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OSHA Standards for the Construction Industry as of August 2009
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CCH® HR MANAGEMENT - 10/30/09

Health reform bill heads to the floor of the House

On October 29, Rep. John Dingell (Mich.) introduced H.R. 3962, the Affordable Health Care for America Act, which is an amalgam of proposals already approved by three House Committees. H.R. 3962 is scheduled to be debated on the House floor next week. According to House Speaker Nancy Pelosi (Cal.), the bill costs under $900 billion over a 10-year period, insures 36 million more Americans, and “does not add a dime to the debt.”

Many of the provisions would have a direct effect on employer provided healthcare plans, some immediately, and some in future years.

Immediate reforms. Employer-related reforms in H.R. 3962 that would take effect on Jan. 1, 2010, include:

• Any health insurer in the small or large group market would have to issue rebates to enrollees if its medical loss ratio fell below 85 percent.
• Group health plans that offer dependent coverage would have to offer the coverage to dependents up to age 27.
• The look-back period allowed for group health plans to apply preexisting conditions exclusions is temporarily reduced to 30 days and the preexisting conditions exclusion period itself is reduced from 12 months to three months. Preexisting condition exclusions would be prohibited starting in 2013.
• Any individual covered by COBRA continuation of coverage on or after the date of enactment could continue the coverage until a National Insurance Exchange took effect in 2013.

Postretirement reductions in healthcare benefits would be prohibited. In other words, plans would be prohibited from reducing the benefits provided to a retired participant if the reduction of benefits occurs after the date the participant retired.

Not-so-immediate reforms. In 2013 or later, the following employer plan reforms would take place under H.R. 3962:

• All plans would be prohibited from imposing preexisting conditions exclusions and would be required to provide guaranteed issue and guaranteed renewal.
• Qualified health benefit plans would have to provide coverage that had an actuarial equivalence of 70 percent of the “reference benefits package,” which in general would be comprehensive health coverage with no cost sharing.
• Employers would have to offer employees a qualified health plan, would have to contribute at least 72.5 percent of the cost of individual coverage and 65 percent of the cost of family coverage.

H.R. 3962 also includes a public health insurance option beginning in 2013 that would negotiate rates with providers and a repeal of the health insurance antitrust exemption in the McCarron-Ferguson Act. Employers that do not provide coverage to their employees would be required to contribute up to 8 percent of payroll into a Health Insurance Exchange Trust Fund.

The full text of the bill is available at http://docs.house.gov/rules/health/111_ahcaa.pdf.

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