The three U.S. House committee chairmen responsible for healthcare reform—Charles Rangel, Henry Waxman, and George Miller—issued a draft proposal of their bill in order to begin deliberations with the House Democratic Caucus on the details. The four-page outline painted in broad strokes the components of their reform plan.
The bill would replace the Sustainable Growth Rate formula that governs Medicare physician payment and would increase “reimbursement for primary care providers, improve the Part D program, and implement many other MedPAC recommendations.” In addition, federal health programs, including the public plan option, will “reward high quality, efficient care, and reduce disparities” through the use of “innovative payment approaches” and will reduce preventable hospital readmissions for Medicare beneficiaries. Incentives would also be offered to entice health professionals to practice primary care.
The proposal includes a “self-sustaining” public health insurance option to compete on a “level field” with private insurers. The public plan would be offered through a health insurance exchange that will provide a “transparent marketplace” for individuals and businesses to shop for insurance plans. Insurers would also be prohibited from excluding pre-existing conditions or basing premiums on health status, age, and gender.
Individuals would be required to have health insurance, and employers would have to provide it or fund the coverage their workers obtain on their own. The smallest companies would be exempted from the so-called play-or-pay requirement, and other small businesses would receive a tax credit for providing health insurance. Low-income families would receive a subsidy to purchase insurance, and eligibility for Medicaid will be expanded, with higher payment rates designed to improve access to primary care under Medicaid.
