Breaking: THE HOUSE TRI-COMMITTEE HEALTH REFORM DISCUSSION DRAFT SUMMARY

Now try saying that five times fast…

Yes, the House’s health reform discussion draft is out (all 900 pages of bill text and a summary, which can be found at the House Committee of Labor and Education’s website here). I have not done anything except peruse it but in that perusal, it is safe to say that it is more “reform-ish” than the outline from the Senate Finance Committee. For example, it includes both a public plan and a national health insurance exchange and I also found it interesting that for products sold through the health insurance exchange, it requires that 85% of health insurance premiums go to services (referred to as the medical loss ratio or MLR).

Here are some high points from the House summary:

I. COVERAGE AND CHOICE
The discussion draft builds on what works in today’s health care system and fixes the parts that are broken. It protects current coverage – allowing individuals to keep the insurance they have if they like it – and preserves choice of doctors, hospitals, and health plan. It achieves these reforms through creating:

• A Health Insurance Exchange. The new Health Insurance Exchange creates a transparent and functional marketplace for individuals and small employers to comparison shop among private and public insurers. It sets and enforces insurance reforms and consumer protections, facilitates enrollment, and administers affordability credits to help low‐ and middle‐income individuals and families purchase insurance. Over time, the Exchange will be opened to all employers as another
  choice for covering their employees. States may opt to operate the exchange in lieu of the national exchange provided they follow the federal rules.
• A public health insurance option. One of the many choices of health insurance within the health insurance Exchange includes a public health insurance option. It will create a new choice in many areas of our country dominated by a just one or two private insurers today. The public option will operate on a level playing field. It will be subject to the same market reforms and consumer protections as other private plans in the Exchange and it will be self‐sustaining ‐‐ financed only by
  its premiums.
• Guaranteed coverage and insurance market reforms. Insurance companies will no longer be able to engage in discriminatory practices that enable them to refuse to sell or renew policies today due to an individual’s health status. In addition, they can no longer exclude coverage of treatments for pre‐existing health conditions. The discussion draft also protects consumers by prohibiting lifetime and annual limits on benefits. The proposal also limits the ability of insurance companies to charge higher rates due to health status, gender, or other factors. Under the proposal, premiums can vary based only on age (no more than 2:1), geography and family size.

Enjoy. More to come later. ~BAA