Health Care Bill has Multiemployer Plans Feeling Ill:

There is a lot of noise surrounding national healthcare.  EUCA is determined to bring you the most up-to-date information that is simple, straight-forward  and relevant to you and your business. The rest we’ll leave to the pundits. 

Here is what you need to know:

The House and Senate each have their own version of the healthcare bill. The Senate will take up debate on its pending health care bill after Thanksgiving and the House of Representatives passed its own version earlier in November.

Here is how the bills compare:

 1. Public option

Both bills include the creation of a government-run insurance provider to compete with private insurers. However, the Senate version would allow states to opt out of the public plan.

2. Who is covered

The House bill covers about 96 percent of legal residents under age 65 – compared with 83 percent now. Government subsidies to buy coverage start in 2013. About one-third of the remaining 18 million people under age 65 left uninsured would be undocumented immigrants.

The Senate bill covers about 94 percent of legal residents under age 65 compared with 83 percent now. Government subsidies to help buy coverage start in 2014. Undocumented immigrants would not receive assistance.

3. What it costs and how it is paid

The Congressional Budget Office estimates the House bill’s cost over 10 years as $1.052 trillion. The Senate overage provisions cost $848 billion over 10 years. Under the House bill, much of the money to pay for the reforms would be raised through a 5.4 percent surtax on high-income people — individuals making more than $500,000 a year or couples with annual incomes in excess of $1 million.

The Senate version imposes a series of new taxes including: a 40 percent tax on “Cadillac health plans” (employer-sponsored group plans with premiums of over $8,500 for individuals or over $23,000 for families); the introduction of annual fees for health care companies; an increase in Medicare payroll taxes from 1.45 percent to 1.95 percent for those earning more than $250,000 a year and a so-called “Botox tax,” that is a five percent tax on elective cosmetic medical procedures.

4. Individual mandates

Each bill requires people to buy insurance or pay a penalty — $750 by2016 in the Senate bill and 2.5 percent of income in the House bill.

 5. Subsidies/exchanges

Each bill sets up insurance marketplaces, called exchanges, in which people without access to affordable coverage through an employer can buy plans. Subsidies are available to households earning up to 400 percent of the poverty level, or $88,200 for a family of four.

6. Employer mandate

The House bill requires employers to pay 65 percent of family premiums or pay a penalty based on payroll; businesses with less than $500,000 in payroll are exempt.

The Senate bill fines employers with more than 50 employees if the employer does not offer health care and any employee receives a subsidy through new government sponsored exchanges. The fine is equal to $750 for every person on the payroll.

7. Insurance reforms

Both bills include bans on lifetime limits, premium disparity based on health status and sex, and coverage denials based on preexisting conditions.

8. Medicaid expansion

The Senate bill expands Medicaid to cover everyone earning less than 133 percent of the federal poverty level, or $29,327 for a family of four.

The House bill expands Medicaid to cover households earning less than 150 percent of the federal poverty level, or $33,070 for a family of four.

9. Abortion provision

The Senate bill bars the use of federal funds for abortion but it requires at least one plan in the exchange to offer abortion and one that doesn’t.

The House bill bans abortion from being covered in the public option or in the exchange’s private plans that take subsidized custumers. There is an exemption if a woman’s life is in danger or in cases of rape or incest.

 What happends when/if the Senate passes its version of the bill?

If the Senate passes its bill, representatives from both legislative houses then meet to “reconcile” the differences between the legislation.

*Above information based on Washington Post and Associated Press reports.

How will this affect my business? 

For multiemployer plans the chief concerns about the final bill are:

• Keeping health care contributions and benefits tax free (Senate bill taxes some benefits).
• Preventing any weakening of ERISA protections that guard trustees and plans from suits for medical malpractice or other medical outcomes (both bills threaten ERISA preemption).
• Barring exemptions that favor non-union employers (House bill has an exemption for small employers).

EUCA will continue to keep you updated – Please do not hesitate to contact us with any questions or concerns, or if you would like more information about the bill.

Tags: health care