The Senate Finance Committee has posted the legislative language of S. 1796 — the 1,502-page America’s Healthy Future Act bill — on its website.
The committee staff directed the AHFA bill proposal under the direction of Senate Finance Committee Chairman Max Baucus, D-Mont. For weeks, the proposal was simply a rough summary, with no bill number. Republicans complained that they had not seen actual bill provisions.
The text of the bill is now available at http://finance.senate.gov/press/Bpress/2009press/prb101909.pdf
The bill number probably will be S. 1796, according to press reports.
The bill is so long that the table of contents takes up more than 12 pages and includes six different divisions, or “titles.”
Title I deals with health care coverage; Title II, with disease prevention and wellness; Title III, with improving the quality and efficiency of health care; Title IV, with transparency and program integrity; Title V, with fighting waste, fraud and abuse; and Title VI, with revenue provisions.
The bill calls for using a combination of coverage mandates, government health program expansion, state health insurance cooperatives, and subsidized health insurance purchasing “exchanges” to try to increase the percentage of U.S. residents who have health coverage.
One provision, Section 2226, would permit a state to opt out of the health exchange system program and other reform requirements, if the state could come up with another method of providing comprehensive coverage for residents that could do at least as well at the exchange system at providing affordable health coverage for all residents and increasing the number of uninsured residents who end up with coverage.
Unlike some of the other major health reform bills, S. 1796 would not start a major new long term care insurance program. Instead, the bill includes a provision, S. 1642, expressing the sense of the Senate that
Congress ought to “address long-term services and supports in a comprehensive way that guarantees elderly and disabled individuals the care they need; and long term services and supports should be made available in the community in addition to in institutions.”
Similarly, instead of including specific provisions concerning changes in medical malpractice rules, S. 1796 includes a provision, Section 3701, that would express the sense of the Senate that Congress ought to consider developing a new system for resolving medical malpractice claims.
The revenue title, which starts on page 1420 of the Web version of the bill text, begins with sections concerning a proposed 40% excise tax on “high cost employer-sponsored health coverage.” The tax would take effect in 2013, for health benefits packages with a value of $8,000 for individuals and $21,000 for families.
The affected “applicable employer-sponsored coverage” would include any group health coverage that would be excludable under Section 106 of the Internal Revenue Code — except that the term would exclude disability coverage, long term care coverage, and any coverage that cannot be deducted from gross income.
The cost of a flexible spending account would include FSA contributions and excess contributions, and the cost of health savings accounts would include any employer HSA contributions.
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