November 20, 2009 10:48 AM

What's in the Senate Health Bill for You?

By
CBSNews
(CBS)  Cathy Elkins lost her job six months ago and now volunteers at a Virginia food bank. With an income of $13,000 a year, she can't afford health insurance.

"Anything could pop up at any time and could ruin me," she said.

Under the Senate's proposed health care bill, she'd qualify for free health insurance.

The bill extends Medicaid benefits to Americans making up to 133 percent of the poverty level. In Cathy's state, Virginia, that means individuals making less than $14,000 or families making less than $29,000.

Americans making more than that - up to roughly $88,000 per family - would get tax credits to help them afford private insurance.

The lower your income, the more help you'd get. Credits would be worth anywhere from a couple hundred dollars a year to thousands.

But those who don't purchase insurance (even with those incentives) will face fines - $75 the first year, $350 the second, and $750 after that.

The Patient Protection and Affordable Care Act, unveiled by Senate Majority Leader Harry Reid on Wednesday night, would extend health coverage to 94 percent of eligible Americans, reducing the number of uninsured individuals by 31 million - leaving about 24 million people uninsured. (That's more Americans covered than under the House bill, because Reid's bill would postpone subsidies for a year, allowing for greater assistance to reduce insurance premium costs.)

The Congressional Budget Office says the bill would cost $848 billion over 10 years, while reducing the deficit by $130 billion.

Patient Protection and Affordable Care Act (Text of Senate's Health Reform Bill)
CBSNews.com Special Report: Health Care

To help pay for it all, the Senate bill would heavily tax high-cost insurance plans, impose a 5% tax on elective cosmetic surgery (which some wags have nicknamed the "Bo-tax," estimated to raised $6 billion), and slightly raise Medicare payroll taxes for the wealthiest Americans.

The Medicare tax rate is currently 2.9%, split between employee and employer, with no wage cap (as there is for Social Security taxes). The Senate bill would increase the employee's rate 0.5% for earnings above $250,000 for joint returns, $200,000 for individuals returns, beginning in calendar year 2013.

Republicans blasted the plan, saying states will end up footing the bill for the poor.

"We are going to do everything we can, obviously, to defeat this bad piece of legislation," said John Thune, R-S.D.

CBS News Congressional correspondent Nancy Cordes outlines some of the bill's key provisions.

Like the House bill, the Senate version would impose an immediate ban on insurance abuses, such as dropping customers with preexisting conditions.

It does include a government-run public option for Americans without insurance, though the Senate version would allow states to opt out of the program if they want to.

It would require most individuals to purchase coverage through their employer, privately, or through a public plan. (It includes hardship exemptions.) Those who choose not to purchase insurance would face fines, beginning at $95 in 2014, and increasing over time to $750.


Key Provisions of the Bill:

• Effective Date 2014

• Creates a new public federal health insurance plan, the so-called "public option" which would compete with private insurers. States would have the choice of opting out by passing a state law.

• Establishes Health Insurance Exchanges, a marketplace where individuals, small businesses and others could purchase health care coverage.

• Insurance companies could not refuse coverage based on pre-existing conditions, and would not allow higher premiums based on pre-existing conditions or gender.

• Allows children to stay on their parents' plan up to age 26.

• There's no employer mandate, but fines are paid by companies if the government subsidizes an employee's coverage.

• Extends tax credits to individuals and families earning up to 400 percent of the poverty level, on a sliding scale depending on income. On the low end of the scale, Americans would pay no more than 2 percent of their income on premiums, rising to 9.8 percent at the high end of the scale.

• Forty-percent tax on high premium insurance plans (so-called "Cadillac" plans) costing over $8,500 for individuals and $23,000 for families.

• Creates a new 5-percent tax on elective cosmetic surgery.

• Increases Medicare payroll taxes by 0.5 percent, to 1.95 percent, for individuals earning more than $200,000 or couples earning more than $250,000.

• Limitations on Health flexible spending accounts, capping annual contributions at $2,500.

• Provides for one-year additional $500 for seniors before hitting the "Medicare donut hole" (the difference between the initial coverage limit and the catastrophic coverage threshold), but does not close the donut hole.

• Expands Medicaid program for low-income people from 100 percent of poverty level to 133 percent of poverty level.

• Immigrants in the country illegally would not receive health care subsidies, nor would they be able to obtain insurance through an insurance exchange.

