To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes
This 1,990-page health care bill includes numerous provisions to restructure the current private and public health insurance systems. Among other features, it provides standards that qualified health plans must meet, including a prohibition on preexisting condition exclusions, a prohibition of discrimination based on health status factors, and mandatory renewal of health insurance coverage. The services the bill requires all health insurance plans to cover include hospitalization, professional services of physicians, prescription drugs, mental health services, maternity care, and children’s services.
The bill creates a new federal agency (the “Health Choices Administration”), with a new federal commissioner and a Health Insurance Exchange, intended to “facilitate access of individuals and employers” to a variety of coverage plans, including government-provided insurance. The bill requires the Social Security Commissioner to enter into an agreement with the Health Choices Commissioner to establish a program to verify the citizenship information of applicants. The bill provides criminal penalties for the unlawful publishing or communication of such information by Health Choices Administration officers or employees. Violations could result in felony convictions and imprisonment of up to five years and criminal fines.
The bill also provides that any individual who does not maintain adequate health insurance is subject to an additional tax equal to the lesser of the national average health insurance premiums or 2.5 percent of the amount in excess of a person’s modified adjusted gross income over a threshold amount. Failure to pay this tax could subject an individual to the civil and criminal penalties of the existing IRS code. Under existing law, criminal penalties for nonpayment of taxes include fines of up to $25,000 and imprisonment of up to one year for misdemeanor willful failure to pay, and fines of up to $250,000 and imprisonment of up to five years for felony willful evasion.
The bill provides for a surtax of 5.4 percent on individuals with an adjusted gross income over $500,000, an excise tax of 2.4 percent on medical devices. It also includes several increased civil penalties for false statements on provider or supplier enrollment applications, for false statements relating to payment for items and services furnished under a Federal health care program, and for failing “to grant timely access” to the Department of Health and Human Services for audits, investigations, and evaluations.