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“ Health Care Reform – The Hospital Perspective in Western Pennsylvania”. Penn-Ohio Regional Healthcare Alliance February 17, 2010. J. Harper President Hospital Council of Western Pennsylvania. Cost and Coverage.
Penn-Ohio Regional Healthcare Alliance
February 17, 2010
Hospital Council of Western Pennsylvania
HB: Costs $1.1 trillion over 10 years and would provide coverage to 36 million more people.
SB: Costs $848 billion over 10 years and would provide coverage to 31 million more people.
HB: All Americans, except for dependents, people living overseas and those with religious objections, will be required to have health insurance by 2013 or will face a 2.5% income tax surcharge.
SB: All Americans, with the same exemptions, would be required to have coverage by 2014 or will be fined $95 in 2014, $350 in 2015 and $750 in 2016.
HB: Individuals making less that $43,320 a year and a family of three earning less than $73,240 would be eligible for subsidies that would help cover the cost of premiums. The subsidy would cover up to 99% of the premium expense for the lowest income brackets and 88% for higher incomes.
SB: A similar sliding-scale subsidy would be available to individuals earning less than $43,320 and a family of three earning less than $72,240 a year.
HB: Allows private insurers to price premiums up to twice as high for older people.
SB: Allows private insurers to price premiums up to three times as high for older people.
HB: Ends state Children’s Health Insurance Program after 2013 and allows children to receive subsidies for private insurance.
SB: Continues the Children’s Health Insurance Program and increases federal funding for the program beginning in 2014.
HB: Companies with payrolls of more than $500,000 would be required to offer employees insurance or face a fine up to 8% of payroll.
SB: Companies with more than 50 workers would pay a fine of $750 for each full-time employee if any worker qualifies for a federal subsidy to defray insurance costs.
HB: Includes a government-run health insurance program for individuals who work for small businesses or who do not get coverage through work. Like private insurers, the public plan would negotiate how much to pay medical providers.
SB: Includes a similar public option, but also allows individual states to opt out by passing a law that is approved by the state legislature and signed by the governor.
HB: Imposes a 5.4% surtax on couples earning more than $1 million a year and individuals making more than $500,000. Cuts Medicare and other federal programs by more than $400 billion over 10 years.
SB: Creates a 40% tax on health insurance plans that cost more than $8,500 for an individual and $23,000 for a family. Increases Medicare payroll tax from 1.45% to 1.95% for workers with incomes of more than $250,000 a year. Cuts Medicare and other federal programs by more than $430 billion a year over 10 years.
staff - especially clinical staff
The plan is structured on the principle that hospitals with similar characteristics should be paid the same base rate for “like” services once case weights are applied to standardized base rates.
The plan should not allow for implementation of APR-DRGs until the disparity in base rates is corrected.