Monday, February 22, 2010

The President's Proposal

is here. It is in the format of a series of changes proposed to the House and Senate bills. The claim is that the changes proposed will result in reduction of deficit over 10 years of $100 Billion, about $30 Billion less reduction than the Senate bill. Alot of these changes delay imposition of taxes, and there is also a reduction of the maximum amount a person could spend on premiums. Quick take highlights include:

*Maintains individual mandate, penalites weakened a bit from Senate bill
*keep income based premium subsidy....with very low income persons getting a bit less (3-4% of income max can pay for premiums just above 133% of poverty up from 1.5% in House bill), but max that can be spent at 400% of poverty is lowered to 9.5% of income (12% in House, 9.8% in Senate).
*Expand tax credits to businesses for insurance and makes available immediately, with penalty for for firms with 50+ employees, if their employees end up with federal income based subsidy
*Create a federal insurance rate approval board;
*Max cost sharing, meaning amout you pay out of pocket if sick is set right between the House and Senate bills; for example, at $55,000, Pres proposal is insurance must cover 73% of costs; House it was $85%, Senate it was 70%.
*ending of the Nebraska Medicaid deal;
*keeping the tax on high cost insurance, but delaying its imposition, raising the threshold for application to $27,500 ($10,200 individual), and implementing it at the same time for all policies (Union or otherwise) in 2017.
*Delay tax on high insurance providers contained in Senate bill until 2014
*Update: Appplies current Medicare payroll tax of 1.45%/1.45% on unearned income.....this is in lieu of House income tax increase (which is not included in Pres plan), and is a bit different from Senate increase in payroll tax for persons above $250,000
*Maintain the CLASS long term care provisions
*eliminates the Medicare part D donught hole....tracks more closely with House version than senate here.
*Expands funding for Community Health Centers, Senate bill had $7.5 B over 10 and Pres bill has $12 B over 10...responding to notion that who will care for low income folks newly insured.
*There are a series of items from Republican bills that the President has adopted, including amendments that failed in comittees. Many of these are related to fraud.

Running today....more later. Updated: This post has a useful table comparing President, House and Senate bills. And some thoughts on the President's tweaks of the (essentially) the Senate bill.

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