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Healthcare Q&a

New system would not be in place until 2013

November 08, 2009|Kim Geiger and James Oliphant

WASHINGTON — Some reader questions on proposed healthcare legislation:

When would the new healthcare system be fully in place? Are there programs designed to cover people in the meantime?

The proposed insurance exchange, a regulated marketplace, would not be in place until 2013. Medicaid expansion and the payment of premium subsidies to individuals and small employers would also begin in 2013. In the meantime, however, the House bill would create a program providing immediate, temporary coverage for the uninsured.

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What are the proposed yearly out-of-pocket limits proposed for plans subsidized by the government?

Yearly out-of-pocket limits for individuals who qualify for subsidized premiums would be capped using a sliding scale based on income. For instance, for an individual who makes $32,490 a year, the cap would be $4,000. For a family of four with an income of $66,150, the cap would be $8,000.

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The federal subsidy for COBRA premiums is about to expire. Would this bill do anything to extend that subsidy?

The subsidy that was provided under the American Recovery and Reinvestment Act covers 65% of premium costs for workers who have lost their jobs and want to continue purchasing coverage through their former employers by using COBRA. However, the subsidy ends Dec. 31. The House healthcare bill would allow COBRA customers to keep their policies until a government-regulated insurance exchange is up and running or until affordable alternatives become available. Some members of the Senate have introduced a separate bill that would extend the subsidy for an extra six months and increase the subsidy amount from 65% of costs to 75%.

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What would prevent employers from discontinuing health benefits and forcing employees to buy into a public option?

The House bill would require employers with annual payrolls of more than $500,000 to provide health benefits to their employees, paying a major portion of the cost. Employers who fail to offer benefits would be assessed an 8% payroll fee. Small employers would be offered tax credits to assist them in paying their portion of employees' premiums.

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kgeiger@latimes.com

joliphant@latimes.com

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