FACTBOX: U.S. healthcare overhaul begins to take shape
(Reuters) - Details of a proposed overhaul of the U.S. healthcare system are beginning to emerge as two Senate committees writing the legislation prepare to hold public reviews in coming days.
President Barack Obama, who spoke to the influential American Medical Association on Monday, has voiced support for the creation of a new government-run insurance plan to compete with private insurers. But this proposal has met resistance from Republicans and some fiscally conservative Democrats.
Senators, meanwhile, are considering a potential compromise that instead would create federally chartered nonprofit cooperatives, owned and operated by their members, to compete with private insurers to provide medical coverage to individuals and small businesses.
Following are some details from the draft legislation proposed so far.
INSURANCE MARKET REFORMS
* A new government-run insurance plan would be created with payments to hospitals and doctors set at 10 percent above the government's Medicare health insurance program for the elderly and disabled.
* Employers and individuals would be required to obtain health insurance coverage, with subsidies to help those who cannot afford it.
* Insurance companies would be barred from refusing to cover people because of health history.
* Insurers also would be required to cover some preventive services.
* Annual or lifetime limits on coverage would be prohibited.
* Children would be allowed to stay on parents' insurance plans up to age 26.
INSURANCE GATEWAY OR EXCHANGE
* Grants would be provided to states to create "gateways" to act as a clearinghouse for individuals and small businesses to buy insurance.
* Reinsurance funding would be provided for plans participating in the gateway.
* A Medical Advisory Council to establish a minimum benefit for companies participating in the gateways would be created.
* Gateway participants would be encouraged to upgrade their information technology to help reduce duplication of treatments and lower costs.
OTHER COVERAGE PROVISIONS
* A sliding scale of subsidies for the purchase of insurance for people with incomes up to 500 percent of the poverty level would be established.
* Millions of people would become newly eligible for the Medicaid government health insurance program for the poor. People with incomes up to 150 percent of the poverty level would be able to get Medicaid.
* A new Community Living Assistance Support Service for disabled, homebound and institutionalized people would be set up.
* Incentives would be created for employers who automatically enroll workers into offered health plans.
(Compiled by Donna Smith in Washington; editing by Will Dunham)
