I obtained a copy of the Senate Health, Education, Labor, and Pension Committee's health insurance bill over the weekend. I read it, the following is a summary of its contents.
The Senate Health, Education, Labor, and Pension Committee released a compromise health insurance bill today. The bill mandates that all Americans purchase health insurance and places some restrictions on private health insurers, but it does not include a public option which progressives say would enable Americans to choose a government-backed plan instead of private health insurance.
It establishes a Medical Advisory Council, which consists of individuals with "appropriate experience and qualifications," to make reports on best practices.
The bill bans private health insurers from charging more to insure patients with chronic illnesses. It also bans increases in premiums based on usage. And the bill prohibits insurers from excluding people with pre-existing conditions from their plans.
It provides block grant funding to states for the creation of an "American Health Gateway" mechanism. This mechanism is designed to encourage Americans to purchase health insurance.
The bill mandates individual coverage, and penalizes those who don't obtain individual coverage with a tax equal to the premiums that they'd pay under the "American Health Gateway," plan. but doesn't mandate the use of the "American Health Gateway."
The bill exempts individuals in states where a Gateway has not yet been established from the mandate, and also exempts individuals "for whom affordable coverage, as defined by the Medical Advisory Council, is not available" from the mandate.
The bill provides a credit for individuals and families who make between 150% and 500% of a person's income based on a percentage scale rounded to the nearest $100. The subsidy is paid on the basis of how much an insurance premium exceeds a certain percentage of an individual's income. Those percentages were left blank in the draft bill I read.
The bill does not include copays, and other out of pocket expenses that an individual or family might incur, when calculating its subsidy. The subsidy is solely based on premiums.
The bill expands Medicaid eligibility to people who make 150% of the federal poverty line or below.
It requires reports on the efficiencies of these state-based Gateways to be delivered to the Congress at certain intervals, and requires the Executive Branch official charged with oversight of the plan to make suggestions from improvements. If a State doesn't establish a Gateway that complies with the bill, the Secretary of Health and Human Services will establish a Gateway in that state. The bill claims that this is similar to the FEHB, in that it would enable citizens to purchase private insurance and force competition among insurers. It is not a public option.
The bill prohibits insurers from establishing annual, or lifetime, benefit maximums.
It raises the age limit on parents insuring their children through their group plan to 26.
The bill creates a new Medicare-like program that allows people to voluntarily enroll in long-term care insurance. This program would then pay a cash benefit of not less than $50 a day to enrollees who are found to have physical or psychiatric disabilities. If a person is institutionalized for their condition, they would get to keep 5% of their daily cash benefit.
The bill mandates state disability determination offices determine whether or not an enrollee is eligible for benefits under this program.
Senator Chris Dodd, who is the manager of the bill in the absence of Senator Edward Kennedy (D-MA), told Politico he is committed to adding a public option to the bill. Sources close to Kennedy told SEIU's blog that an updated version of the bill will be released on Friday, and will include a public option.