| Plan |
A New Vision For American Health Care (Sen. Ted Kennedy D-MA) | |
| Date |
| |
| Overall Approach |
Universal coverage through public & private insurers, made available through a American Health Benefits Gateways (exchanges) | |
| Universal Coverage |
Yes | |
| Guaranteed Coverage |
Yes | |
| Portability |
Not Addressed | |
| Voluntary Employer-Based System |
Yes | |
| New Programs |
American Health Benefit Exchange
State-based Exchanges
Establishes a public health care option
Establishes a Patient Safety Research Center
Creates a Center for Health Outcomes Research & Evaluation
Creates a Retiree Reinsurance Program
Creates a CLASS Independent Benefit program for disabled individuals
Creates a National Prevention, Health Promotion and Public Health Council | |
| Expansion of Existing Public Programs/Federal Law |
Expands Medicaid coverage
Establishes an Office of Women's Health in a number of federal agencies | |
| Insurance Pool |
Not Addressed | |
| State Responsibility |
Option to establish their own Exchanges in collaboration with the federal government | |
| Individual Mandate |
Yes - Coverage enforced through penalty | |
| Employer Mandate |
Policy not yet determined | |
| Private Insurance Mandates |
Guaranteed issue and renewal
No medical underwriting or pre-existing condition requirements
Profit cap
Required to make incentive payments to providers for high quality of care
Requires coverage of preventive care
Dependent coverage extended to age 26
Prohibits lifetime/annual limits | |
| Individual Subsidies |
Sliding scale premium assistance for individuals and families with income up to 500% of the federal poverty level | |
| Individual Vouchers |
Not Addressed | |
| Employer Subsidies |
Provides credites to small businesses for coverage of employees | |
| Individual Plan/Provider Choice |
Yes | |
| National Health Board |
Establishes a Medical Advisory Council to establish minimum qualifying coverage and benefits eligible for low- and moderate-income credits | |
| Tax Changes |
25% credit to employers participating in CLASS Independent Benefits program | |
| Premium/Co-Pay/Deductible |
CLASS Independent Benefit: limited to $65 per month; those with incomes below poverty will pay no more than $5 per month
Sets 3 different cost sharing structures for Gateway coverage | |
| Health Quality Improvement |
Preventing medical errors by using innovative tools and methods
Maximizing the use of health technology and simplifying administrative procedures”
Preventing hospital readmissions by mandating discharge planning
Managing chronic conditions through better coordination and integration of care made possible by medical homes and community health teams
Reducing health disparities by ensuring they are taken into account in workforce programs and quality measures | |
| Information Technology / Electronic Medical Records |
Establishes health IT standards & protocols
Provides Health IT grants | |
| Individual Responsibility for Health and Lifestyle |
Not specifically addressed | |
| Preventive care |
Creates a Center for Health Outcomes Research and Evaluation
Establishes a National Prevention, Health Promotion and Public Health Council to develop a national prevention, health promotion, public health, and integrative health care strategy
Creates a Prevention & Public Health Investment Fund
Remove barriers to preventive services that discourage individuals from participating in screenings and preventive initiatives such as copayments and deductibles | |
| Transparency |
Requires public reporting of quality measures & readmission rates | |
| Drug Reimportation |
Not Addressed | |
| Medicare Rx Drug Price Negotiation |
Not Addressed | |
| Medical Personnel Education |
Create a Workforce Commission to make recommendations on how to ensure a sufficient supply of primary care physicians, nurses, and other practitioners
Creates various grant & loan forgiveness programs to specially train health professional
Adds new programs to increase the number of nurse faculty.
Calls for curriculum focused on cultural competency measures, prevention and public health competency measures, working with individuals with disabilities competency measures | |
| Mental Health Parity |
Not Addressed | |
| Other Provisions |
Expands access to prescription drug discount program for children’s hospitals, critical access hospitals, and certain rural referral centers and sole community hospitals | |
| Cost |
Not yet scored by CBO | |
| Cost Containment |
Crack down on waste, fraud and abuse | |
| Financing |
Not Addressed | |
| Source |
“Affordable Health Choices Act” Draft, Senate Committee on Health, Education, Labor and Pensions, June 9, 2009
“A New Vision for American Health Care: Strengthening What Works and Fixing What Doesn’t,” Senate Committee on Health, Education, Labor and Pensions, May 21, 2009 | |
