Senate Democrat Leadership Releases Revised Health Care Reform Bill
November 19, 2009
Late yesterday, Senate Majority Leader Harry Reid (D-NV) released the revised and combined Health Care Reform Bill in front of a meeting of the Senate Democratic Caucus. The 2,074 page bill is an attempt to combine the work product from the Senate Finance Committee and the Senate HELP Committee, which had passed separate versions of the health care reform legislation earlier in the year.
The legislation has been scored by the Congressional Budget Office (CBO) as costing $849 billion over ten years. CBO has also determined that the legislation would provide health insurance coverage to 31 million Americans currently without insurance and would reduce the federal deficit by $127 billion. The legislation is largely paid for by taxes on "Cadillac" insurance plans and a half a percentage point increase in Medicare taxes on couples earning more than $250,000 a year.
Below, please find a brief outline of the notable elements of the legislation and click here to view a summary that was provided by the Senate Democratic Leadership. The Big "I" government affairs staff will be analyzing the bill in greater detail over the next few days and will of course continue to provide detailed information on this legislation and the House bill as the process moves forward.
Summary of Notable Elements of the Senate Health Care Reform Bill:
Role of Agents and Brokers
Explicitly states that agents and brokers will be allowed to enroll individuals and employers in qualified health benefits plans, including the public option, both inside and outside of the exchange.
"Navigators" Enrollment Program
Creates a Navigators program for eligible participants to receive federal grants to conduct the following assistance measures: consumer information, outreach, counseling, enrollment assistance, and technical assistance with respect to participating in the Health Insurance Exchange. Navigators must be licensed and agents and brokers are eligible to participate.
State Health Insurance Exchanges
Each state would be required to establish an exchange. Each exchange would provide qualified private health insurance plans, the public option (if the state did not opt out) as well as a co-op. Four tiers of products (60%, 70%, 80% and 90% actuarial values). Individuals and small employers (2-100 employees) will be eligible to purchase in the exchange.
Marketing and Commission Regulations Inside State Exchanges
The Secretary of HHS is given the authority to establish rate schedules for broker commissions as well as marketing regulations for products in the state exchanges.
Public Option
A government-run insurance program similar to Medicare that would compete with private insurers. Individual states could opt out of offering the public plan, and the government would negotiate how much to pay for medical services.
Employer Mandate
Companies with more than 50 workers that do not offer insurance would pay $750 for each employee that receives a government subsidy for insurance.
New Tax on Cadillac Insurance Plans and Increase in Medicare Tax
A half-percentage-point increase in the Medicare payroll tax for individuals who earn more than $200,000 and couples who make more than $250,000 a year. Insurance plans that exceed $8,500 for individuals and $23,000 for couples would be taxed 40%, and elective cosmetic surgeries would be taxed 5%.
Creation of CO-OPs
Would provide government start-up loans to establish cooperative health plans that compete with private insurers and the public health insurance option. The original bill did not contain such language.
NO Repeal of Anti-Trust Exemption for Health Insurers and Medical Malpractice Insurers
Unlike the House Health Reform bill, the Senate legislation does not contain a repeal of the anti-trust exemption or any language authorizing the FTC to study the business of insurance.
Creation of a New National Disability Insurance Program
Would create a new national long-term care insurance program. The benefit would be tied to one's inability to perform two or three Activities of Daily Living (ADLs). The benefit amount is varied based on the "scale of functional ability" with a $50-$75/day cash benefit.
Medicaid Expansion
Would expand Medicaid to income levels up to 133 percent of poverty.
Click here to view a summary that was provided by the Senate Democratic Leadership.
