposal “would reduce out-of-control costs, improve choices and competition for consumers and expand access to quality, affordable health care for all Americans.”   They also say that the proposal outlined in the discussion draft would “…guarantee that almost every American is covered by a health care plan that is both affordable and offers quality, standard benefits by 2019.”

According to the announcement of the proposal, over the past several months House Committees on Education and Labor, Ways and Means, and Energy and Commerce have been working together as one committee to develop a proposal for health care reform.   The chairmen – Congressmen George Miller (D-California, the Chairman of the Education and Labor Committee, Charles Rangel (D-New York), Chairman of the Ways and Means Committee, and Henry A. Waxman (D-CA), the Chairman of the Energy and Commerce Committee – on Friday reiterated that they will continue to seek the input of all members and stakeholders during hearings and markups in the coming weeks.

On the other hand, Congressman Miller, in announcing the draft said, “If there is one thing that is ‘off of the table’ it is saying ‘no’ to health care reform.”

According to the announcement, the key principles of the House Democratic discussion draft for health care include, among other things:

  • If an individual likes their current plan, they would be able to keep it.
  • For individuals who either aren't currently covered, or wanted to enroll in a new health care plan, the proposal would establishes a health care exchange where consumers can select from a menu of affordable, quality health care options: either a new public health insurance plan or a plan offered by private insurers. People will have similar choices that Members of Congress have.

The new marketplace would "reduce costs, create competition that leads to better care for every American, and keep private insurers honest," according to the Congressmen.   Patients and doctors would have control over decisions about their health care, instead of insurance companies.

The proposal would ensure that Americans have "portable, secure health care plans - so that they wouldn't lose care if their employer drops their plan or they lose their job", according to the announcement:

  • Every American who receives coverage through the exchange will have a plan that includes standardized, comprehensive and quality health care benefits.   
  • It would end increases in premiums or denials of care based on pre-existing conditions, age, race or gender.
  • The proposal would also eliminate co-pays for preventative care, cap out-of-pocket expenses and guarantee catastrophic coverage that protects every American from bankruptcy.

According to the announcement, the proposal also:

  • Guarantees that every child in America will have health care coverage that includes dental and vision benefits.
  • Provides better preventative and wellness care. Every health care plan offered through the exchange would cover preventative care.
  • Grows the health care workforce to ensure that more doctors and nurses are available to provide quality care as more Americans get coverage.
  • Strengthens Medicare and Medicaid so that seniors and low-income Americans receive better quality of care and see lower prescription drug costs and out-of-pocket expenses.

Consumers First

Finally, the proposal claims to "put the interests of consumers first, protect them from any problems in getting and keeping health care coverage, and reduce waste, fraud and abuse".  According to the Congressmen, it:

  • Provides transparency in plans in the health exchange so that consumers have the clear, complete information needed to select the plan that best meets their needs.
  • Establishes Consumer Advocacy Offices as part of the exchange to "protect consumers, answer questions and assist with any problems related to their plans".
  • Would identify and eliminate waste, fraud and abuse by simplifying paperwork and other administrative burdens. Patients, doctors, nurses, insurance companies, providers and employers would all encounter a streamlined, less confusing, more consumer friendly system.

A complete summary of the discussion draft is available at http://edlabor.house.gov/documents/111/pdf/publications/DraftHealthCareReform-BillSummary.pdf

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