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Reader questions on House healthcare bill

How Nancy Pelosi's healthcare bill would affect taxes, Medicare prescription drug benefits, and more.

November 01, 2009|By Kim Geiger and James Oliphant
  • Speaker of the House Nancy Pelosi unveiled a bill with a “public option,” angering insurers.
Speaker of the House Nancy Pelosi unveiled a bill with a “public… (Alex Brandon / Associated…)

Reporting from Washington — Some reader questions on the national healthcare debate, focusing on the House bill unveiled Thursday by Speaker Nancy Pelosi (D-San Francisco):

Healthcare overhaul: An article in the Nov. 1 Section A that gave questions and answers about the House healthcare bill unveiled by Speaker Nancy Pelosi (D-San Francisco) said that the measure would exempt employers with yearly payrolls of less than $250,000 from providing health benefits to employees. Employers with annual payrolls of less than $500,000 would be exempted. —

Would the House Democrats' bill raise my taxes more than the other bills making their way through Congress?

It depends on your income. The House bill would impose a surcharge on individuals who make more than $500,000 and couples who make more than $1 million. The previous House bill would have imposed the surcharge on individuals who make $280,000 and families that make $350,000. The current bill also would impose a tax of 2.5% of income for those who make more than $250,000 and fail to purchase health insurance.

How would the bill affect my prescription drug benefits under Medicare?

The bill would speed the closing of the Medicare Part D "doughnut hole" -- the coverage gap that occurs when a patient's prescription costs exceed a certain yearly amount. Over time, this bill would create a 50% discount for prescription drugs bought in the doughnut hole. That process would be completed in 2019 -- five years earlier than proposed in the original House bill. The bill also would require the Health and Human Services secretary to negotiate for Medicare drug prices.

Why do insurers say this bill would raise healthcare costs?

Insurers are not happy that the bill includes a "public option," a government-run plan that would be funded through an increased payroll tax for those who choose it. The public option would compete with private options in a regulated insurance exchange. Insurers say the public option will disrupt the healthcare market and could force some companies out of business. The bill also ends insurers' exemption from antitrust laws that prohibit price-fixing, another element that they say could drive up costs.

How would the bill affect small businesses?

It would exempt more small businesses from a requirement to provide insurance benefits to employees. Employers with yearly payroll costs of less than $250,000, compared with $500,000 under the previous House bill, would be exempt from the requirement.

What parts of the bill would take effect as soon as it became law?

The bill would immediately eliminate lifetime coverage limits and rescission, the process an insurer uses to cancel a policy because the policyholder failed to disclose a preexisting condition.

In addition:

* People could keep their COBRA plans until the insurance exchange designed to offer affordable options is in place.

* Young people could stay on their parents' insurance plans until they turn 27.

* Co-pays and deductibles for preventive services to Medicare patients would be eliminated.

* It would create a temporary insurance program for people who have been uninsured or denied coverage due to a preexisting condition.

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