I’m live Tweeting the Senate Finance Committee’s mark-up on @wonkroom.
Sen Max Baucus (D-MT) has just released a Chairman’s amendment to his mark. The new amendment enhances the bill’s affordability measures and increases the threshold on so-called Cadillac health care plans for ‘high-risk’ Americans. The modified amendment also preserves a subsidy to certain Medicare Advantage plans.
Baucus accepted 29 Republican amendments, including 10 from Sen. Olympia Snowe (R-ME), who has indicated that she is open to voting for the Senate Finance Committee bill. Baucus did not address any public option amendments and will likely consider Snowe’s trigger proposal during mark-up.
Below are the most significant revisions:
|Provision||Baucus Mark||New Baucus Amendment||Amendments Accepted (Modified)|
|Affordability of premiums||Families 100% FPL contribute 3% of income to premiums. Families 300% FPL would contribute 13% of income to premiums.||Families 100% FPL contribute 2% of income to premiums. Families 300% FPL would contribute 12% of income to premiums.||Menendez, Kerry, Bingaman and Schumer as amendment C1; Kerry & Menendez as amendment C9, Stabenow as amendment C1.|
|Out of pocket protections||300%+ FPL = HSA limit ($11,900 families, $5,590 individuals); 200-300% FPL = 1/2 of HSA limit; 100-200% FPL = 1/3 of HSA limit;||300-400% FPL = 2/3 of the HSA limit||Menendez as amendment C13.|
|Affordability for older Americans||Insurers can charge an older person 5x more for coverage.||Insurers can charge an older person 4x more for coverage.||Wyden as amendment C9, Kerry as amendment C15.|
|Easier to opt out of unaffordable employer coverage||If the costs of employer-sponsored coverage exceed 13% of income, an individual can enroll in the Exchange.||If the costs of employer-sponsored coverage exceed 10% of income, an individual can enroll in the Exchange.||Snowe amendment number C2.|
|Increasing threshold for excise tax on ‘Cadillac’ plans||Insurers w/ policies @ $21,000/families, $8,000/individuals pay 35% excise tax.||New thresholds for high-risk enrollees & non-Medicare retirees aged 55+ ($23,000/families, $8,750/individuals- insurers pay 40% excise tax). Excise tax increased to 40% for all other enrollees, threshold level set at Consumer Price Index (CPI) + 1 percent..||Kerry, Rockefeller, Schumer, Stabenow, Cantwell, & Menendez as amendment F2.|
|Reducing penalty on individuals/families that don’t meet the requirements of the individual mandate.||Families 100-300% FPL, penalty = $750 – $1,500. More than 300% FPL, penalty = $950-$3,800.||Families 100-300% FPL, penalty = $750-$1,500 . More than 300% FPL, penalty = $1,900 max. Individuals below 100% FPL,no penalty||Snowe as amendment F4 and Schumer as amendment C6|
|Catastrophic coverage opened to Americans exempt from individual mandate||Only Americans 25 years old and younger could enroll in a ‘high deductible’ catastrophic plan.||Individuals who would otherwise qualify for the exemption from the individual mandate, could now purchase the “young invincible” policy,||Snowe as amendment F5.|
|Preserving some overpayments to private plans participating in Medicare Advantage||The Medicare Advantage program is opened to competitive bidding.||Preserves Medicare Advantage subsidies for seniors living in high cost areas where plans deliver benefits below the average cost of traditional Medicare.||Bill Nelson as amendment D10.|
|Federal employees eligible for the Exchange.||Federal employees would not eligible to enroll in the Exchange until approximately 2022.||Beginning in 2013 elected officials and federal employees may purchase coverage through a state-based exchange, rather than using the traditional Federal Employees Health Benefits Plan||Grassley Amendment C3|
Excluded from Taxation: The Baucus amendment excludes Class II medical devices (i.e. powered wheelchairs and some pregnancy test kits. 43% of medical devices fall under this category) and clinical labs from taxation.
,Opening up the Exchange: By 2015 states can allow businesses with up to 100 employees to enroll in the Exchange. By 2017, businesses with more than 100 employees can utilize the Exchange.