Here are the key points of the health care plan that President Barack Obama outlined in his speech Wednesday night to a joint session of Congress:
— Current coverage: Those who now are getting employer-provided coverage or are insured through Medicare, Medicaid or the Veterans Administration would not be required to change their plans or their physicians.
— Cost: About $900 billion over 10 years.
— How it would be paid for: By finding “savings within the existing health care system,” mostly by trimming waste and rooting out fraud. Also, insurers would be charged a fee for their most expensive policies.
— Health insurance exchanges: Consumers and small businesses without coverage could comparison shop at these marketplaces among private and perhaps also public plans. The competition is supposed to help lower prices. The exchanges would take effect in four years.
— Pre-existing conditions: Insurers would not be permitted to deny coverage because of pre-existing medical conditions. Nor could they cancel or dilute coverage when people get very sick.
— Affordability: No limits on how much coverage a consumer could get in a year or a lifetime — but limits on out-of-pocket health care expenses. Tax credits would be available for those needing aid.
— Preventive medicine: Insurers must cover, at no extra charge, regular preventive care and check-ups, such as mammograms, colonoscopies and routine check-ups.
— Public option: People without coverage would be able to choose a not-for-profit government-run insurance plan that would have the same rules and protections that private insurers do. A government option plan might be available only if private insurers fail to meet coverage benchmarks in designated markets. Alternatively, a nonprofit co-op might administer a competitive insurance plan.
— Catastrophic insurance: Low-cost coverage would be available in the years before the exchanges are created to protect against financial ruin in case of a serious illness.
— Individual insurance mandates: Everyone would have to have basic insurance. Most businesses would be required to offer insurance or “chip in” to help cover workers. Only hardship cases and some small businesses would be exempt.
— Medical malpractice lawsuits: The administration will seek experimental “demonstration projects” in different states aimed at helping to revamp the tort system.
(c) 2009, McClatchy-Tribune Information Services.