Where we stand in the health care debate

This is not original reporting. All information has been compiled from The Washington Post and Henry J. Kaiser Family Foundation website. Silver Chips Online posts this article to provide a forum for discussion.

In a Feb. 24 address to Congress, President Obama identified heath care as a pressing concern for his administration. He spoke of his commitment to insure the 30 million Americans currently without coverage and cut waste and inefficiency plaguing Medicare and Medicaid. Obama evoked a sense of urgency, declaring that "health care reform cannot wait, it must not wait and it will not wait another year," and called on health care providers, businesses, doctors and policymakers to initiate negotiations that underlie reform efforts.

Since then, heath care has become the year's hot-button political issue. As lawmakers in the House and Senate bring myriad proposals to the table, Republican figureheads condemn Obama for "nationalizing" heathcare and local officials hold town hall meetings that attract notoriously raucous crowds. The confusion caused by excessive news coverage of a system with countless problems and no easy solutions is enough to make any student's head spin. Fortunately, Silver Chips Online is here to provide you with a breakdown of the top proposals in Congress as well as leading developments in the contemporary heath care debate to ease the interminable headache.

Obama's priorities

Since his inauguration, Obama has championed the case for extending health care coverage to every American, requiring companies of a certain size to provide coverage for its employees and regulating the heath care industry to reduce costs and improve quality of care. Obama's high level of involvement in the reform of our heath care system is evident in his day-to-day itineraries, which include negotiations with the heath care and pharmaceutical industries, visits to states around the country for town hall meetings and frequent public announcements on improvements to his plan. Most recently, he delivered a speech to Congress outlining his top priorities for the final drafts of House and Senate legislation, expected to emerge within the next month.

The 47-minute speech delineated three main objectives of reform - to provide "more security and stability to those who have health insurance," "insurance to those who don't" and "slow the growth of health care costs for our families, our businesses and our government." Obama conceded that the means by which we should accomplish these goals are often the subject of embittered debate along party lines, but promised to "seek common ground in the weeks ahead." On the flip side, he warned that he has no patience for those whose only goal is to delay the passage of reform.

Obama pledged to regulate the insurance industry to eliminate several appalling practices, including denying coverage due to a pre-existing condition, dropping coverage due to a technicality and capping the amount of coverage a client can receive in a year or lifetime. His plan also dictates that insurance companies adhere to limits on out-of-pocket expenses and provide coverage for routine checkups and preventive care.

For those who still cannot afford policies offered by private insurance companies, Obama proposed the creation of a public insurance option as part of the exchange. This is arguably the most controversial part of Obama's plan, which some Republicans consider a step towards complete nationalization of heathcare. Obama rejected these claims in his speech, pointing out that the public option will not be subsidized by the government, but maintained that he will "remain open to other ideas that accomplish our ultimate goal."

The remainder of the speech was devoted to assuaging fears that heath care reform will pose an undue tax burden on citizens and increase our national deficit. Obama argued that requiring all citizens to obtain heath care, either through the exchange or an employer required to help cover costs, will eliminate incidents of emergency hospitalization for those without insurance – one of today's hefty tax burdens. He abandoned earlier plans to tax those earning less than $250,000 a year to support his $900 billion reform, promising instead to draw funding by slashing wasteful government subsidies for Medicare programs and taxing heath care providers for their most expensive policies.

House Tri-Committee proposal

The House Tri-Committee proposal, known formally as America's Affordable Health Choices Act of 2009, will incorporate key components of separate proposals submitted by the Committee on Energy and Commerce, the Committee on Education and Labor and the Committee on Ways and Means. The House is currently in the process of reconciling the differences between the three proposals, but analysts treat the House versions as one piece of legislation.

The proposal would designate the creation of a health insurance exchange for individuals and small businesses as advised by the Obama administration. Individuals and households up to 400 percent of the federal poverty level would be eligible for government subsidies through the exchange, and a public insurance option would also be available to the uninsured with the same rates offered by Medicare.

America's Affordable Health Choices Act of 2009 seeks to facilitate heath care coverage for all Americans, requiring employers with a payroll of more than $250,000 to cover a specified percentage of individual and family plan costs. If companies choose not to provide a heath care plan for their employees, they are subject to a penalty tax of two to eight percent of their payroll. Citizens above a certain income level are required to obtain coverage or pay a penalty equal to 2.5 percent of their income.

Employers with less than $250,000 payroll are exempted from mandatory heath care coverage, but credits are available to pay 50 percent of all health insurance costs for small businesses. These credits are not made available when companies have 25 full-time employees.

Senate Health, Energy, Labor and Pension (HELP) Committee proposal

The Senate HELP Committee proposal, which also requires most companies to cover heath care costs for their employers and offers credits to small companies, is similar to the one offered by the House Tri-Committee. The main difference between the two proposals is that the Senate version calls for the development of a state-based health insurance exchange. The proposals also vary according to the basis on which each exempts companies from covering heath care costs and the penalties for failure to obtain insurance.

Under the Senate HELP proposal, also known as the Affordable Health Choices Act, employers with 25 or fewer employees would be exempt from providing coverage. Instead of turning over a percentage of the company's payroll as a penalty for neglecting to provide coverage, businesses would be required to pay $750 for each uninsured full-time employee and $375 for each uninsured part-time employee. Individuals who fail to obtain coverage have to pay a tax penalty of no more than $750.

Senate Finance Committee Proposal

The Senate Finance Committee proposal, headed by Chairman Max Baucus (D - Mont.), is the only committee that designed bipartisan heath care legislation. The final draft of the bill has not yet been released, but associated documents reveal that significant differences exist between the two Senate bills.

Specifically, the Finance Committee seeks to place looser requirements on small businesses. While other committees have submitted legislation calling for most companies to provide insurance to their employees, the Senate Finance Committee proposal would only require employers with more than 50 full-time workers to cover insurance, and only if their employees are eligible for federal subsidies. The intention is to protect small businesses, but some opponents claim this may discourage employers from hiring lower-income citizens.

The Senate Finance Committee proposal will also include an alternative to the public option that many Republicans fear is a precursor to socialism. Instead of a government-run program, the proposal would establish a system of 51 non-profit cooperatives run by its members. Federal funding would be required to found the system, but it would eventually become financially independent.