Comprehensive Federal Bills Introduced in the 110th Congress
The Healthy Americans Act
(S. 334)
Senator Wyden (D-Oregon) and four bipartisan cosponsors
The following is a summary of the Healthy Americans Act. To review
the status of the bill, visit Thomas.gov.
The Healthly Americans Act would:
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guarantee private health care coverage for all Americans;
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provide health benefits equal to those that Members
of Congress now enjoy;
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provide incentives for individuals and insurers
to focus on prevention, wellness and disease management;
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establish tough cost containment measures that save
$1.48 trillion over 10 years; and
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be fully paid for with the $2.2 trillion currently
spent on health care in America today.
Under the Healthy Americans Act, health coverage would be portable.
Individuals could keep the coverage they have as they move from job
to job. Insurance would also no longer be tied to employment. If an
individual is laid off, leaves their job voluntarily, or develops a
serious illness, he or she would continue to be covered.
All employers, along with individuals and the government,
will share the responsibility of financing health care. During a two-year
transition period, employers who provide employee health benefits would
be required to convert their workers' health care premiums into higher
wages. Employers who don't currently offer health benefits would have
to make phased-in "Employer Shared Responsibility Payments,"
which would be used to provide financial assistance to individuals and
families of modest income. After two years, all employers would make
"Employer Shared Responsibility Payments." These payments
would reflect the relative ability of small and large employers and
low- and high-wage industries to make such payments, and would have
no direct impact ON the coverage that is available to their employees.
Employees, in turn, would be required to purchase private
health coverage with their higher wages. To ensure that it's affordable,
the plan would fully subsidize the premiums for those who live below
the poverty line. Those people between 100 percent and 400 percent of
the federal poverty line would also receive subsidies on a sliding scale
to help pay their premiums.
Individuals would choose from a variety of private plans
offered in their state. State-based Health Help Agencies (HHAs) would
guide individuals through the enrollment process. These agencies would
also provide consumers with unbiased information about competing private
health plans and determine premium reductions that will ensure every
American can afford their health plan. HHAs would ultimately lower administrative
costs by coordinating payments from employers, individuals and the government.
As for the insurance companies, they would no longer be
allowed to "cherry pick" their customers. Under the current
system, insurance companies can pick and choose which customers they
sign up — typically the healthy ones — and send those in fragile
health to government programs more fragile than they are. The Healthy
Americans Act stipulates that insurance companies be required to cover
every individual who chooses to enroll and that they be prohibited from
raising prices or denying coverage if individuals are sick or are at
risk of becoming sick. Previous and existing health problems, occupation,
genetic information, gender and age could no longer be used to determine
eligibility or the price paid for insurance.
The government, for its part, would make sure that every
American has, and can afford, health insurance. Every time an individual
interacts with local, state or federal government, they could be required
to verify their enrollment in a private health insurance plan.
The Healthy Americans Act focuses on preventive care and
provides insurance companies with an incentive to keep their subscribers
healthy. Individuals would not be charged co-pays for preventive services
or chronic disease management. Insurers would be able to offer discounts
and other incentives based on participation in wellness programs, like
nutrition counseling, tobacco cessation and exercise. Primary care physicians
would be reimbursed for investing time in chronic disease management
and prevention. And with HHAs publishing consumer-oriented information
on every plan's success in prevention and disease management, insurance
companies would ultimately be competing to keep Americans healthy.
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