Drafters of a proposed Senate health bill manager’s amendment say Medicare should cut physicians’ reimbursement rates 21% in 2010, rather than increasing the reimbursement rates 0.5%, according to the Congressional Budget Office.
The proposed amendment also would make many other changes.
Health Insurance Consumer Protection Provisions
– Prohibit wellness programs from asking or using information about the “presence or storage of a lawfully-possessed firearm or ammunition in the residence or on the property of an individual” or “the lawful use, possession, or storage of a firearm or ammunition by an individual.” (Section 2716(c))
– Limit insurers’ ability to cap annual coverage for “essential health benefits” from now until 2014, then ban annual coverage limits. (Section 2711)
– Require health insurers to cover out-of-network emergency services as if the services were provided in-network. (Section 2719A)
Health Insurance Plan Operations Provisions
– Reduce the proposed annual health insurance provider fee for small insurers. Health insurers with less than $25 million in annual health insurance net written premiums would pay no annual fees, and insurers with health net written premiums in the $25 million to $50 million range would have to count only half of their health premiums when calculating the annual fees. (Section 10905)
– Require a health insurer to provide rebates if the share of premiums going to administrative costs exceeded specified levels. At the federal level, the minimum ratio of claims expenses to premiums would be 85% in the large group market, and 80% in the small group and individual markets. States could require higher minimums. (Section 2718(b))
Health Insurance Customer Provisions
– Expand access to a small business health insurance tax credit. (Section 10105)
– Authorize $200 million for small business wellness program grants. (Section 10408)
– Prohibit health insurance plans from discriminating in favor of highly compensated individuals. (Section 2716(a))
– Keep the proposed $2,500 annual cap on flexible spending account contributions, but index the cap for inflation for any taxable year after Dec. 31, 2011. (Section 10902)
– Require some employers to provide “free choice vouchers” for some employees who would have to pay 8% to 9.8% of household income for group coverage. (Section 10108)