Comprehensive Federal Bills Introduced in the 110th Congress
AmeriCare Health Care
Act of 2007
(H.R. 1841)
Congressman Stark (D-Calif.)
The following is a summary of the AmeriCare Health Care Act of
2007. To review the status of the bill, visit Thomas.gov.
OVERVIEW: The AmeriCare Health Care Act is a
practical proposal to ensure that everyone has health coverage in
our country. It builds on what works in today's health care system
to provide simple, affordable, reliable health insurance.
People would be covered under the new AmeriCare system,
modeled on Medicare, or they would continue to obtain health coverage
through their employer. Using the administrative efficiencies within
Medicare and building on the existing coverage people receive through
their jobs today, we can create an affordable, efficient, and stable
universal health care system in America - and guarantee access to
medical innovation and the world's most advanced providers and facilities.
STRUCTURE AND ADMINISTRATION: Creates a new title
in the Social Security Act, "AmeriCare." Provides universal
health care for all U.S. residents, with special eligibility for children
(under 24), pregnant women, and individuals with limited incomes (<300%
FPL). Sets out standards for supplemental plans with a focus on consumer
protection. Requires the Secretary to negotiate discounts for prescription
drugs.
BENEFITS: Adults receive Medicare Part A and
B benefits; preventive services, substance abuse treatment, mental
health parity; and prescription drug coverage equivalent to the BC/BS
Standard Option in 2005. Children receive comprehensive benefits and
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) coverage
with no cost-sharing.
COST SHARING: There is a $350 deductible for
individuals, $500 for families, and 20% coinsurance. Total spending
(premiums, deductibles, and co-insurance) is capped at out-of-pocket
maximum of $2,500 individual/$4,000 family, or 5% of income for beneficiaries
with income between 200% — 300% FPL and 7.5% of income for beneficiaries
with income between 300% — 500% FPL. There is no cost sharing
for children, pregnant women, low-income (below 200% FPL). Sliding
scale subsidies are in place for cost-sharing for individuals between
200% and 300% FPL.
FINANCING: At April 15 tax filing each year,
individuals either demonstrate equivalent coverage through their employer
or pay the AmeriCare premium based on cost of coverage and class of
enrollment (individual, couple, unmarried individual with children,
or married couple with children). Employers may either pay 80% of
the AmeriCare premium or provide equivalent benefits through a group
health plan (the contribution for part-time workers is pro-rated).
AmeriCare does not affect contracts or collective bargaining agreements
in effect as of the date of enactment, and employers may choose to
provide additional benefits. Employers with fewer than 100 employees
have until January 1, 2012 to comply (employees of small businesses
would still only pay 20 percent of the premium).
