The Republicans do have a health care bill H.R. 3400

The so called party of No does have a health care reform bill. After reading it, I think its much better then the Democrats plan. Keep in mind that H.R. 3400 still needs some work, but its a start in the right direction. I have underlined a few things that I really like.

1) Make the Purchase of Health Care Financially Feasible Using a Hybrid Tax Structure

Extends the income tax deduction on health care premiums to those who purchase coverage in the non- group/individual market (above the line deduction)
Deduction is capped to allow for a deduction up to the average value of the national health exclusion for Employer Sponsored Insurance (family/ singles) grown at inflation
Provides low-income tax credit for premiums on a sliding scale phased out based on income
Credit based on average health care insurance costs across the U.S. Credit offered is $2,000 individual/$4,000 joint/$5,000 family
Advanceable/Refundable
Full credit for individuals and families up to 200% FPL
Phased out credit from 200%-300% FPL
Allows individuals the choice to opt out of Federal benefits (including Medicare with the ability to retain SS benefits), FEHBP and employer subsidized group health plan and instead receive the credit to buy private health insurance
Limitations on federal funds being used for abortion funding
Must be a legal permanent resident or citizen of the United States

2) Protect Employer Sponsored Insurance

Allows for an employer to auto-enroll employees with an opt-out
Small business tax incentives for adoption
Requires employers to disclose on the W2 Form the annual amount the employer spends on the employee’s premium

3) Portability and Choice

Gives patients the power to own and control their health care plan
Allows for a defined contribution and gives employers more flexibility in benefits

4) Improvements in the Individual Market

Pooling Mechanisms:
Small Business Health Fairness – AHPs (H.R. 2607 – Johnson)
Individual Membership Accounts (H.R. 3218 – Shadegg)
allows individuals to shop for insurance across state lines (H.R. 3217 – Shadegg)
Trigger: An individual in a state may only shop across state lines if one’s state premium exceeds 10% above the national average, starting no sooner than two years after date of enactment

5) Ensuring Coverage for Those with Pre-Existing Conditions or High Health Care Needs
High Risk Pool/Reinsurance Pools
Increased Federal block grant for functioning, qualified pools
Incentives: states will not receive credits unless they establish a pool

6) Medical Liability Reform

Caps on non-economic damages (H.R.1086 – Gingrey)
Health Courts
Affirmative defense through provider established best practice measures
No presumption of negligence if a participating physician does not adhere to the guidelines

7) Reforming Medicare Physician Payments

Rebases SGR and establishes two separate conversion factors (baskets), one for primary care and one for all other services
Removes physician administered drugs from the formula

Incentives for Providers
Primary care physicians:
help with loan repayment up to $50,000 after 5 years of practice
All physicians:
Creates a new Health Professional Student Loan (HPSL) program for medical schools with deferment of payments until after full residency and any fellowship training program
ER physicians:
Allows for a deduction for uncompensated care

9) Quality

Comparative Effectiveness Research Program Improvements
Nothing the Federal Coordinating Council for Comparative Effectiveness Research (FCCCER) suggests can be finalized unless done in consultation with and approved by medical specialty societies
HHS/CMS cannot base coverage decisions or deny care based on FCCCER data
Establishment of performance-based quality measures endorsed by the Physician Consortium for Performance Improvement (PCPI) and physician specialty organization
Ensures the definition of quality is not ceded to the government

10) Safety-Net Reforms

tates must cover 90% of SCHIP eligible individuals below 200% FPL first before they can expand current eligibility levels (H.R.3176 – Barton/Deal)
Medicaid/SCHIP voucher to purchase private insurance (H.R.3176 – Barton/Deal)
Unspent money refunded based in state/federal share unless enrollee in an HSA
Requires States to now include pathways for premium assistance for employer sponsored insurance as part of the State plan (H.R.3176 – Barton/Deal)
Incentivizes providers to work in Community Health Centers and emergency areas
Cover “volunteer” practitioners in community health centers and in emergency areas under the Federal Tort Claims Act (FTCA) to promote “Good Samaritan” care

11) Transparency and Insurance Reform Measures

Requirements for insurance receipt and response to requests for claim information under certain group plans to enable employers to make better coverage and cost determination for employees
Health Plan and Provider Portal Website
Provides information on insurance plans and providers rather than acting as a purchasing mechanism
Federal government’s role: standardize forms / information / metrics
Additional measures to be included as determined by the Secretary and appropriate stakeholders (risk adjusted outcomes, satisfaction)
Federal incentives for uptake and implementation

12) Wellness and Prevention

Self responsibility – allow for employers to offer discounts for healthy habits
HSA clarification for the treatment of capitated primary care payments as amounts paid for medical care (H.R. 2520 – Ryan)

13) Offsets

Savings from health care efficiencies and coverage
Reduce DSH Medicare and Medicaid payments in response to coverage expansion
Waste, fraud, and abuse (fund OIG, Health Care Fraud and Abuse Control Program (HCFAC), strengthen Medicare provider enrollment standards and safeguards, etc.)
Reinstate the Medicare Trigger
SCHIP / Medicaid (voucher / recapture of excess funds)
Medical liability reform – reduce defensive medicine
Interstate shopping
Enforces discretionary spending limits
Repeals unspent stimulus funding