House, Senate bills diverge on details

November 09, 2009|Associated Press

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Subsidies: Tax credits for individuals and families likely making up to 400 percent of the federal poverty level, which computes to $88,200 for a family of four. Tax credits for small employers.

Benefits package: All plans sold to individuals and small businesses would have to cover basic benefits. The government would set four levels of coverage: Under legislation passed by the Senate Finance Committee the least generous would pay an estimated 65 percent of health care costs per year; the most generous would cover an estimated 90 percent. Those numbers could change.

Insurance industry restrictions: No denial of coverage based on preexisting conditions. No higher premiums allowed for preexisting conditions or gender. Limits on higher premiums based on age and family size.

Government-run plan: Reid proposed a new federal insurance plan last week with payment rates to providers negotiated by the Health and Human Services secretary. Unlike the House bill, states could opt out of the plan. It’s not clear the proposal commands enough votes to survive, and it could be replaced by a standby system pushed by moderates that would not go into effect until it was clear individual states were experiencing a lack of competition among private companies. The bill also would create nonprofit, member-owned co-ops to compete with private insurers.

How you choose your insurance: Self-employed people, uninsured individuals, and small businesses could pick a plan offered through new state-based purchasing pools. Employees would be generally encouraged to keep their work-provided coverage.