Copyright 2009 CBS. All rights reserved.
Add a Comment See all 95 Comments
by broomtown December 26, 2009 1:38 PM EST
I am a retired Federal Employee. Under the new Health Plan before the House, will I lose my BC/BS Health Insurance and be forced to take out a plan taht will be proposed by 2013 or 2014? I am covered by the same Federal Employees Benefit Program as those idiots in Washington.
Reply to this comment
by downrivers December 24, 2009 11:34 AM EST
We spend more than any other country while failing to cover some 30-40 million people, and yet many countries who spend less of their GDP on healthcare than we do insure ALL of their citizens and those visiting their country.

Those who want the privilege of paying exorbitant premiums for lousy policies should be allowed to continue to do so.
Reply to this comment
by mccowanphil November 20, 2009 6:38 PM EST
What we are continuing to see is the non-stop march toward Socialism in this country that used to be a republic. It is close to the point where people will be better off stopping work and going on the government dole. Welfare, Unemployment, Food Stamps, Medicare, GFree Healthcare, and a bevy of other freebies await those who jump on the gravy train (Trough)and quit paying taxes at all. My question is then: "What is the government going to pay for all these perks when there is no person working in the future? Right now, what's in the Obama & company health care bill for me is higher taxes and future bankruptcy of the economy. I am learning to speak Chinese. So should each of you if this passes.
Reply to this comment
by reveal4 November 20, 2009 7:04 PM EST
Reform is sending a message to Wall Street to stop ripping us off. Rich folks will pay for reform, not the average Joe. Rich folks have earned that right over the last two decades. They've been getting fatter and fatter and sassier while the rest of Americans have lost ground, and benefits, and pensions, and real wages, and...healthcare benefits. I don't feel sorry, at all, for rich folks. Trickle up worked just fine, it's time for trickle down to commence.
by mary-miami November 21, 2009 2:01 PM EST
Healthcare is a basic human right. The rich are not the only ones who have a right to good health. The Bush right wing republicans have destroyed the American economy with their greed. Anyone who makes $200,000 a year needs to start paying more taxes...The majority are all insensitive people who only care about themselves and care nothing about the United States. All Americans deserve access to medical care, vision care, and dental care...
www.marymiami.wordpress.com
by dajjadrian November 20, 2009 4:54 PM EST
I would like to express my opinion as a member of this great country. I have never spoken about any other issues or felt as strong as I do about the public option in this health care bill. I feel like legislation is being crammed down ourthroats, and I feel frustrated and helpless. I wish that this bill could be voted on by the American people, because I think it would be crushed. I have a medical background, several medical, nurse, and doctor friends, and I will assure you that there is not full support on this public option part of the bill in the medical world. Yes, we need reform, we need some controls on insurance coverage, and better ability for people to get insurance. We need caps on people sewing the medical industry for ridiculous amounts of money. We need reform, but not this bill. Please, talk to people from other countries that have socialized types of medicine, the public-option is heading that way. They will tell you how horrible their health care and medical conditions really are with this type of medicine. How their loved-ones wait months and months for care, and some die before getting the care. Some even are so thankful to have the US to go to and get this care WHEN they need it, even if they have to pay out of their own pockets. I know personally a few doctors that moved to the US from Canada because of the bad conditions of their health care system. We need reform, we need help, but not the public-option of this bill. We need to be passing more legislation and giving help to those suffering in our poor economy now, people losing their jobs, not having money to pay for health care. Maybe the economy is more to blame in this situation then the health care system. Thank you for allowing me to express my views in this great and free country.
Reply to this comment
by reveal4 November 20, 2009 5:18 PM EST
The public option will cover less than 5% of the population. It is an insurance program. Polling shows that doctors support reform, and about 1/3 of doctors support socialised medicine. People in other major countries like their systems. False fairy tales about people waiting eternally for care and dying are false, scare tactics. Period. Your humble post misstates fact. New polling out this week from separate news organizations also shows that a majority of Americans now support reform with the public option. Your "humble" post is ingraciating, your facts are false.
by dajjadrian November 20, 2009 4:54 PM EST
I would like to express my opinion as a member of this great country. I have never spoken about any other issues or felt as strong as I do about the public option in this health care bill. I feel like legislation is being crammed down ourthroats, and I feel frustrated and helpless. I wish that this bill could be voted on by the American people, because I think it would be crushed. I have a medical background, several medical, nurse, and doctor friends, and I will assure you that there is not full support on this public option part of the bill in the medical world. Yes, we need reform, we need some controls on insurance coverage, and better ability for people to get insurance. We need caps on people sewing the medical industry for ridiculous amounts of money. We need reform, but not this bill. Please, talk to people from other countries that have socialized types of medicine, the public-option is heading that way. They will tell you how horrible their health care and medical conditions really are with this type of medicine. How their loved-ones wait months and months for care, and some die before getting the care. Some even are so thankful to have the US to go to and get this care WHEN they need it, even if they have to pay out of their own pockets. I know personally a few doctors that moved to the US from Canada because of the bad conditions of their health care system. We need reform, we need help, but not the public-option of this bill. We need to be passing more legislation and giving help to those suffering in our poor economy now, people losing their jobs, not having money to pay for health care. Maybe the economy is more to blame in this situation then the health care system. Thank you for allowing me to express my views in this great and free country.
Reply to this comment
by velma179 November 20, 2009 3:24 PM EST
I thought I'd mention this one thing, so folks can put it in perspective.

