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CCH® BENEFITS — 02/17/09

Healthy Americans Act Makes 2009 Debut

from Spencer’s Benefits Reports: On February 5, Sens. Ron Wyden (Ore.) and Bob Bennett (Utah) introduced S. 391, the Healthy Americans Act, which would guarantee health care coverage to all Americans. The senators, who introduced similar legislation in the previous Congress, were joined in the introduction by a bipartisan group of 11 other senators: Daniel Inouye (Hawaii), Arlen Specter (Pa.), Joseph Lieberman (Conn.), Mary Landrieu (La.), Mike Crapo (Idaho), Bill Nelson (Fla.), Debbie Stabenow (Mich.), Maria Cantwell (Wash.), Lindsey Graham (S.C.), Lamar Alexander (Tenn.), and Jeff Merkley (Ore.).

S. 391 would require every adult to enroll in a Healthy Americans Private Insurance (HAPI) plan, which could include a plan established by the states or a plan offered by an employer (in a two-year transition period), unless coverage is provided through Medicare, Medicaid, a retiree health plan, a collectively bargained plan, a veterans’ plan, or a plan of the Indian Health Service. Adults also would be responsible for enrolling their dependent children.

Individuals who fail to enroll in a HAPI plan would be fined an amount equal to the cost of coverage available plus a penalty of 15%.

In general, a HAPI plan would be required to provide benefits for health care items and services that are actuarially equivalent to or greater in value than the benefits offered as of Jan. 1, 2009, under the Blue Cross/Blue Shield Standard Plan provided under the Federal Employees Health Benefits Program.

All employers, along with individuals and the government, would share the responsibility of financing health care. During a two-year transition period, employers that provide employee health benefits would be required to convert their workers’ health care premiums into higher wages. Employers that do not currently offer health benefits would have to make phased-in “employer shared responsibility payments,” which would be used to provide financial assistance to individuals and families of modest income.

After two years, all employers would make employer shared responsibility payments. These payments would reflect the relative ability of small and large employers and low- and high-wage industries to make such payments, and would have no direct impact on the coverage that is available to their employees.

According to a recent Commonwealth Fund report, the Wyden-Bennett health reform proposal would increase total health spending by $13.7 billion over a ten-year period, which would include a $98.4 billion spending increase by employers and decreases in spending by the federal government ($39.6 billion), state and local governments ($29.0 billion), and households ($16.2 billion).

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