President Barack Obama and congressional Democrats are pulling together a final version of a health care overhaul bill and pushing for House votes as early as this week. Democrats are awaiting cost assessments from the Congressional Budget Office that will allow them to finish details. Some of the main features as the bill takes shape:
How many covered: 31 million uninsured Americans.
INSURANCE MANDATE: Like the bills approved last year by the House and the Senate, the proposal would require almost everyone to be insured or pay a fine. There is an exemption for low-income people.
INSURANCE MARKET REFORMS: Stops unpopular insurance industry practices such as denying coverage to people with pre-existing conditions or charging women more. In response to recent insurance premium rate increases, the legislation adopts an Obama proposal to give the federal government the authority to block rate hikes, roll back premium prices and force insurance companies to give rebates to consumers.
MEDICAID: The legislation would expand the federal-state Medicaid insurance program for the poor to cover people with incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four.
TAXES: The legislation would scale back a Senate-passed tax on high-cost insurance plans that was opposed by House Democrats and labor unions. The tax would be delayed from 2013 until 2018 and the thresholds at which it is imposed would be moved up from policies worth $8,500 for individuals and $23,000 for families, to $10,200 for individuals and $27,500 for families.
PRESCRIPTION DRUGS: The proposal would close the "doughnut hole" coverage gap in the Medicare prescription drug benefit that kicks in once seniors have spent $2,830.
EMPLOYER RESPONSIBILITY: The legislation keeps the approach in the Senate bill, which doesn't require businesses to offer coverage but charges fees to companies with more than 50 employees if the government subsidizes employees' coverage. The proposal increases the fees to $2,000 per worker instead of $750, but grants companies an allowance that was not part of the original Senate plan.
SUBSIDIES: The proposal provides more generous subsidies for purchasing insurance than the Senate bill did. The aid is available for households making up to four times the federal poverty level ($88,000 for a family of four).
GOVERNMENT-RUN PLAN: The proposal does not include the government-run insurance plan. It gives Americans purchasing coverage through new insurance exchanges the option of signing up for national plans overseen by the federal office that manages the government health plan available to members of Congress. Those plans would be private, but one would have to be nonprofit.
ABORTION: The proposal tries to maintain a strict separation between taxpayer dollars and private premiums that would pay for abortion coverage. No health plan would be required to offer coverage for the procedure. In plans that do cover abortion, beneficiaries would have to pay for it separately, and that money would have to be kept in a separate account from taxpayer money. States could ban abortion coverage in plans offered through the exchange. Exceptions would be made for cases of rape, incest and danger to the life of the mother.
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