WASHINGTON — Capping months of work, House Democratic leaders on Tuesday introduced their plan for a sweeping remake of the nation's healthcare system. Among the provisions in the 1,018-page bill: creation of a new government insurance option, increased regulation of the insurance industry and other steps to ensure near-universal medical coverage for the first time in U.S. history.
The bill would also set out new initiatives to begin curbing costs in a healthcare system that is expected to consume nearly $2.5 trillion this year. And the legislation's more than $1-trillion cost would be offset in part by a new tax on wealthy Americans.
The proposal, among the most liberal of several competing blueprints for revamping the system, drew swift criticism from Republicans and more than 30 business groups, many of which have supported some form of change.
Foreshadowing legislative battles ahead, Sen. Jeff Bingaman (D-N.M.), who has been working on a more moderate version, said, "I don't think it's going to go anywhere in the Senate." But Obama and several liberal groups praised the House proposal.
Here are some of the bill's major features and the issues they may raise:
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How will the bill ensure that everyone has health coverage?
For the first time, nearly all Americans would be required to get health insurance or pay a penalty based on their adjusted gross income. Employers would be given an option to provide coverage or pay the government a fee based on 8% of their payroll.
Small businesses with payrolls under $250,000 would be exempt from the fee, which would be phased in for employers with payrolls between $250,000 and $400,000.
Also, new regulations would prohibit insurance companies from denying coverage to people with preexisting medical conditions and from denying coverage for treatments.
All poor Americans making up to 133% of the poverty level would become eligible for Medicaid, which in some states is now limited to families.
Others seeking insurance would be able to shop for plans in a new "exchange" run by the federal government. Private insurers offering insurance on the exchange would have to offer a standard benefit package designed by the government.
In addition, a new government insurance program would be offered, to be financed with premiums paid by customers. The new government plan initially would pay hospitals and doctors slightly more than Medicare rates.
