DEMOCRATIC CANDIDATES' HEALTH PLANS |
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courtesy Kaiser Family Foundation, Health Policy Alternatives, Inc. http://health08.org |
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Individual Mandate |
Employer Mandate |
Pooling |
Private Insurance |
Financing |
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No. |
No. Small businesses could buy into the new FEHBP-like insurance pool with federal subsidies based on the proportion of low-wage workers. Cover catastrophic care through a federal reinsurance pool to reimburse employers insurers or associations for 75% of costs exceeding $50,000 per individual. |
Uninsured and small businesses to buy into Federal Employee Health Benefit Plan clone. FEHBP insurers required to offer plans in the new universal buy-in plan and could receive risk adjusted payments based on age and health status. | Allow insurers in the individual market access to the reinsurance pool if they agree not to turn applicants away because of pre-existing conditions or risk of them and use community rating. | Not specified, but estimates that total costs of the initiative would be $110 billion. | |
| Yes. Tax credit set to ensure that premiums do not exceed a percentage of family income. |
Play or pay for large employers. No mandate for small employers. Employers could buy coverage through the new Health Choices Menu (FEHBP) on behalf of workers or early retirees. A “retiree health legacy initiative” would provide qualifying public and private sector employers offering retiree health plans with a tax credit to offset catastrophic health expenditures, | Health Choices Menu offered through the FEHBP, with FEHBP specs, along with a public plan option similar to Medicare. Mental health parity and dental included. |
Require private insurers to provide coverage on a guaranteed issue and guaranteed renewable basis. Limit premium variations on basis of age, gender or occupation. Require insurers to meet minimum loss ratio. |
Costs $110 billion a year. $35 billion financed by savings from quality and modernization initiatives. $21 billion in savings from Medicare private plans, recapturing Medicare and Medicaid payments to hospitals for the uninsured, and constraining prescription drug costs. Also $54 billion in revenue from limiting the tax exclusion for employer-paid health insurance and discontinuing tax cuts for those with incomes over $250K. | |
| Yes. Enrollment into HealthMart automatic unless individuals and employees elect other coverage. |
Play or pay. Require employers that elect not to offer coverage to pay a defined contribution into HealthMart. | Universal HealthMart, for those not covered by employer or other private health insurance. HealthMart modelled on FEHBP. The feds would subsidize premiums for low income individual and businesses. | HealthMart would offer coverage through private insurers that are willing to agree to specific standards, such as guaranteed issue, and offer comprehensive benefit packages. | The Universal HealthMart financed by a combination of employer and individual/family premiums and from savings through “eliminating the existing inefficiencies in the system.” Additional revenues to finance transition costs would come from “other revenue streams” including those that result from ending the war in Iraq. | |
| Yes. Tax credits to help subsidize the cost of insurance purchased through Health Markets. | Play or pay. | Health Markets, nonprofit purchasing pools offering competing public and private health plans, establishes , and expands public insurance to serve low income | Require all health insurers to spend at least 85% of premiums on patient care benefits. Under the new Health Markets, at least one public insurance plan based on Medicare would be offered to people who do not have other coverage. | Costs $90-$120 billion a year. Would finance the plan by rolling back tax cuts for those earning more than $200,000 a year. | |
| No. Every citizen gets a voucher with copays and deductible | No. Opposes mandates on employers or tax incentives related to coverage. | n.a. | Permit the purchase of additional coverage by individuals beyond coverage provided under a voucher. | Medicare/Medicaid would be phased out over time. Anticipates savings of 30% of current spending from reductions in administrative costs from single payer. | |
| Not needed as standard coverage available to all. Benefits would be comprehensive, including dental, mental health and vision services, and long-term care, and no deductibles or other cost sharing would be imposed. (H.R. 676) | Not necessary | All citizens = one pool | Replace existing public and private health insurance plans with a new universal public plan. Prohibit private health insurance from covering benefits provided under the new public program. Permit coverage of additional benefits. | Federal payroll tax increase of 1.45 percent to 4.75 percent for both employee and employer; stock transfer tax of 0.25 percent on both buyer and seller; income tax surcharge of 5 percent on annual income between $184,000 and $279,999 and surcharge of 10 percent on annual income of $280,000 or more; and repeal of the 2001 and 2002 Bush tax cuts for the wealthy. Funds that would have been spent on Medicare, Medicaid, SCHIP and other federal health care go to new program. | |
| Require all children to have health insurance | Play or pay | National Health Insurance Exchange for employers and individuals without other coverage. Require participating insurers to: offer coverage on a guaranteed issue basis; charge a fair and stable premium that is not rated by health status; offer coverage at least as generous as the new public plan. Can enroll in the new public plan or in approved private plans. | Prohibit insurers from denying coverage based on pre-existing conditions. Require health plans to disclose the percentage of their premiums that actually goes to paying for patient care as opposed to administrative costs. | $50 to $65 billion a year. Expects much of the financing to come from savings within the health care system. Additional revenue to come from discontinuing tax cuts for those with incomes over $250,000. | |
| Yes. Make available sliding scale, refundable tax credits for purchase of coverage through employer plans, or to buy into the FEHBP or Medicare. | Play or pay. Contributions required from employers would be on a sliding scale basis according to the size of the business. | Make FEHBP available to individuals, families, and small businesses; coverage would be portable. | Prohibit insurers from excluding coverage due to pre-existing conditions. Require insurers to spend at least 85% of premium dollars on direct care benefit | Efficiency savings sufficient to cover the $104 to $110 billion per year cost. He says that the plan is achievable “without increased taxes.” | |
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