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    Updated March 4, 2010


Actors Equity Weekly Health Care Up-date 3/3/10 - 3/10/10

"So, no matter which approach you favor, I believe the United States Congress owes the American people a final vote on health care reform. We have debated this issue thoroughly, not just for a year, but for decades. Reform has already passed the House with a majority. It has already passed the Senate with a supermajority of sixty votes. And now it deserves the same kind of up-or-down vote that was cast on welfare reform, the Children's Health Insurance Program, COBRA health coverage for the unemployed, and both Bush tax cuts - all of which had to pass Congress with nothing more than a simple majority. I have therefore asked leaders in both Houses of Congress to finish their work and schedule a vote in the next few weeks. From now until then, I will do everything in my power to make the case for reform. And I urge every American who wants this reform to make their voice heard as well - every family, every business owner, every patient, every doctor, every nurse."

The above quote is from President Obama's speech on March 3rd in regard to moving forward on health care reform. Essentially what he has said is the reconciliation process will be used to finalize a health care bill. In order to proceed, the House would have to first pass the Senate-passed health bill. Then both chambers would use reconciliation to pass a package of changes that would bridge gaps between the initial House and Senate versions. The final bill language would then be sent to the Congressional Budget Office for evaluation and scoring.

While the leadership is supposedly hoping to wrap up healthcare reform by March 18, when the President departs for Indonesia and Australia, the more likely target date is by March 29, when the week-long Easter recess begins.

The issue for most Americans is still less about process and more about the content of a final bill. As mentioned in last week's up-date, the President's plan does include some of the better proposals from the Senate and House bills, such as expanded Medicaid, subsidies for low and moderate income people to buy insurance, closing the Medicare drug benefit "donut hole," and insurance regulations. It also includes a federal commission with the authority to prohibit excessive premium increases.

That said, President Obama's proposal still does not do enough to create affordable health care and lower costs. Equity would continue to be concerned with the following:

  • Equity members and all Americans could see an individual mandate to purchase insurance without any sturdy mechanism to ensure its affordability or the quality of coverage.

  • Multi-employer health plans such as ours may be taxed resulting in reductions in benefits and/or eligibility.

  • In the absence of any public option, the "open market" state-by-state approach could mean that insurers would be able to sell their plans across state lines, putting consumer protections in jeopardy. Insurers could gravitate to states with the most lax regulations and coverage requirements, craft insurance policies there and sell them to people across the country.

In his speech, the president urged every American to make their voice heard; once again, Equity encourages the same. All Equity members concerned with the effects that any reform will have on themselves and our health plan need to reach out to members of the House, Senate and White House.

Let them know:

1. A public option must be a part of any final bill

2. No tax on health benefits is acceptable

3. Any individual mandate must be affordable

4. Multi-employer plans such as ours need special consideration

www.senate.gov

www.house.gov

www.whitehouse.gov or 202-456-1111

To help you better understand the differences in each proposal and to assist with your emails and calls to elected officials, below is a comparison of the key elements in each of the 3 proposals:

COMPARISON OF OBAMA HEALTH CARE PROPOSAL WITH HOUSE & SENATE PROPOSALS

Key:
FPL = Federal Poverty Level
CBA = Cost Benefit Analysis

 

House

Senate

Obama

Public Option

National public option with negotiated provider rates between Medicare and average private plan rates

No Public Option

No Public Option

Benefits Tax

No tax on health benefits

40% tax on health plan cost in excess of $8,500 (individual) or $23,000 (family) beginning in  2013

 

 

40% tax on health plan cost in excess of $10,200 (individual) or $27,500 (family) in 2018

 

Adjustments for age and gender mix.

Tax on Wealthy

5.4% surtax on individuals earning more than $500,000 and families earning more than $1 million

Increase Medicare payroll tax rate by 0.9% for individuals earning more than  $200,000 and families earning more than $250,000

Increase in Medicare payroll tax same as Senate PLUS

 

2.9% assessment  (total of Medicare payroll tax paid by employees and employers) on unearned income for individuals earning more than $200,000 and families earning more than $250,000

National Exchange

National exchange overseen by federal government to negotiate and enforce agreements with insurers

State exchanges

 

Federal government sets up exchange if state fails to do so by 2013

Same as Senate

Affordability

Exchange subsidies limit premium contribution from 1.5% to 12% of income based on FPL percentage

 

 

Plan coverage of anticipated costs range from 97% for lowest income brackets to 70% for 350% FPL and above

 

Out-of-pocket limits in exchange from $500/$1,000 to $5,000/$10,000. 

 

Employees offered coverage at work are eligible for exchange if premium contribution exceeds 12% of income (subject to CBA rule)

Exchange subsidies limit premium contribution from 2% to 9.8% of income based on FPL percentage

 

Plan coverage of anticipated costs range from 90% for lowest income brackets to 70% for 200% FPL and above

 

Out-of-pocket limits in exchange from $1,980/$3,960 to $3,960/$7,920. 

 

Employees offered coverage at work eligible for exchange if premium contribution exceeds 9.8% of income

Exchange subsidies limit premium contribution from 2% to 9.5% of income based on FPL percentage

 

Plan coverage of anticipated costs range from 94% for lowest income brackets to 70% for 250% FPL and above

 

Out-of-pocket limits same as Senate

 

 

 

Same as Senate

Rate Review

State-based review of insurance rates that requires insurers to document and justify reasons for rate increases

Similar to House

Similar to House and Senate, plus

new Federal Insurance Rate Authority to oversee and assist states

 

Require insurance companies to lower premiums or pay rebates if rate increases unreasonable and unjustified


Past AEA Healthcare Updates...

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