Analysis of Congressional health reform bills highlights similarities, differences, costs

A new Commonwealth Fund report analyzes the similarities, differences, potential impacts, and costs of current bills passed by the five committees of jurisdiction in the United States Congress: Finance Committee and Health, Education, Labor, and Pensions (HELP) Committees in the Senate and the U.S. House of Representatives' Ways and Means, Education and Labor, and Energy and Commerce committees. The report, Provisions of Comprehensive Health Reform Bills of 2009: Health Insurance, Delivery System, and Financing, says all of the bills include provisions that:

• seek to expand and improve health care coverage by building on the strongest aspects of the United States' mixed public-private system—employer-sponsored insurance and Medicaid and the Children's Health Insurance Program—while reorganizing and regulating the individual and small group insurance markets;
• establish requirements for insurers to offer coverage to all Americans who apply and prohibit them from denying coverage or charging more based on people's health;
• create a new health insurance exchange or exchanges;
• set an essential benefit standard for health insurance;
• provide subsidies to help people afford insurance premiums and out-of-pocket costs;
• require all individuals to have health insurance;
• have employers share responsibility for financing coverage;
• improve health care quality and outcomes while controlling costs;
• invest in primary care and provide more funding for prevention and wellness; and
• test innovative provider payment methods.

"The many areas of agreement among the bills currently being considered by Congress reflect broad consensus on what is needed to fix our fragmented and inefficient health care system," said Commonwealth Fund President Karen Davis. "We have a historic opportunity to enact comprehensive national health care reform that ensures that all Americans can get the high quality, affordable health care we need and deserve."

The report also points out that there are differences among the bills in terms of how reform would be financed, and what actions would be taken to control costs and expand coverage, including:

• choice of a public health insurance plan option to be offered through the new insurance exchanges in addition to private plans;
• exemptions from the individual requirement to have health insurance;
• requirements for employers to provide coverage or contribute to a health insurance fund;
• the level of subsidies to purchase health insurance and cost-sharing subsidies; and
• the degree to which revenues to pay for reforms are derived from high income households or from insurers and device manufacturers..

The report will be updated continually as the legislation evolves. An audio companion piece from Commonwealth Fund President Karen Davis, additional breakdowns, comparisons, and an interactive side-by-side chart are available on The Commonwealth Fund's Web site, www.commonwealthfund.org.

Source: Commonwealth Fund