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Comparing the Three Main Health Reform Bills

John Commins and Janice Simmons, August 4, 2009

Under the "shared responsibility" section, all individuals would be required to obtain healthcare coverage, although some exceptions could be made for those who cannot afford coverage. Employers with 25 or fewer employers also would be exempt from penalties. The bill's minimum penalty to accomplish the goal of "enhancing participation" is $750 per individual annually.

The bill also has a greater focus on prevention and wellness efforts than the House bill. The bill also calls for:

  • Prohibiting insurers from denying applicants coverage based on their health status
  • Promoting higher quality of care through health insurance policies that include financial incentives as rewards for providers involved in using, for instance, care coordination, chronic disease management, and medical error reduction
  • Coverage of preventive health services
  • Extending coverage for dependent adults, with all individual and group coverage policies being required to continue offering dependent coverage for children until the child turns age 26
  • No lifetime or annual limits on the dollar value limits of individual or group health insurance policies

The Senate Finance Committee bill. Nobody knows what this bill will include because there is no bill nor is there draft language. There's not even a lofty, official-sounding name like the Liberty and Justice and Healthcare for All Bill of 2009.

There is great debate about whether or not the bill will include the public plan option found in the other bills. Over the last several months, the committee has laid out a series of papers that could be viewed as a possible framework for the eventual bill.

Finance Committee Chairman Max Baucus (D-MT) says the committee will begin the mark up before the Aug. 7 start of the committee's summer recess. The eventual bill may include a mandate for individuals to have health insurance.

To facilitate the requirement, the bill may create a Health Insurance Exchange where people and small businesses can buy coverage with financial assistance available to the poor. The bill is also expected to expand SCHIP and expand at least temporary coverage for Medicare/Medicaid.


John Commins is an editor with HealthLeaders Media. He can be reached at jcommins@healthleadersmedia.com.
Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.