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FACTBOX: Provisions of the US House healthcare legislation

Thu Nov 5, 2009 5:19pm EST
 
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(Reuters) - A close vote is expected on a sweeping U.S. healthcare overhaul bill in the House of Representatives on Saturday. Here are the main provisions of the bill.

INSURANCE MARKET CHANGES

* Creates an insurance market exchange where individuals and small businesses would purchase coverage. Sets minimum benefit packages that may be offered through the exchange.

* Creates a new government health insurance plan that would be sold through the exchange.

* Provides for the creation of nonprofit healthcare cooperatives that would sell coverage through the exchange.

* Bars insurers from excluding people for pre-existing conditions and from charging more based on medical history.

* Creates a temporary national high-risk pool program to provide medical coverage to the uninsured, including those with pre-existing conditions who have been denied coverage. The program would operate until the exchange becomes available.

* Young adults up to the age of 27 would be able to remain on their parents' health insurance policy.

* Provides for rebates for consumers if premiums far exceed the cost of covering their medical expenses.

* Sets up a state/federal process under which insurers would have to justify premium increases.

* Eliminates lifetime limits on coverage.

* Provides for states to enter compacts to allow for the sale of insurance across state lines.

COVERAGE MANDATES AND PENALTIES

* Individuals are required to obtain healthcare coverage. Those who do not would face a 2.5 percent tax penalty.

* Most employers are required to provide coverage to their workers and pay for at least 72.5 percent of the premium for individual full-time workers, 65 percent for family coverage.

* Small firms with up to $500,000 in payroll are exempt.  Continued...

 

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