Taylor family: good coverage through employer

Under the Proposed Health Reform Bills:

Choices

• The Taylors can keep the coverage they have now. Randy’s employer is likely to continue offering health coverage to employees and to contribute toward the family’s premium, or a pay a penalty.
• As they can today, the Taylors can opt out of thie employer's coverage and purchase coverage on their own but this option is more expensive because the family would no longer have their employer's contribution to the premium.

Cost

• The Taylors will continue to benefit from the financial security of having a comprehensive health insurance policy.
• After reform, large employer premiums are expected to stay much the same.

Differences

House Bill (H.R. 3962, passes November 7, 2009):

• All but the smallest employers would be required to offer health coverage to employees and contribute a certain amount towards the premium, or pay a penalty. This minimum contribution is set at 72.5% of the premium for single coverage, and 65% for family coverage. Employers who don’t offer coverage must pay up to 8 percent of their payroll into a fund that helps those purchasing coverage in the exchange.
• Eventually, all employer-based health coverage will have to meet certain standards, including preventive care, hospitalization, prescription drugs, etc. Most large companies’ health plans already meet these standards.

Senate Bill (H.R. 3590, passed December 24, 2009):

• As is the case today, employers are not required to offer coverage to workers. However, if they have more than 50 workers and one or more of those workers who purchases health insurance using the new premium credits, then the employer will have to pay into a fund that helps finance those credits. In most cases, workers whose employer offers coverage are not eligible for these premium credits, thus the provision would apply to the tiny minority of employers who have more than 50 workers and don’t offer coverage. If they have workers who enroll in Medicaid coverage, no employer fee is assessed.
• No coverage standards are imposed on large employers, although if their plan they offer falls below a certain standard, their employees may become eligible for tax credits in the exchange and the employer may be liable for the resulting fee.
• A 40 percent excise tax would be levied against employers that offer so-called Cadillac plans, which total more than $8,500 for individuals and $23,000 for families. That threshold would grow along with inflation. Employers whose workers engage in high-risk professions would be exempt from the tax.

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