Sen Max Baucus (D-MT) has just released a
Chairman’s amendment to his mark, enhancing the bill’s affordability measures and increasing the threshold on so-called Cadillac health care plans. The modified amendment also preserves a subsidy to certain Medicare Advantage plans.
Baucus accepted 29 Republican amendments, including 10 from Sen. Olympia Snowe (R-ME), who has indicated that she is open to voting for the Senate Finance Committee bill. Baucus did not address any public option amendments and will likely consider
during mark-up.
Below are the most significant revisions:
<...>Affordability of premiums
Baucus Mark: Families 100% FPL contribute 3% of income to premiums. Families 300% FPL would contribute 13% of income to premiums.
New Baucus Amendment: Families 100% FPL contribute 2% of income to premiums. Families 300% FPL would contribute 12% of income to premiums.
Amendments Accepted: Menendez, Kerry, Bingaman and Schumer as amendment C1; Kerry & Menendez as amendment C9, Stabenow as amendment C1.
Out of pocket protections
Baucus Mark: 300%+ FPL = HSA limit ($11,900 families, $5,590 individuals); 200-300% FPL = 1/2 of HSA limit; 100-200% FPL = 1/3 of HSA limit;
New Baucus Amendment: 300-400% FPL = 2/3 of the HSA limit
Amendments Accepted: Menendez as amendment C13.
Affordability for older Americans
Baucus Mark: Insurers can charge an older person 5x more for coverage.
New Baucus Amendment: Insurers can charge an older person 4x more for coverage.
Amendments Accepted: Wyden as amendment C9, Kerry as amendment C15.
Easier to opt out of unaffordable employer coverage
Baucus Mark: If the costs of employer-sponsored coverage exceed 13% of income, an individual can enroll in the Exchange.
New Baucus Amendment: If the costs of employer-sponsored coverage exceed 10% of income, an individual can enroll in the Exchange.
Amendments Accepted: Snowe amendment number C2.
Increasing threshold for excise tax on ‘Cadillac’ plans
Baucus Mark: Insurers w/ policies @ $21,000/families, $8,000/individuals pay 35% excise tax.
New Baucus Amendment: New thresholds for high-risk enrollees & non-Medicare retirees aged 55 ($22,000/families, $8,750/individuals- insurers pay 40% excise tax). Excise tax increased to 40% for all other enrollees, threshold levels preserved.
Amendments Accepted: Kerry, Rockefeller, Schumer, Stabenow, Cantwell, & Menendez as amendment F2.
Reducing penalty on individuals/families that don’t meet the requirements of the individual mandate.
Baucus Mark:Families 100-300% FPL, penalty = $750 – $1,500. More than 300% FPL, penalty = $950-$3,800.
New Baucus Amendment: Families 100-300% FPL, penalty = $750-$1,500 . More than 300% FPL, penalty = $1,900 max. Individuals below 100% FPL,no penalty
Amendments Accepted: Snowe as amendment F4 and Schumer as amendment C6
Catastrophic coverage opened to Americans exempt from individual mandate
Baucus Mark: Only Americans 25 years old and younger could enroll in a ‘high deductible’ catastrophic plan.
New Baucus Amendment: Individuals who would otherwise qualify for the exemption from the individual mandate, could now purchase the “young invincible” policy,
Amendments Accepted: Snowe as amendment F5.
Preserving some overpayments to private plans participating in Medicare Advantage
Baucus Mark: The Medicare Advantage program is opened to competitive bidding.
New Baucus Amendment: Preserves Medicare Advantage subsidies for seniors living in high cost areas where plans deliver benefits below the average cost of traditional Medicare.
Amendments Accepted: Bill Nelson as amendment D10.
Federal employees eligible for the Exchange.
Baucus Mark: Federal employees would not eligible to enroll in the Exchange until approximately 2022.
New Baucus Amendment: Beginning in 2013 elected officials and federal employees may purchase coverage through a state-based exchange, rather than using the traditional Federal Employees Health Benefits Plan
Amendments Accepted: Grassley Amendment C3
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