• The health reform law requires employers to include employer-paid health insurance to workers’ W-2 forms for information only.  The purpose of this change is to help people get a better understanding of the full cost of their health insurance benefits.  Typically, employees pay part of the cost of insurance.  On average in Texas, employers cover 68% of premiums for family coverage and employees pick up the other 32%.
• The value of the employer’s health insurance contribution printed on the W-2 will not be counted as taxable income for workers.  Health reform does not make you pay income tax on your employer’s contribution toward your health insurance.

Want the complete story?  FactCheck.org exposes the truth about this myth.

This week the Texas Legislature took its first steps to help Texas prepare for implementation with the naming of House and Senate committees to monitor national health reform.

Speaker Straus named a 15-member House Select Committee on Federal Legislation. The committee’s work will include, “monitoring Congress’s health care reform efforts and their potential impact on the state’s health care system, health insurance regulation statutes and policies, Medicaid and children’s health insurance programs, eligibility system, workforce recruitment and retention, and health care financing mechanisms.”  Rep. John Zerwas will serve as chair and Rep. Garnet Coleman as co-chair.  Speaker Straus’ press release lists the full committee membership.

Senate interim charges released this week by Lt. Governor Dewhurst included the following joint charge on health reform to the Senate Health and Human Services Committee and the Senate State Affairs Committee.

Upon passage of federal legislation relating to reform of the health care industry and health insurance industry, study the implication of such legislation on Texas, the health care industry, and public and private insurance.  Study and monitor the implementation of the insurance regulatory changes, changes to the high risk pool, and any other insurance mandates.  Study the health care policy changes and the impact to the Medicaid and CHIP programs and the state budget.  Assess the impact to all state uninsured and uncompensated care programs and county programs for the uninsured, including county property tax programs to pay for the uninsured. Make recommendations for the efficient implementation of programs.

• 2010 Early Deliverables:  New high-risk pool; some immediate consumer protections and insurance reforms; premium rate disclosures and oversight;
• Major Coverage Reforms in 2013 or 2014:  Health Insurance Exchanges create marketplace for insurance under new reforms that prohibit denial or pricing based on health status; premium assistance and out-of-pocket caps, Medicaid expansion for poorest; individual and employer responsibility with exemptions for small firms and financial hardship; 
• Improved Medicare coverage for prescription drugs and preventive care
• Both bills fully paid for through budget savings and revenue increases:  both reduce federal deficit by more than $100 billion in the first 10 years, and continue to reduce it in the second decade.

Key Differences to Negotiate:

• Financing:  House progressive income taxes versus Senate excise taxes on high-cost health benefits.
• Affordability: House much better for low-income premiums and all incomes on cost-share and benefits; Senate premiums better for moderate-income.  Obvious solution = best of both bills, but where will the money come from?
• Exchanges and Insurance Regulation:  House bill tighter oversight, more consumer-friendly regulation of the insurance industry, Health Insurance Exchange greater negotiation power.
• Abortion:  Both bills prohibit direct federal support or subsidy for abortion coverage.  Issue is whether Exchanges can sell coverage that includes abortion as an “add-on” paid for by the consumer.
• Public Option:  House has a moderately weak model and Senate has none, though would have OPM contract with insurers to offer minimum of 2 plans that meet “qualified health plan” standards and at least one of these must be non-profit.
• Employer Responsibility:  House includes a “pay or play” provision, Senate charges employers penalties only if their employees actually access subsidized coverage.
• Undocumented immigrants:  Senate bill prohibits undocumented from buying insurance through the exchange, even with their own funds.  House does not and Congressional Hispanic Caucus opposes Senate language.
• Closing the Medicare Part D “doughnut hole”:  How to pay for this is the issue.

For more on the differences, see the Community Catalyst blog and the House Tri-Committee staff comparison of key differences

The New York Times Prescriptions Blog post “Program for Children Has Uncertain Future”  provides a nice summary of some of the most pressing concerns regarding the future of CHIP. 

The additional links below provide greater detail on the wide range of advocacy perspectives on the House and Senate proposals impact children’s coverage.

• December First Focus Report – “Children in Health Reform: Comparing CHIP to the Exchange Plans”
• First Focus Health Reform Resources
• December Center on Budget & Policy Priorities – “Vast Majority of Children Would Be As Well Off or Better Off Under House Health Bill Than Under Current Law”

We also recommend checking out Georgetown University’s Center for Children and Families (CFF) as an excellent resource for policy expertise and advocacy:

• Georgetown’s Center Children and Families website on health reform
• CFF Children’s Health Policy Blog: Say Ahhh!

More information on affordability in health reform from Community Catalyst:

• Affordable Coverage Must Be a Priority in Merging the House and Senate Reform Bills
• Increasing Access to Health Care for African Americans Depends on Improving Affordability during the Merge of the House and Senate Bills    
• Increasing Access to Care for Hispanic Families Depends on Improving Affordability during the Merge of the House and Senate Bills 
•  $900 Billion is $900 Billion – or is it? Gross vs Net Spending and Why It Matters

• Adopting the House bill’s stronger affordability measures for families below 250 percent of the federal poverty income guidelines; and
• Requiring the House’s much stronger standards for a Health Insurance Exchanges–whether through a single national exchange or state-level exchanges–to empower exchanges to negotiate with insurers and deliver better value to individuals and small businesses.

You can read the full letter here.

There are presently 10 million Americans in need of long term services and supports and this number is expected to increase to almost 15 million by 2020, according to the Alliance for Retired Americans. While approximately 45 million Americans do not have medical insurance, more than 200 million adult Americans lack any insurance protection against the cost of Long Term Services and Supports (LTSS).

There are two primary health care bills being considered in the Senate and three in the House of Representatives. The Senate Finance Committee approved a health care bill on Tuesday, Oct. 13th. Senate Democratic leaders will now have to merge that bill with another bill which passed the Senate HELP Committee in July. Meanwhile, the House is working to merge three bills passed by House Energy and Commerce, Ways and Means, and Education and Labor committees into one bill to take to the full House.

None of the minimum benefit packages in the bills include long-term services and supports. Only the bill passed by Senate Finance Tuesday includes a comprehensive approach to long-term services. In the bill are the Community Living Assistance Services and Supports (CLASS) Act, the Community First Choice Option, the Home and Community Balancing Incentives Act and Coordinated Health Care Office (CHCO).

For more information:

Detailed information about the benefits of these reforms

CLASS Act Briefing – On October 20, the Kaiser Family Foundation will host a briefing to examine this major proposal to change the way that the U.S. pays for long-term care. The briefing, “The Sleeper in Health Reform: Long-term Care and the CLASS Act,” will be posted on www.kff.org on the same day.