November 22, 2009 / 1:21 AM / 10 years ago

FACTBOX: Details of Senate healthcare reform bill

(Reuters) - Democrats in the Senate cleared the first procedural hurdle for sweeping healthcare reform on Saturday by voting to open debate on the historic legislation.

The Senate debate due to start on November 30 is expected to last for at least three weeks.

The bill resembles a measure passed by the House of Representatives on November 7, but there are some major differences that will eventually have to be ironed out.

Here are some of the details of the Senate bill.

INSURANCE MARKET REFORMS

* Establishes a new government healthcare insurance program that would compete with private insurers.

* States could “opt out” of the proposed government insurance plan.

* Provides for the creation of non-profit cooperatives that would provide medical coverage to members.

* Creates insurance market exchanges where individuals and small businesses can shop for insurance.

* Sets minimum benefits in four categories of insurance policies that would be offered through the exchanges.

* Starting in 2010, insurers would be barred from dropping people from coverage. A ban on excluding people for pre-existing conditions begins in 2014.

* States could band together to form larger regional exchanges.

MANDATES AND AFFORDABILITY MEASURES

* Beginning in 2013, most U.S. citizens and legal residents would be required to obtain health coverage.

* Provides subsidies for people with incomes up to 400 percent of poverty level to help buy insurance.

* Limits deductibles and out-of-pocket expenses. Limits put on a sliding scale based on incomes.

* Penalties for failure to purchase insurance would be phased in starting with $95 per adult in 2014 and $350 in 2015. By 2017, the penalty would be $750 per adult. Higher penalty imposed for failing to cover children.

* Exemptions provided for financial hardship and religious purposes.

* Young adults up to age 26 can stay on parents’ healthcare policies.

* Medicaid, the healthcare program for the poor, expanded to qualify everyone up to 133 percent of poverty-line income.

* Employers not required to offer health insurance but firms with 50 or more full-time workers would pay a $750 per employee penalty if any of their workers obtain federally subsidized insurance on the exchange.

* Offers tax credits for small businesses to help provide health coverage for employees.

REVENUE-RAISING FEES AND TAXES

* An excise tax of 40 percent would be levied on insurance companies for health plans with annual premiums above $8,300 for individuals and $23,000 for families.

* For people in high-risk professions or who live in high-premium states, the excise tax kicks in at annual premiums of $11,300 for individuals and $26,000 for families.

* Raises the Medicare payroll tax to 1.95 percent from current 1.45 percent for individuals earning $200,000 or more and couples earning $250,000.

* Health insurance providers collectively would pay an annual fee of $6.7 billion starting in 2010. The fee would be allocated by companies’ market share.

* Pharmaceutical companies collectively would pay an annual fee of $2.3 billion, allocated by market share.

* Medical device makers collectively would pay an annual fee of $2 billion, allocated by market share. Some items sold at retail for less than $100 would be exempted from the fee calculation.

* Imposes a 5 percent tax on elective cosmetic surgery.

Reporting by Donna Smith; Editing by Arshad Mohammed and Sandra Maler

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