Proposals to Provide Affordable Coverage to All Americans: A Synopsis

I've finally managed to work my way through the Senate Finance Committee's paper on policy options to expand coverage. This is, as Ezra Klein notes, the guidebook that the Committee will use when building its bill. For our purposes, I've highlighted 20 of what I feel to be the key proposals on the table:

1. Merge the individual and small group markets, so as to better distribute risk
2. Grandfather current coverage plans available, so that citizens may keep their current coverage if they so choose
3. Create one or more national insurance exchange(s)
4. Mandate health insurers offer a bare minimum of four standard coverage options: high, medium, low, and lowest
5. Provide tax credits and assist with continuation of COBRA coverage for low income tax individuals and certain small employers
6. Establish a public plan (either Medicare-like, TPA, or state-run)
7. Expand Medicaid access and coverage (e.g. income eligibility up to 150% FPL, elimination of face-to-face interview entry requirements, include drug coverage as a mandatory benefit, expand Medicaid coverage in U.S. territories)
8. Increase CHIP income eligibility to 275% FPL
9. Change the Federal Medicaid Assistance Percentage (FMAP) formula to more efficiently distribute funds to needier states
10. Establish at CMS an Office of Coordination for Dually Eligible Beneficiaries, to more effectively manage the disproportionate use of care
11. Reduce or phase-out the Medicare Disability Waiting Period
12. Temporary Medicare Buy-In for individuals aged 55-64.
13. Establish an individual mandate, effective 1/1/2013 (at the latest)
14. Perhaps establish an employer mandate -- not yet definitive
15. Encourage development of a personalized prevention plan and routine wellness visit for all Medicare beneficiaries
16. Remove or limit Medicare & Medicaid beneficiary cost sharing for all preventive services (e.g. no copayment or deductible)
17. Establish additional grants to states for the prevention of chronic disease and encouragement of healthy lifestyles
18. Employer wellness credits
19. Bolster Medicaid HCBS (Home & Community Based Services) program and shift focus away from institutional LTC
20. Establish new requirements for data collection and public reporting

Those are the big ones.