Legislation Library

Title I would encourage adults (19 and older) and require children to be insured and provide that insurers make available policies that include "core" benefits. It would also eliminate most current tax subsidies for health insurance and replace them with: (1) an above-the line standard tax deduction for health insurance and (2) a refundable health insurance tax credit to help low-income individuals pay for policies with core benefits (see separate side-by-side). Title II would require the states to merge their individual and group insurance markets to apply more broadly the portability protections established under the Health Insurance Portability and Availability Act of 1996 (HIPAA). Title II would also provide for limits on the variations in premiums for private insurance policies, provide for small business and other pooling arrangements, and provide for "harmonization" of state insurance laws applicable to the individual and group health insurance markets relating to form filing and rate filing, market conduct review, prompt payment of claims, and internal review. Title III includes initiatives relating to health care quality improvements and cost containment, increased access to health care services, and medical malpractice reform.

Provides increased appropriations for the State Children's Health Insurance Program (SCHIP) through 2012, prohibits future coverage of adults other than pregnant women and reduces federal matching rates for covered individuals other than targeted low-income children (generally those under 200% of the federal poverty level (FPL)), provides grants to states for improved outreach and enrollment of eligible children, gives states an option for using SCHIP funds for employer plan premium assistance, and reduces federal matching funds for Medicaid administrative expenses.

Provides increased appropriations for the State Children’s Health Insurance Program (SCHIP) through 2013, provides states the option of covering pregnant women under SCHIP and certain legal immigrant children and pregnant women under Medicaid and SCHIP, phases out coverage of childless adults, limits coverage of parents, reduces federal matching payments for children above 300% of the federal poverty level (FPL), provides for improved outreach and enrollment of eligible children, requires dental coverage and mental health parity, gives states an option for using SCHIP funds for employer plan premium assistance, requires development of child health quality measures and makes other changes to SCHIP and Medicaid.

Establishes a health insurance tax credit for eligible small businesses to help subsidize the cost of health insurance bought through the new Small Business Health Options Program (SHOP) or through the small group health insurance market in states meeting certain new federal requirements.

Seeks to cover all Americans through private insurance with federal premium subsidies (on a sliding scale) for families with incomes up to 400% of the federal poverty level (FPL).  Within 2 years of enactment, states would have to create a system to provide individuals the opportunity to purchase a Healthy Americans Private Insurance plan that meets the requirements of the bill.  Requires all adults, with limited exceptions, to purchase private coverage for themselves and their dependent children. Ends SCHIP and Medicaid, except for wraparound benefits.