Baucus' Reform Bill Likely To Face Challenges Next Week

The Chairman's Mark basically includes provisions outlined a week's earlier in the reform framework released a week earlier by the Senate Finance Committee. The provisions touch on the areas of healthcare coverage, costs, quality, preventive care, efficiency, and wellness.

Among the bill's highlights are:

• Reforming the insurance market to prevent individual exclusion from insurance coverage based on pre-existing conditions and health status.


• Eliminating yearly and lifetime limits on the amount of coverage plans can provide.


• Creating Web-based insurance exchanges to standardize health plan premiums and coverage information to make purchasing insurance easier.


• Giving consumers the choice of nonprofit, consumer-owned and oriented plans (CO-OPs).


• Standardizing Medicaid coverage for everyone under 133% of the federal poverty level.


• Providing value based incentive payments to acute care hospitals that meet certain quality performance standards beginning in fiscal 2012.


• Creating incentives for healthcare providers to improve quality by using safer, more cost effective health technology, such as electronic medical records.


• Providing annual wellness visits for Medicare Creating a new Medicaid state plan option under which Medicaid enrollees—with at least two chronic conditions or with one chronic condition and at risk of developing another chronic condition—could designate a provider as their health home.


• Eliminating out-of-pocket costs for screening and prevention services in Medicare.


• Creating incentives in Medicare and Medicaid for completing healthy lifestyle programs.