Promising universal cover by 1999, the US Democrats have unveiled a national health plan, modelled on the measure passed in July by the House Ways and Means Committee, which President Clinton says achieves the goal of universal coverage while being simpler, more flexible and more sensitive to the needs of smaller businesses.
The plan contains an 80% employer mandate with subsidies for small, low-wage firms, and a Medicare extension that would act as a safety net for the unemployed, part-time workers and those without coverage through work. The basic package calls for nationally guaranteed, comprehensive coverage, including prescription drugs, mental health and substance abuse services, preventive care and a new long-term care program to provide home- and community-based services to people with severe disabilities. Employers would have to offer at least one health plan with an unlimited choice of providers and one managed care plan.
Those employed by small companies (under 100 staff) offering private cover could buy insurance through the program that covers federal employees, and some smaller employers could choose to enroll their employees in the new Medicare Part C program, which would also offer cover for the unemployed, low-income families and part-time and seasonal workers. New insurance rules would permit easier coverage, including for people with pre-existing conditions. A basic benefits package would be defined and a system of subsidies established to help low-income working people afford coverage. Plans would not be able to not deny cover to any eligible group or person, even with pre-existing conditions. Rates for plans sold to groups of 100 or less would have to be based on average costs for all people covered in a geographic area.
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