The Senate released its long-awaited version of a health care reform bill last night, the Patient Protection and Affordable Care Act. The New York Times has a good interactive table, comparing the Senate bill with the House bill. Here are the highlights:
- Individual mandate (with exemptions for native Americas and people with religious objections)
- No employer mandate (but employers with 50 or more employees would have to pay a penalty for workers buying subsidized insurance in the exchange – read more about this provision)
- Exchange – states would create their own insurance exchanges (House bill creates a national exchange)
- Public option – states allowed to opt out
- Subsidies for purchasing insurance in the exchange available to those making up to 400% of the federal poverty level (on average the Senate subsidies are about $1000 less per person as compared with the House bill)
- Expands Medicaid to cover everyone with incomes less than 133% of the federal poverty level ($29,327 for a family of four); House bill expands to 150%
- Restricts federal funding of abortion – unlike the House bill, the Senate plan allows individuals to purchase policies that cover abortion on the exchange, with federal subsidies, but mandates that the revenue has to be segregated; i.e., only money from private premiums can pay for abortion services
- Prohibits undocumented immigrants from purchasing insurance in the exchanges (House bill allows them to buy insurance with their own money)
- Premiums for older people cannot be more than four times the premium for young adults (House ratio is 2 to 1)
- Does not strip health insurance companies of their longstanding exemption from federal antitrust laws (House version does)
- Would insure 31 million currently uninsured; would leave 23 million uninsured
- Pays for the bill through an excise tax on “Cadillac” health plans, Medicare savings, an increase in the Medicare payroll tax for workers with incomes over $250,000, and a 5% tax on elective cosmetic surgery.
For additional resources on health care reform, visit the Abundant Life health care page.