The way a bill is written is not like a book, magazine or web article.

The margins are very wide and the text is double spaced with Sections, Headings and References (lots! of references... mainly because "new law" is often canceling out "old laws"). Then, of course there is the language of law... "legalese" -- it is VERY detailed and that is important, this is law making, not holiday reading.

So, if you were to take a 2074 page piece of legislation and format it like things you normally read... it would be approximately 600 pages long.
Reply to this comment
by jgg000015 November 20, 2009 2:26 PM EST
by reveal4 November 20, 2009 1:20 PM EST
jgg...You say Obama is now allowing for the first time people with aids to immgrate. This sounds incomprehensible and completely foolish. Can you back your statement up with anything substantive, anything at all? Any information, any reasonable news source, anything at all?


yes, "incomprehensible and completely foolish" was my reaction too.
I'm glad we agree on something.
Reply to this comment
by reveal4 November 20, 2009 4:41 PM EST
I was wrong. I've learned Aids is not easily communicable by casual contact. Therefore, America split with the middle eastern countries and Russia, and now allows immigration for folks with aids. After reading about this, it seems reasonable to allow this change in immigration rules. The CDC made the call, Obama signed the ruling. America is now on board with almost every other country on earth in allowing immigration for folks with aids.
by mmvale November 20, 2009 2:00 PM EST
Don't you find it interesting that the people writing this healthcare bill have excluded themselves from it? Wonder why?
Reply to this comment
by mmvale November 20, 2009 1:58 PM EST
Let's help all people get health insurance, but can we do it in 10 pages or less? Yes, we can, Americans speak up!
Reply to this comment
by zien106 November 20, 2009 1:57 PM EST
Healthcare Cost less than 1 Trillion ?
I don't think so since when you give FREE HEALTH CARE to people so called poor they WILL ABUSE it.
Go to the Emerging Room for any minor health reason , go to the Doctor's Office anytime you like it SINCE YOU DO NOT HAVE to PAY ANYTHING. The state will pay for you.

To make HEALTH CARE reasonable CONGRESS MUST FIND the Ways to eliminate FRAUD and ABUSE... FIRST
Reply to this comment
by bearjoint November 21, 2009 6:10 AM EST
The poor already have free health insurance -- probably better than yours. It is the 'working poor', the ones with several jobs just trying to make ends meet without going on the dole that have inferior or no insurance. An Emergency Room cannot refuse service, so the poor without insurance come to the ER in lieu of a doctor, because they cannot be refused treatment (and testing and wherever that leads). Hospitals end up writing off a lot of this care as uncollectible. By providing resonably priced health care to everyone, we could break the cycle of using the ER as a primary care physician and get care to people before minor problems become major catastrophies. Outpatient testing is cheaper and makes more sense. This doesn't even deal with the problem of illegals who come to the ER because they know then cannot be refused. This new healthcare will not cover them, but as a whole we will continue to pay for their care because they know to use the Emergency Room system where they cannot be refused. If you think that you are going to take on "New Debt" by caring for the poor than you are woefully ignorant of what is happening right now in healthcare. YOU ARE ALREADY PAYING FOR THIS AND HAVE BEEN FOR A VERY LONG TIME. I try not to complain, for me it is job security
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