If you, like so many people, have been following the genesis and progression of the Senate and House healthcare bills then it is very likely at this point that you have more questions than answers about the proposals and how they will affect you and your family here in the real world. Today the LA Times tackled some of the most pressing queries that have been issuing in from their readers. The questions – and their answers – are useful to people all over the country who have been wondering what life will be like in a country with government-sponsored insurance.
The first question raised in the article had to do with people who currently have insurance through an employer that is not feasibly affordable for their household. Will these families be more able to afford healthcare under the new bill(s)? The answer to that is yes – probably. One of the best aspects of healthcare reform for those who already have their own insurance is the requirement that consumers’ share of premiums not exceed a fixed percentage of their incomes: ten percent under the Senate’s bill, and twelve percent under the House’s. Of course, those families with incomes under four hundred percent of the federal poverty level will be eligible under either bill for subsidized insurance through the government. As it stands now, families with low- to moderate incomes would pay reasonable insurance premiums under these plans.
Another big concern about the healthcare proposals comes from senior citizens who may be planning on retiring early, before their Social Security payments and benefits kick in. Right now, older Americans taking this route are compelled to pay the very expensive COBRA payments to keep themselves insured. Under both the House and Senate versions of the progressive healthcare reform measure, insurance exchanges would be set up to help early-retiring seniors compare and purchase healthcare policies. They’d be able to compare the costs and benefits of each plan on these websites. The benefit of the proposed insurance exchanges is that insurance companies will no longer be able under law to discriminate against customers based on their age or preexisting conditions. And, of course, these seniors would have the same options as others to obtain federal subsidies if their income level falls below four hundred percent of the federal poverty level.
Another major concern with the House and Senate medical insurance bills is the issue of medical bill related bankruptcies, which so many consumers with chronic illnesses have had to file because of the exorbitant costs of their out-of-pocket obligations. It is believed that either the House or Senate healthcare bills would greatly reduce so-called medical bankruptcy, although it would be unrealistic to expect that either would wipe it out completely. Both proposals contain standards meant to protect consumer households from the tragedy of enormous medical bills through government-established healthcare exchanges. These exchanges would, again, be open to those who either don’t get healthcare through their employer or cannot afford the coverage that is offered.
Employers who keep more than a certain amount of employers would be obliged to either offer healthcare coverage to their workers or else face a fine. Of course, for some employers it will be cheaper to pay the fine then it would be to pay for healthcare for everyone in their employ. If your employer does not offer insurance, you too will be eligible for healthcare under one of the insurance exchanges.
Both the House and Senate bills contain ceilings on cost-sharing, or the out-of-pocket expenses (co-payments, deductibles) that consumers are expected to pay in addition to their premiums. The House would cap out-of-pocket expenses at five thousand dollars annually for individuals and eleven thousand dollars a year for families. The Senate’s cap is $5,950 for individuals and $11,900 for families. Granted, lawmakers acknowledge that this will not completely eradicate medical debt and possibly the crisis of bankruptcy. This is especially true for those who are chronically ill, and may run up against their ceiling for many years in a row. Hopefully either one of the proposals would make a major dent in the massive amount of medical bankruptcies, however.
Until both the House and Senate healthcare bills are merged or Congress as a whole decided to keep and move forward with just one of the bills, there is still so much uncertainty about the future of medical insurance in America. For now, consumers can only watch the news closely and follow along with the many changes and discussions that are taking place. Hopefully, anything that comes of all this legislative wrangling will still be better than what so many people have right now, which is nothing.