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Thomas Field, thumbing through Sec. 3105, found a section stipulating that individuals or families making less than 500 percent of the poverty level will not have to pay more than 10 percent of their income toward health care costs. Those who make below 150 percent of the poverty level would have to pay a maximum of 1 percent.
The current poverty level is $10,830 for an individual and $22,050 for a family of four. Regardless of income, those who do not buy coverage or are without coverage for 90 days will be taxed, Kris DiGiovanni and Jeoffry Gordon noted, barring poverty hardships, membership in a Native American tribe or residence in a state that does not recognize the Public Health Safety Act. The tax would be determined annually by the Treasury and Health and Human Services secretaries.
Individuals and families are required to report on their tax returns the amount spent on health insurance and the number of months each family member was insured, DiGiovanni found in Sec. 6055. Under an amendment to the Fair Labor Standards Act of 1938, employers are required to inform employees about the health coverage in their area and provide contact information.
In lieu of a public option or stronger cost controls, much of the bill focuses on a bevy of secondary issues, which one reader determined to be an attempt by Democrats to make it appear as if real reform were being taken on when in reality they were only tinkering.
Several readers, in fact, noticed that the section on a public health care option is thin. Real thin.
DiGiovanni, Gordon and Stephen McClurkin all noted its near absence. In Sec. 3116, the only definition that appears under "Public Health Insurance Option" is "[Policy under discussion]," and given what Chris Dodd has been saying, there's no guarantee it'll make it at all.
Ditto Sec. 3115, "Shared Responsibility of Employers," though the bill mandates that there be "no changes to existing coverage." Sec. 142 states that all Americans should have affordable health care choices comparable to those enjoyed by members of Congress, but does not provide a federal means of seeing that through.
Rather, as Tim Sylvester found, individual states will set up federally subsidized systems similar to the Federal Employees Health Benefits Program, which relies on private insurers but holds them to certain standards of coverage. Sylvester calculated that he would save more than $2,000 per year on medications alone if allowed to choose among the plans in his area.
There is, however, room for a public option in the bill. In Sec. 3105, Jon Walker noticed that federal subsidies for all individuals buying private insurance are calculated based on the prices of the three lowest-cost plans, so a strong public option could significantly reduce personal subsidies overall. Given that section, Walker estimated that the Congressional Budget Office would score a bill with a public option about $15 billion cheaper per year than one without it.
David Leslie highlighted Sec. 222, which calls for comprehensive electronic records within two years of the bill's passage and a National Health Plan Identifier system to be established by the Department of Health and Human Services within one year. Besides information technology, Gordon found provisions for comparative-effectiveness studies of medical technology, fraud prevention and expansion of the health care workforce and local health departments.
A more radical move, which both Gordon and Jane Henderson found, is the establishment of a "Community Living Assistance program," or CLASS, which would subsidize home and family care for the disabled to keep them out of nursing homes or other institutions.
The bill has a lot for advocates of preventative care to like, too, Henderson said. She counted 45 appearances of the word "preventive" and 86 mentions of "prevention," excepting references to fraud prevention. The first line of the bill, which lists objectives, places "enhance disease prevention" fourth after availability, cost control and improved quality.
Preventive care also earns some enforcement language in Sec. 2708, which requires insurers to cover items or services that are recommended or strongly recommended by the U.S. Preventive Services Task Force.
Finally, Pat Eastman made a good point: Much of the bill amends or at least requires a look at the Public Health Service Act or Internal Revenue Service codes. If that seems like too much work but you'd still like to help, plenty of the 615 pages are more readable, at least by the standards of congressional legislation.
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