Comparing healthcare proposals

By ERICA WERNER and RICARDO ALONSO-ZALDIVAR

The Associated Press

WASHINGTON — Here is a comparison of the three healthcare bills before Congress, including one by House Democrats and an alternative by House Republicans.

In the Senate, Majority Leader Harry Reid, D-Nev., is finalizing legislation merging the work of two committees and making other changes. The Senate Democrats’ bill has not yet been made public, so some specifics are unknown.

House Democratic bill: Affordable Health Care for America Act

Who’s covered: About 96 percent of legal residents younger than 65 — compared with 83 percent now.

Cost: The Congressional Budget Office says the bill’s cost of expanding insurance coverage over 10 years is $1.055 trillion. The net cost is $894 billion.

How it’s paid for: New income taxes on single people making more than $500,000 a year and couples making more than $1 million.

Requirements for individuals: Individuals must have insurance, enforced through a tax penalty of 2.5 percent of income.

Requirements for employers: Employers must provide insurance or pay a penalty of 8 percent of payroll. Companies with payrolls under $500,000 annually are exempt.

Subsidies: Individuals and families with annual income up to 400 percent of poverty level, or $88,000 for a family of four, would get sliding-scale subsidies to help them buy coverage beginning in 2013.

How you choose your health insurance: Beginning in 2013 through a Health Insurance Exchange. States could opt to operate their own exchanges if they follow federal rules.

Benefits package: A committee would recommend a so-called essential benefits package including preventive services. Out-of pocket costs would be capped.

Insurance industry restrictions: No denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender.

Government-run plan: A new public plan available through the insurance exchanges.

House Republican bill: Common Sense Health Care Reform and Affordability Act

Who’s covered: About 83 percent of legal residents younger than 65 — roughly in line with the share covered now.

Cost: CBO says the gross cost of the bill is $61 billion over 10 years.

How it’s paid for: No new taxes.

Requirements for individuals: No mandates.

Requirements for employers: No mandate.

Subsidies: Expands and revamps high-risk pools for people who can’t get health insurance because of pre-existing medical conditions.

How you choose your health insurance: Allows individuals to buy coverage across state lines.

Benefit package: No federal standard for basic benefits package.

Insurance industry restrictions: Insurers barred from dropping coverage when a person gets sick, except in cases of fraud.

Government-run plan: None.

Senate Democratic bill:

Who’s covered: The Senate Finance version would cover an estimated 94 percent of Americans.

Cost: Senate leaders aim to keep it under $900 billion over 10 years.

How it’s paid for: Fees on insurance companies, drugmakers, medical-device manufacturers. Cuts to Medicare and Medicaid. A fee on employers whose workers receive government subsidies to help them pay premiums. Fines on people who fail to buy coverage.

Requirements for individuals: Almost everyone must get coverage through an employer, on their own or through a government plan.

Requirements for employers: Not required to offer coverage, but companies with more than 50 full-time workers would pay a fee as high as $750 multiplied by the total size of the work force if the government ends up subsidizing employees’ coverage.

Subsidies: Tax credits for individuals and families likely making up to 400 percent of the federal poverty level. Tax credits for small employers.

Benefits package: All plans sold to individuals and small businesses would have to cover basic benefits.

Insurance industry restrictions: No denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age and family size.

Government-run plan: Reid proposed a new federal insurance plan last week with payment rates to providers negotiated by the health and human services secretary. Unlike the House bill, states could opt out of the plan.

How you choose your health insurance: Self-employed people, uninsured individuals and small businesses could pick a plan through state-based pools.

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