Making Sense Of The Various Healthcare Reform Proposals

Now that I have discussed the role that the uninsured and underinsured play in the healthcare debate, it’s time to take a closer look at the various bills that are under discussion in Congress and what each would mean for you, the patient.

It’s not clear what the final bill that will actually pass would look like, or whether it would pass at all, but what we know is that there are currently three bills under discussion in the House and in the Senate.

First of all, the America’s Affordable Health Choices Act (HR 3200, commonly referred to as the Tri-Conference Bill) is under discussion in the House. Without getting into too much jargon (if that is even possible in this debate), the main aspects of this bill include a public health insurance option, a health insurance exchange, mandating insurance and new coverage standards.

In simple terms, the public insurance option means a government-run health insurance plan (similar to Medicare but for all ages). The health insurance exchange means that there would be a setting where the newly created public plan and the private ones would be brought together to compete, so individuals and small companies can shop around, compare prices and coverage, and select a plan. Mandating coverage is requiring everyone to purchase health insurance or pay a tax penalty (equal to 2% of your income). New coverage standards means preventing health insurance plans from refusing coverage for people who have a pre-existing health condition and putting limits on variations in premiums.

In the Senate, one bill under discussion is the Affordable Health Choices Act, (commonly referred to as the Senate HELP committee bill). Generally speaking, this bill features all the proposals included in the House Bill discussed above. The only difference is that this Senate bill has a stronger emphasis on prevention and wellness.

The other bill being negotiated in the Senate is the Senate Finance Committee Bill (no name has been assigned yet, but you might have heard about the “gang of six” Senators working on this bill). This Bill clearly differs from the above-mentioned bills in that it only includes a health insurance exchange, but not a public option. Instead, a health cooperative is being discussed. But what is a health co-op after all?

A health co-op, without getting into much detail, is a an entity made of a health insurance plan and a collection of healthcare providers (hospitals and physicians) that is controlled by its own members -- the insured people. The idea is that the health co-op would compete with the existing private plans as part of the insurance exchange being created.

The two House bills are expected to be merged at some point in time. It will be really interesting to see whether the public option will survive in the final Bill.

There are obviously plenty of details that I have purposefully left out in my discussion. Anyone interested in getting more detailed (and more confusing!) information should go to the bills’ websites.

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