Today, three separate House committees — Ways and Means Committee, Energy and Commerce Committee, Education and Labor Committee — released a single health care reform bill, the Tri Committee Proposal. In a press release announcing the legislation, the three panels with jurisdiction over health policy in the House announced that they had developed “a single bill that fulfills President Obama’s goals of reducing health care costs, protecting and increasing consumers’ choices, and guaranteeing access to quality, affordable health care for all Americans.”
Unlike the HELP bill and the draft (leaked) language of the Senate Finance Committee, the Tri-Committee proposal seems to contain a fairly robust public insurance option. While details are still being worked out, the proposal establishes a public plan in 2013 that will compete with private insurers, within the Exchange, on a level playing field. The public option will be required to abide by all marketing, operations, and rating rules and would initially be allowed to use Medicare plus rates. After some time, the plan would have to independently negotiate fees with providers.
On the whole, the bill’s affordability measures are impressive. Full details are after the jump but the plan offers subsidies on a sliding scale (up to 400 percent of poverty) and opens up Medicaid to Americans at or below 133% of the federal poverty level. While I haven’t seen the cost-sharing details, the robust public plan that could use Medicare plus rates would be able to force private insurers to aggressively negotiate with providers and pass on savings to consumers.
Below is a comparison table of all three bills, full details of the Tri Committee’s proposal are after the jump:
|HELP Bill (About $1 trillion/10 years)||Senate Finance Draft ($774 billion/10 years)||Tri House Bill($1.04 trillion/10 years)|
|Employer Mandate||Yes (Large employers would pay $750 per full-time employee, $375 for each part-time employee or provide adequate coverage.)||No, but employers with workers at or below 300% FPL have to pay||Yes|
|Medicaid Expansion||150% FPL, but still unclear||133% FPL||133% FPL|
|Subsidies||between 150 – 400% FPL on sliding scale||between 133 – 300% FPL on sliding scale; flat rate for 300%-400%||between 133 – 400% FPL on sliding scale|
|Public Option||Yes (Will have to compete on a level playing field with private providers and offer competitive rates and premiums. )||No (Conrad’s co-op compromise)||Yes, Medicare + 5%|
|Insurance Regs||Guarantee issue, modified community rating (2:1), no rescissions||Guarantee issue, modified community rating (7.5:1), no rescissions||Guarantee issue, modified community rating (2:1), no rescissions|
Next week, all three committees will hold hearings on the legislation. Mark-up (each committee will hold three markups on the same bill) will begin in mid-July and the bill will likely go to the floor of the House before the August recess.
Details on the Tri-Committee bill: Read more