Elements of The Bill
According to a preliminary analysis by the Congressional Budget Office in May 2008, the bill includes the following elements:
- Administration of the program is by new state-sponsored "Health Help Agencies" (HHA). States must establish these organizations, which will approve health plans from private insurers, provide for enrollment in plans, and act as a conduit for premium payments from the federal government to individual insurance carriers.
- All citizens and permanent residents would be required to pay for coverage as part of their federal tax liability. Payment would be made via tax withholding by employers. Individuals would effectively pay the federal government, which would channel the funds to the appropriate HHA and from there to the insurers. Employers would no longer provide basic coverage in most cases.
- Taxpayers would have a large healthcare standard deduction, which would increase with inflation. This would help taxpayers pay the tax liability that has now replaced insurance premiums. This essentially replaces the tax exclusion for health care benefits presently paid by employers. Certain low-income taxpayers would be eligible for premium assistance.
- The size of the standard deduction for 2009 would range from $6,000 for individuals to $15,210 for couples with children, with incremental amounts for additional children. As a standard deduction, this reduces the income reported as subject to tax. However, this deduction would phase out for higher-income taxpayers, reducing to zero for couples earning over $250,000.
- Mandates that employers provide salary and wages increases over a two-year period essentially equal to the amount paid previously for basic healthcare insurance premiums, as employers no longer have to provide basic healthcare coverage.
- Employers pay a new tax equal to between 3 percent and 26 percent of the national average premium for the minimum benefits package for each employee, depending on their firm size and amount of gross revenues per employee.
- The basic plan would be equal to the Federal Employee Health Benefits (FEHB) Program, with some exceptions. For example, Medicare and military healthcare recipients would be outside the scope of this bill.
- Premiums can vary only to reflect geography and smoking status.
- Individuals can have more expensive (i.e., non-basic) coverage plans paid directly to insurers.
- Certain individuals would be phased out of the Medicaid program, via participation in their state's HHA.
Read more about this topic: Healthy Americans Act
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