Health-care overhaul comes at a price

WASHINGTON (AP) — Have your checkbooks and credit cards ready. There’s a price for health-care security.

President Barack Obama’s overhaul — now looking like it really will happen — should give uninsured Americans options they’ve never had before. But it won’t be a free ride.

As with the Medicare prescription-drug benefit that passed when Republicans ran Washington, consumers will face a dizzying lineup of health-plan choices — with different costs and benefits.

“People who need to buy coverage as individuals and small employers are going to have a lot more in the way of attractive health- insurance options, and they won’t have to worry about whether their medical condition precludes them from being covered,” said policy expert Paul Ginsburg, who heads the nonpartisan Center for Studying Health System Change.

The downside: “Sticker shock is going to come to some.”

Get ready for a whole new set of trade-offs.

For example, people in their 50s and early 60s, when health problems tend to surface, are likely to pay less than they would now. Those in their 20s and 30s, who get the best deals today, will face higher premiums, though for better coverage.

On Wednesday, Obama hailed a tentative deal by Democratic senators to give millions of Americans the option of signing up for private plans sponsored by the federal employee health system, which covers some 8 million including members of Congress. Senators continued to debate for a 10th day, with Democrats pushing to pass the bill by Christmas.

The 2,074-page Senate bill will grow even longer as amendments are considered, but the basic outlines of the legislation most likely to pass are becoming clearer.

The overhaul will be phased in slowly over the next three to four years. But eventually, all Americans will be required to carry coverage or face a tax penalty, except in cases of financial hardship. Insurers won’t be able to deny coverage to people with health problems, charge them more or cut them off.

Most of the uninsured will be covered but not all. As many as 24 million people would remain uninsured in 2019, many of them otherwise eligible Americans who still can’t afford the premiums.

No dramatic changes are in store for most people who get coverage through their jobs — about 60 percent of those under age 65. The Congressional Budget Office says the bill wouldn’t have a major effect on premiums under employer plans, now about $13,000 a year. Parents would be able to keep dependent children on their coverage longer, age 27 in the House bill.

One benefit for people with employer coverage is hard to quantify: It should be easier to get health insurance if they’re laid off.

Some people’s taxes would go up.

To pay for expanded coverage, the House bill imposes a 5.4 percent income-tax surcharge on individuals making more than $500,000 and families earning more than $1 million. The Senate slaps a 40 percent tax on insurance plans with premiums above $8,500 for individual coverage, and $23,000 for family plans, among other levies.

The rest of the financing would come mainly from cuts in federal payments to insurers, hospitals, home health-care agencies and other medical providers serving Medicare.

The Associated Press. All Rights Reserved.