Ahead of Thursday’s bipartisan White House health-care summit, the White House has unveiled the president’s blueprint for the way forward. As expected, there are no sweeping changes (and by that I mean, there’s no public option, even while some Senate liberals are attempting its revival.) The president basically offers a bunch of tweaks to the version that passed the Senate on Christmas Eve. Here are the big-ticket items:
1. The “Cornhusker Kickback,” Ben Nelson's special deal to help Nebraska pay for Medicaid extensions, is eliminated. Instead, the administration is offering additional payments to all states to help cover Medicaid payment increases that result from the bill.
2. The president’s plan will set up a new Health Insurance Rate Authority charged with helping states review unfair premium hikes by private insurers. The government will have the power to ban or roll back such rate hikes.
3. The Medicare “donut hole” will be closed. In 2020, all Medicare recipients will pay a standard 25% coinsurance when they hit the coverage gap.
4. The excise tax on "Cadillac plans" will be delayed and altered. Under the president’s proposal, the Cadillac Tax won’t be implemented until 2018, so that employers and unions have time to renegotiate health-care coverage. The threshold will be raised to $27,500 for families and $10,200 for individuals. Vision and dental won’t be included in the calculation, and there will be exemptions for high-risk occupations and workforces with an unusual composition of workers with expensive health-care needs (for example, older workers or high numbers of women needing maternal care.)
5. Additional measures to prevent waste, fraud and abuse in Medicare and Medicaid will be instituted. Administration officials cite GOP legislation as the source of these ideas, including registration and background checks on billing agencies and individuals. (Their briefing document references Rep. Mark Kirk’s of Illinois, the Republican nominee for the president’s old Senate seat, proposed legislation several times, as well as the Republican Study Committee’s bill.)
6. Lower-income families will receive additional tax credits to help them afford coverage. The President’s measures are more generous than the House bill for families in the $55,000-$80,000 income range, and more generous than the Senate bill in the $44,000-$66,000 income range.
7. Individual responsibility requirements (that is, the penalties imposed on individuals choosing not to purchase insurance) will be lowered. The hardship provisions in the Senate bill, where couples who earn less than $18,700 or people who would have to pay more than 8 percent of their income in premiums, will be preserved.
8. The president makes no changes to the controversial abortion language included in the Senate bill.