Question of the Week: Health Care Reform
These questions are culled from phone calls, letters, faxes and e-mails sent to my Thousand Oaks, Solvang, and Washington offices. Each week I will add another question and answer.
Week of July 31, 2009
• Question: What major changes have been made to H.R. 3200, the health care bill, since it was first introduced?
→ Answer: H.R. 3200 as introduced:
Would have required small businesses with payrolls as low as $250,000 a year to offer insurance or pay increased taxes.
The bill as amended:
Would exempt businesses with payrolls up to $500,000 from new payroll taxes. The bill would still impose a surtax on individuals and small businesses with incomes above $350,000. The bill also still imposes a payroll tax of up to 8 percent on businesses with payrolls above $500,000.
The bill as introduced:
Would have provided taxpayer subsidies to ensure people would not have to pay more than 11 percent of their income on health insurance, if they do not get insurance through their employers and earn less than 400 percent of federal poverty level ($43,420 for an individual and $88,200 for a family of four).
The bill as amended:
Would provide taxpayer subsidies to ensure they do not pay more than 12 percent of their income on health insurance.
The bill as introduced:
Would have allowed the government-run health care plan to use Medicare rates to reimburse doctors and other medical providers. Medicare rates are usually lower than the actual cost to provide the services. This has resulted in “cost shifting,” because private patients and insurance companies have been forced to make up the difference to ensure doctors and hospitals stay in business.
The bill as amended:
Would require the government-run health care plan to negotiate payment rates with doctors and hospitals.
The bill as introduced:
Would have required federal taxpayers to pay the full cost of expanding Medicaid (called Medi-Cal in California) to cover all people who make up to 133 percent of the federal poverty level ($14,440 for an individual and $29,400 for a family of four). Under current law, the federal government pays 57 percent of the cost for those who are at 100 percent of the federal poverty level ($10,830 for an individual and $22,050 for an individual).
The bill as amended:
Would require states to pay part of this cost, which would be an unfunded mandate.
One of the sections of the bill that has not changed: The Energy and Commerce Committee rejected an amendment by Rep. Norman Deal that would have established an enforcement mechanism to ensure illegal immigrants do not get taxpayer-subsidized health insurance. Therefore, illegal immigrants may be able to get taxpayer subsidies for health care under H.R. 3200.
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