By Cliff Montgomery – Nov. 10th, 2009
The Congressional Research Service (CRS) on Oct. 30th, 2009, released an informative overview of theAffordable Health Care for America Act, which the U.S. House of Representatives passed on Saturday.
The CRS report offers Americans a fairly easy-to-understand explanation of this complex bill.
The American Spark below quotes major parts of this telling CRS study:
“H.R. 3962, Affordable Health Care for America Act, was introduced in the House of Representatives onOctober 29, 2009. H.R. 3962 is based on H.R. 3200, America’s Affordable Health Choices Act of 2009, whichwas originally introduced on July 14, 2009, and was reported separately on October 14, 2009, by three HouseCommittees—Education and Labor, Energy and Commerce, and Ways and Means. […]
“On October 29, the Congressional Budget Office (CBO) released a ‘preliminary analysis’ of H.R. 3962 thatprojects the bill would reduce federal deficits by $104 billion over the 10-year period of 2010-2019 and, by2019, would insure 96% of the non-elderly, legally present U.S. population.
“The gross 10-year cost of the Exchange subsidies ($605 billion), increased federal Medicaid expenditures($425 billion), and tax credits for small employers ($25 billion) would total $1.055 trillion. Taking into accountemployer and individual tax penalties and other issues pertaining to coverage, the net cost of the coverageprovisions, according to the CBO analysis, would be $894 billion over 10 years.
” ‘Over the 2010–2019 period, the net cost of the coverage expansions would be more than offset by thecombination of other spending changes, which CBO estimates would save $426 billion, and receipts resultingfrom the income tax surcharge on high-income individuals and other provisions, which JCT [the JointCommittee on Taxation] and CBO estimate would increase federal revenues by $572 billion over that period,'[according to a Congressional Budget Office letter to Rep. Charles Rangel].”
“In general, H.R. 3962 would require individuals to maintain health insurance and employers to either provideinsurance or pay a payroll assessment, with some exceptions.
“Several insurance market reforms would be made, such as modified community rating and guaranteed issueand renewal. Both the individual and employer mandates would be linked to acceptable health insurancecoverage, which would meet required minimum standards and incorporate the market reforms included in thebill.
“Acceptable coverage would include (1) coverage under a qualified health benefits plan (QHBP), which couldbe offered either through the newly created Health Insurance Exchange (the Exchange) or outside theExchange through new employer plans, (2) grandfathered employment based plans, (3) grandfathered non-group plans, and (4) other coverage, such as Medicare and Medicaid.
“The Exchange would offer private plans alongside a public option.
“Based on income, certain individuals could qualify for subsidies toward their premium costs and cost-sharing(deductibles and co-payments) – these subsidies would be available only through the Exchange.
“In the individual market (the non-group market), a plan could be grandfathered indefinitely, but only if nochanges were made to the terms and conditions of that plan, including benefits and cost-sharing, andpremiums were only increased as allowed by statute. Most of these provisions would be effective beginning in2013.
“The Exchange would not be an insurer – it would provide eligible individuals and small businesses with accessto insurers’ plans in a comparable way.
“The Exchange would consist of a selection of private plans as well as a public option. Individuals wanting topurchase the public option or a private health insurance not through an employer or a grandfathered non-group plan could only obtain such coverage through the Exchange. They would only be eligible to enroll in anExchange plan if they were not enrolled in Medicare, Medicaid, and acceptable employer coverage as a full-time employee.
“The public option would be established by the Secretary of Health and Human Services (HHS), would offerthree different cost-sharing options, and would vary premiums geographically. The Secretary would negotiatepayment rates for medical providers, and items and services.
“The bill would also require that the Health Choices Commissioner to establish a Consumer Operated andOriented Plan (CO-OP) program under which the Commissioner would make grants and loans for theestablishment of not-for-profit, member-run health insurance co-operatives. These co-operatives would provideinsurance through the Exchange.
“Only within the Exchange, credits would be available to limit the amount of money certain individuals would payfor premiums and for cost-sharing (deductibles and co-payments).
“(Although Medicaid is beyond the scope of this report, H.R. 3962 would extend Medicaid coverage for mostindividuals under 150% of poverty – individuals would be ineligible for Exchange coverage if they were eligible forMedicaid.)”
