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HEALTH PLAN CLOSES SOME, BUT NOT ALL, GAPS

A plan by Democratic Sen. Max Baucus of Montana would most benefit people who are self-employed, but it would affect most other families.

WASHINGTON - You're a 51-year-old single mother raising two kids and juggling a mortgage and a car loan. Because you're self-employed, getting health insurance has always been a problem. Under the new Senate plan, you still might have to stretch your budget to pay premiums even if the coverage is more secure.

For consumers, the health care plan unveiled by Finance Committee Chairman Sen. Max Baucus, D-Mont., comes with costs and benefits. Though people with employer-provided health care would not see dramatic changes, the plan is broad enough that it would touch every American family in some way. Here's a look at how people in different circumstances would be affected:

Self-employed head of household

If anyone is meant to benefit from the plan, it's people who have to scramble to find and keep coverage because they work for themselves, not a large employer.

Baucus would eliminate onerous insurance practices, such as denial of coverage due to a pre-existing health problem. But subsidies in the plan may not be enough to make coverage affordable for all middle-class families, who would be required under the bill to carry insurance.

The Washington-based Center on Budget and Policy Priorities, which advocates for low-income people, compared Baucus' plan to two other major proposals - the House Democratic plan and the Senate health committee bill.

A family of three earning about $55,000 - three times the federal poverty level - would have to pay 13 percent of its income. That's roughly $7,100 a year. It compares with costs of about $5,500 under the House bill, and $4,300 in the Senate health committee bill.

A family of three earning about $27,500 would have to pay 5.5 percent, a premium of about $1,570. That compares with $824 a year in the House legislation, and $275 under the Senate health committee proposal.

The numbers used in the examples are based on 2009 incomes. The dollar figures would likely be higher - to account for inflation - when subsidies take effect under the plan in 2013.

Senior on Medicare

Seniors would get a 50 percent discount on medications if they fall into the "doughnut hole" coverage gap in the Medicare prescription drug benefits.

Medicare recipients also would get a free annual wellness visit with their doctor. Coverage for preventive care would be expanded.

"Most Medicare beneficiaries will feel like they have gotten something very tangible," said John Rother, the top policy strategist for AARP.

Baucus has proposed scores of changes in Medicare to make the program more efficient. The cuts are about $409 billion over 10 years, but Rother said the cuts should not erode the benefits seniors receive.

Single woman in 20s

People in their twenties account for a sizable share of the uninsured. Under the Baucus plan, they'd be required get coverage and pay into the pool. But depending on income, they'd be eligible for subsidies they can't get now. They'd also have the option of buying a lower-cost plan, tailored to those 25 and under, which would cover mainly preventive care and catastrophic medical costs.

Insurers would not be allowed to charge women more because of gender, a practice that is now common.

Baucus said his plan would not allow federal funds to be used to pay for abortions, except in cases of rape, incest or to save the life of the mother.

Immigrants

Immigrants are more likely to be uninsured than the U.S. population as a whole. The Baucus plan would let legal immigrants get federal subsidies for health insurance, but would bar benefits for those here illegally. U.S.-born children of illegal immigrants - who are considered citizens under the law - would be eligible for benefits.

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