A Breakdown of Health Care Reform Part 2

Again, I'd like to thank the fine people at The Henry J. Kaiser Family Foundation for providing a website that shows a side by side comparison of the Health Care reform proposals. Here's a breakdown of what the President wants, how different members of Congress are trying to achieve that, and how it's going to affect you.

Part 2

A- Individual Mandate: The plan must put the country on a clear path to cover all Americans. In this section we focus on how each individual proposal plans to reach every American and how it will be enforced.

-Senate Finance Committee: Their plan requires all Americans to have health care that meets minimum coverage standards. The proposal plans to enforce this through an excise tax that would be equal to the lowest premium option available through the Health Insurance Exchange in each individuals area. Hardship exemptions include individuals where the lowest option exceeds 10% of their income and individuals within 100% the Federal Poverty Level.

-Senate HELP: Their plan would require individuals to have qualified health care. The proposal plans to enforce this through a minimum tax penalty that will not exceed $750 per year. Exemptions from this include residents in states where states have not established an American Health Benefit Gateway, members of Indian tribes, and those without coverage for fewer than 90 days.

-House Tri-Committee: This plan would require all individuals to have "acceptable health coverage". The proposal plans to enforce this through a penalty of 2.5% of modified adjusted gross income up to the cost of the average premium for individual or family coverage under the Health Insurance Exchange. Exceptions include dependants, religious objections, and financial hardships.

-Sens. Tom Coburn and Richard Burr, Reps. Paul Ryan and Devin Nunes: Their plan has no requirement for individuals to have coverage. It allows to states to establish procedures to automatically enroll individuals into a low cost, high deductible health care through the Health Insurance Exchange with incentives to maintain coverage.

-Rep. John Conyers: All individuals residing in the US are covered under his proposal.

-Rep. John Dingell: Under his proposal, individuals meeting certain requirements are eligible.

-Rep. Tom Price: Under his proposal, there are no requirements for individuals to have coverage. The plan does allow employers to automatically enroll individuals into the lost cost health care as long as they can opt out of their coverage.

-Sen. Bernie Sanders: Under his proposal all individuals residing in the US are covered.

-Rep. Pete Stark: Under his proposal all US residents are eligible for coverage. However, certain individuals can opt out if they are covered under group coverage.

-Sens. Ron Wyden and Bob Bennett: Their plan requires all individuals over 19, and their dependants, to have insurance. Their plan will be enforced through financial penalties based on the number of uncovered months and weighted average of Healthy American Private Insurance premiums.

-Former Majority Leaders: Sens. Howard Baker, Tom Daschle and Bob Dole: Their plan requires all Americans and legal residents to have health care that meets minimum coverage standards. Their proposal has several enforcement proposals including: default enrollment in basic coverage through an employer or Health Insurance Exchange when starting a job; tax penalties including loss of federal deductions or exemptions; or a "fair share" fee added to income tax. Exceptions would include religious objections and financial hardships.

B- Employer Requirement: President Obama has not addressed specific principles for this issue. However, we will focus on what will be required by employers and how they will be effected by health care reform.

-Senate Finance: Their proposal has two options. Option A would require employers that have more than $500,000 inn total payroll to offer coverage to employees and contribute a minimum of 50% of the premium or pay an assessment. There are three options to the employer assessment; option 1 would set a fee per enrollee per month based on total annual payroll; option 2 would set a tiered penalty calculated as a percentage of payroll; and option 3 would set a larger penalty only on firms with an annual payroll of $1.5 million.

Option B of the Senate Finance proposal would eliminate the "pay to play" assessment fee.

-Senate HELP: Their proposal would require employers to offer health care to employees and contribute a minimum of 60% of the premium or pay $750 per uninsured fill-time employee and $375 per uninsured part-time employee who is not offered coverage. Employers who are subjected to this assessment will receive an exemption for their first 25 employees. However, those exempt employers who have 25 or less employees are required to provide coverage.

-House Tri-Committee: Their proposal would require employers to offer health care to employees and contribute a minimum of 72.5% of the premium for individuals or 65% of the premiums for families. These minimum contributions would correlate to the lowest cost plan that meets benefit requirements, or employers would have to pay 8% of payroll into Health Insurance Exchange Trust Fund. The Committee on Education and Labor amended for hardships to include employers that would be negatively affected by job losses as results of the proposal requirements.

The Committee of Energy and Commerce amended the reduction on the "pay or play" assessment for small employers with an annual payroll of less than $400,000 to less than $750,000. The assessment breaks down as follows: Those whose payroll is less than $500,000 is exempt; from $500,000 to $585,000 would pay 2% of payroll; from $585,000 to $670,000 would pay 4% of payroll; from %670,000 to $750,000 would pay 6% of payroll.

Their proposal would also require employers that offer coverage to automatically enroll individuals who are not covered into the employer's lowest cost premium plan.

-Senators and Representatives: Their current proposal does not address this issue.

-Rep. Conyers: His current proposal does not address this issue.

-Rep. Dingell: His current proposal does not address this issue.

-Rep. Price: Under his current proposal, employers can offer employees a defined amount for the purchase of health care in the individual market. It does require employers to disclose the total amount they plan to spend on employees health care.

-Sen. Sanders: His current proposal would prohibit employers from offering health care that duplicates that offered by the State.

-Rep. Starks: His proposal would require employers to contribute a minimum of 80% of AmeriCare premiums or a minimum of 80% of qualified employee group plan premium. His plan would allow employers with 100 employees or less three additional years to comply with provisions. There maybe a surcharge on employers to prevent adverse selection.

-Sens. Wyden and Bennett: Their proposal would require employers to contribute an amount equal to the average premium of their workforce times the number of workers. Premiums would vary for large and small businesses from 2% to 25%. For the first two years of their proposal, employers who had previously provided coverage would be permitted to raise wages by the amount of health care premiums instead of the above mentioned percentages. Employers that continue to sponsor plans will be required to provide Healthy American Private Insurance information to employees. It would also require employers to deduct individual and family premiums from employee payroll.

-Former Majority Leaders: Their proposal would require all employers to cover their employees or pay a fee based on payroll percentage ranging from 1% for employers with payrolls between $1 and $2 million and 3% for payrolls above $3 million. Small businesses with payrolls less than $1 million are exempt from fee.

***Coming Soon, Part 3: Expansion of Public Programs and Subsidies for Employers and Employees***