In May 2009, committees at the House of Representatives and the Senate held various discussions on expanding health care coverage and health care reform. Lawmakers are working to draft legislation that will begin moving through the committee and the floor debate process in June.
The following proposals are under discussion and could become part of upcoming reform legislation:
- Require most individuals to obtain insurance coverage (individual mandate)
- Require most employers to offer and contribute to the cost of coverage (employer mandate)
- Establish a health insurance exchange and a national Web site through which individuals and families could obtain information and enroll in health coverage
- Establish a public plan option
- Impose guaranteed issue and renewal requirements and premium rating restrictions on health insurance coverage
- Provide subsidies to help individuals and families whose incomes are up to 400 percent of the poverty level purchase coverage
- Try to reduce costs and improve quality by expanding the use of health information technology, emphasizing primary and preventive care, providing incentives for care coordination and medical homes, and encouraging wellness
- Establish a long-term care program funded through voluntary payroll deductions.
Several revenue-raisers are being considered:
- A cap on the tax exclusion for employer-provided health benefits
- Limits on health flexible spending accounts (FSAs) and health reimbursement arrangements (HRAs)
- New requirements for health savings accounts (HSAs)
- Changes to the definition of qualified medical expenses eligible for reimbursement through FSAs, HRAs and HSAs