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But in all seriousness
The American Health Choices Plan will make health insurance more affordable for the millions of Americans who want it. It includes a number of straightforward policies to achieve this end: 1) Ensuring Premium Affordability Through Refundable Tax Credits: Premiums have skyrocketed over the last several years – nearly double since 2000. The American Health Choices Plan helps working families afford coverage through refundable, income-related tax credits to ensure that accessible, high-quality health coverage is affordable to all. 2) Limiting Premium Payments to a Percentage of Income: This credit will ensure that securing quality health care is never a crushing burden for any working family. This guarantee will be achieved through a premium affordability tax credit that ensures that health premiums never rise above a certain percentage of family income. The tax credit will be indexed over time, and designed to maintain consumer price consciousness in choosing health plans, even for those who reach the percentage of income limit. 3) Promoting Shared Responsibility for Large Employers: Hillary Clinton’s comprehensive agenda to lower costs and improve quality will substantially lower costs for employers, making it easier for all firms to continue coverage or offer new health benefits to their workers. In return, large employers will be expected to provide health insurance to their employees or make some contribution to the cost of coverage. This responsibility will take into account firms’ size and average wages. 4) Creating Small Business Tax Credit: Small businesses are engines of job growth in our economy. They account for 80 percent of net new jobs since 1990xvi and create jobs that stay here in America. Yet, they also face the most acute challenges to providing health care for their employees. Small businesses face higher premiums due to limited purchasing power and tend to employ lower-income workers.xvii As a result, small employers cover far fewer of their employees – and the proportion that offers coverage in the first place is less than half that of large firms that offer health insurance. Coverage among small employers is eroding. Since 2000, the share of these small firms offering coverage has fallen from 57 percent to 45 percent.xviii At a time when health care costs are increasingly undermining the economic competitiveness of American business, Hillary Clinton’s plan seeks to make it easier — not harder — for small businesses to create new jobs with health care for workers here in the U.S. Specifically, small businesses that provide quality coverage (e.g., benefits like what Members of Congress receive) and contribute most of the premiums for their workers would qualify for a refundable tax credit. The tax credit could be structured as a traditional policy (e.g., a credit equal to 50 percent of premiums for firms with fewer than 25 employees and less for medium-size employers). As President, Hillary Clinton would work with the small business community and Congress to design the parameters of the credit (e.g., protecting against subsidizing boutique high-income firms) as well as how the credit might dovetail with the tax credit going to individuals and families to make premiums affordable. 5) Strengthening Medicaid and the State Children’s Health Insurance Program to Serve All Low-Income Individuals: These programs serve over 55 million Americans, and have done so successfully through federal-state and private-public collaborations. The holes in this safety net (e.g., lack of coverage of poor, childless adults) will be fixed to ensure that the most vulnerable populations receive affordable, quality care. Similarly, the other part of the safety net, like public hospitals and community health centers, will continue to receive support to serve vulnerable populations. 6) Creating a Retiree Health Legacy Initiative: For major American employers with workforces that face unusually high health care costs due to a high ratio of retirees, health care costs can be a drag on competitiveness and job creation – particularly for our major manufacturers. The American Health Choices Plan will provide a tax credit for qualifying private and public retiree health plans to offset a significant portion of catastrophic expenditures that exceed a certain threshold. Such reinsurance would be time-limited to reflect the short-term demographic need of the aging baby boomers, and would be devised in a manner that does not add to our long-term fiscal challenges. The policy will be designed to make companies more competitive and assist workers – and not to take pressure off the need for strong managerial leadership at the top. Participating companies would also have to demonstrate that they are employing best health practices, including chronic care management, information technology, and other modernization initiatives that maximize value, quality, and accountability. Finally, employers will also have the option of buying early retirees into the new Health Choices Menu.
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