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Top 10 Changes to Expect in Health Insurance Bill

The following is a summary of the top ten changes we can expect to see as a result of the health insurance bill now being considered by Congress.

1. Reduces the deficit - According to the CBO, the revised bill reduces the deficit by $30 billion over the first 10 years. (The original bill reduced the deficit by $6 billion over the first 10 years). The revised bill also continues to reduce the deficit over the second 10 years.

2. End health insurance company exemption from anti-trust laws - In order to open up health insurance markets to real competition, the revised bill ends insurers’ blanket exemption from anti-trust laws, bringing antitrust enforcement to the two most abusive practices of health insurers – price fixing and market allocation.

3. Extend coverage for young people through parent's insurance up to 27 years old - The revised bill requires health plans to allow young people through age 26 to remain on their parents’ policy, at their parents’ choice.

4. Create new voluntary public long-term care insurance program - The revised bill creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. The measure provides a cash benefit to help individuals with community-based services.

5. Exempt small business from employer mandate - The revised bill exempts a greater number of small businesses from the employer mandate – exempting 86% of all America’s businesses. Specifically, the bill exempts firms with payrolls up to $500,000 (instead of $250,000) from the mandate and provides only a graduated penalty for not offering coverage for firms with payrolls between $500,000 and $750,000 (instead of firms with payrolls between $250,000 and $400,000.)

6. Limit health insurance surcharge to millionaires - Under the revised bill, only the wealthiest 0.3% of Americans would pay a surcharge on the portion of their income above $500,000 (instead of $280,000) for individuals and $1 million (instead of $350,000) for couples, in order to help make health insurance affordable for middle class families.

7. Fixes geographic variations in medicare payments and reward care effectiveness - The revised bill provides that the Institute of Medicine (IOM), through two studies, will make recommendations on how to fix the current Medicare reimbursement system, including addressing current geographic variations. Under the bill, the Centers for Medicare and Medicaid Services (CMS) will implement the IOM recommendations on changes to Medicare payment systems unless disapproved by Congress.

8. Closes Part D donut hole - The revised bill moves forward the effective date of reducing the donut hole by $500 and instituting a 50% discount for brand-name drugs in the donut hole, from January 1, 2011 to January 1, 2010. It also completes elimination of the donut hole by 2019 (instead of 2024).

9. Provide immediate help for uninsured - To fill the gap before the Exchange is available, the revised bill immediately creates an insurance program with financial assistance for those who have been uninsured for several months or denied a policy because of pre-existing conditions.

10. HHS negotiates prices of drugs - Under the revised bill, the Secretary of HHS is required to negotiate drug prices on behalf of Medicare beneficiaries.