ABOUT HEALTH CARE BILLS. #1

Thanks to the NY Times here are some differences between the House and Senate Plans. These will have to be compromised before a final bill is passed. This doesn't include any of the pork belly amendments that have been attached Io the bills , like Nebraska receiving complete Federal Subsidies for Medicaid in perpetuity. Good old Senator Nelson made out like a bandit for his # 60 vote,

Each day I will post a few of the problems.

Require that most Americans have a minimum level of health insurance or else pay a penalty.

House version
Includes mandate.
Penalty: Tax equal to 2.5 percent of adjusted gross income over certain thresholds ($9,350 for individuals, $18,700 for couples).
Exemptions: American Indians, people with religious objections and people who can show financial hardship.
Senate version
Includes mandate.
Penalty: $95 a year per person in 2014; $350 in 2015; $750 or 2 percent of a household’s income, whichever is greater, in 2016 and beyond. No penalty if the cost of cheapest available plan exceeds 8 percent of household income.
Exemptions: American Indians, people with religious objections and people who can show financial hardship.


Require most employers to contribute to the cost of coverage for some or all of their employees.

House version
Require employers with annual payrolls of $500,000 or more to offer coverage to employees or pay a new federal tax.
Penalty: Up to 8 percent of wages in payroll taxes. Employers with payrolls of $500,000 to $750,000 would pay 2 percent to 6 percent of wages, and those with payrolls above $750,000 would pay the full 8 percent.
Employers would have to contribute at least 72.5 percent of the premium cost for individuals and 65 percent for families for the lowest-cost plan that meets the minimum benefit requirements set by the government.
Senate version
Would not explicitly require employers to offer coverage. But a company with 50 or more full-time workers would pay a penalty if it does not offer health benefits and if any of the workers obtain subsidized coverage through the new health insurance exchanges.
Penalty: $750 for each full-time worker in the company.
Employer’s contribution to health coverage could be converted into a voucher. Workers could use the voucher to shop for coverage on their own through the new health insurance exchanges.

Create health insurance marketplaces, where individuals and employers can shop for insurance and compare prices and benefits.

House version
Would create a national insurance exchange. States could operate their own exchanges, with federal approval.
Open to people who do not have qualifying coverage through an employer or a public program.
Open to employers with 25 or fewer employees in the first year, 50 or fewer in the second year and 100 or fewer in the third year. The exchange could be expanded to larger employers over time, “with the goal of allowing all employers access.”
Until the exchange is established, a temporary program would provide coverage to “those who have been uninsured for several months or denied a policy because of pre‐existing conditions.”
Senate version
States would form their own exchanges. Several states could join together to form a regional exchange.
Open to people who do not have qualifying coverage through an employer or a public program.
Open to employers with 50 or fewer employees, but states could allow employers with up to 100 workers to participate. Starting in 2017, states could also allow larger businesses to participate.
Penalty: Typically $750 for each employee at the firm.

Create a new government insurance plan to compete with private insurers.

House version
Public plan would negotiate payment rates with doctors and hospitals (rather than using Medicare rates set by the government).
The government would allocate $2 billion in start-up money, but beneficiary premiums would have to cover the full cost of the plan. The government would also provide loans to start nonprofit insurance cooperatives.
Senate version
Would not create a public plan. The federal Office of Personnel Management, which provides health benefits to federal employees, would sign contracts with insurers to offer at least two national health plans to individuals, families and small businesses. The new plans would be separate from the program for federal employees, and premiums would be calculated separately. At least one of the plans would have to operate on a nonprofit basis.