Excerpts
Now that the Senate has caught up with the House by passing a sweeping health care bill, lawmakers are on the verge of extending coverage to the tens of millions of Americans who have no health insurance.
But what about the roughly 160 million workers and their dependents who already have health insurance through an employer? For many people, the result of the long, angry health care debate in Washington may be little more than more of the same.
As President Obama once promised, “If you like your health plan, you can keep your health plan.”
That may be true even if you don’t like your health plan. And no one seems to agree on whether the legislation will do much to reduce workers’ continually rising out-of-pocket costs.
True, there is an important advantage for the working insured: more peace of mind for people who are worried about being laid off or would like to change jobs.
There are still many gaps to bridge between the House and Senate bills. But even before the House-Senate negotiations begin in January, both bills offer this assurance: If you lose your job or move to one that does not provide benefits, there should be better alternatives when shopping for your own coverage.
And both the House and Senate bills share the same basic goal of placing new rules on insurers so that even someone with a pre-existing medical condition, or a few years to go before qualifying for Medicare, should have a much easier time finding a relatively affordable policy.
The legislation should give most working people “the guarantee of security if their circumstances change,” said Karen Davis, the president of the Commonwealth Fund, an independent research group that has studied the House and Senate bills.
Of course, with more security will come more obligation. Congress seems likely to impose an individual mandate that will require people to be insured or face a financial penalty.
The other proposed changes for employer-provided coverage seem aimed mainly at workers whose benefits are either very generous or exceedingly skimpy.
The “impact of this change will be minimal on most employers, but would be quite meaningful for the small number of employees who meet the limits,” according to the study, conducted by policy analysts from the University of California, Berkeley, the benefits consultant Watson Wyatt Worldwide and the National Opinion Research Center at the University of Chicago.
Congress is also considering annual limits on out-of-pocket medical costs. The House seems to think $5,000 is as much as somebody should pay in medical bills, while the Senate has picked a figure closer to $6,000.
Under the Senate proposal, the new limits would not apply to self-insured employers — big companies that provide their own insurance and have enough employees to effectively spread the risk of paying any large claims.
The real unknown, of course, is whether any final legislation will accelerate the rise in premiums or slow it. At least one impartial analysis, by the nonpartisan Congressional Budget Office, concluded that the legislation was not going to have much of an effect on the cost of premiums either way.
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