SUMMARY
The bill provides quality affordable health care for all Americans and controls health care cost growth.
Key provisions of the bill being released this week include:
COVERAGE AND CHOICE
AFFORDABILITY
SHARED RESPONSIBILITY
CONTROLLING COSTS
PREVENTION AND WELLNESS
WORKFORCE INVESTMENTS
I. COVERAGE AND CHOICE
The bill builds on what works in today’s health care system and fixes the parts that are broken. It
protects current coverage – allowing individuals to keep the insurance they have if they like it – and
preserves choice of doctors, hospitals, and health plans. It achieves these reforms through:
A Health Insurance Exchange. The new Health Insurance Exchange creates a transparent and
functional marketplace for individuals and small employers to comparison shop among private and
public insurers. It works with state insurance departments to set and enforce insurance reforms
and consumer protections, facilitates enrollment, and administers affordability credits to help low‐
and middle‐income individuals and families purchase insurance. Over time, the Exchange will be
opened to additional employers as another choice for covering their employees. States may opt to
operate the Exchange in lieu of the national Exchange provided they follow the federal rules.
A public health insurance option. One of the many choices of health insurance within the health
insurance Exchange is a public health insurance option. It will be a new choice in many areas of our
country dominated by just one or two private insurers today. The public option will operate on a
level playing field. It will be subject to the same market reforms and consumer protections as
other private plans in the Exchange and it will be self‐sustaining – financed only by its premiums.
Guaranteed coverage and insurance market reforms. Insurance companies will no longer be able
to engage in discriminatory practices that enable them to refuse to sell or renew policies today due
to an individual’s health status. In addition, they can no longer exclude coverage of treatments for
pre‐existing health conditions. The bill also protects consumers by prohibiting lifetime and annual
limits on benefits. It also limits the ability of insurance companies to charge higher rates due to
health status, gender, or other factors. Under the proposal, premiums can vary based only on age
(no more than 2:1), geography and family size.
Essential benefits. A new independent Advisory Committee with practicing providers and other
health care experts, chaired by the Surgeon General, will recommend a benefit package based on
standards set in the law. This new essential benefit package will serve as the basic benefit package
SUMMARY
The bill provides quality affordable health care for all Americans and controls health care cost growth.
Key provisions of the bill being released this week include:
COVERAGE AND CHOICE
AFFORDABILITY
SHARED RESPONSIBILITY
CONTROLLING COSTS
PREVENTION AND WELLNESS
WORKFORCE INVESTMENTS
I. COVERAGE AND CHOICE
The bill builds on what works in today’s health care system and fixes the parts that are broken. It
protects current coverage – allowing individuals to keep the insurance they have if they like it – and
preserves choice of doctors, hospitals, and health plans. It achieves these reforms through:
A Health Insurance Exchange. The new Health Insurance Exchange creates a transparent and
functional marketplace for individuals and small employers to comparison shop among private and
public insurers. It works with state insurance departments to set and enforce insurance reforms
and consumer protections, facilitates enrollment, and administers affordability credits to help low‐
and middle‐income individuals and families purchase insurance. Over time, the Exchange will be
opened to additional employers as another choice for covering their employees. States may opt to
operate the Exchange in lieu of the national Exchange provided they follow the federal rules.
A public health insurance option. One of the many choices of health insurance within the health
insurance Exchange is a public health insurance option. It will be a new choice in many areas of our
country dominated by just one or two private insurers today. The public option will operate on a
level playing field. It will be subject to the same market reforms and consumer protections as
other private plans in the Exchange and it will be self‐sustaining – financed only by its premiums.
Guaranteed coverage and insurance market reforms. Insurance companies will no longer be able
to engage in discriminatory practices that enable them to refuse to sell or renew policies today due
to an individual’s health status. In addition, they can no longer exclude coverage of treatments for
pre‐existing health conditions. The bill also protects consumers by prohibiting lifetime and annual
limits on benefits. It also limits the ability of insurance companies to charge higher rates due to
health status, gender, or other factors. Under the proposal, premiums can vary based only on age
(no more than 2:1), geography and family size.
Essential benefits. A new independent Advisory Committee with practicing providers and other
health care experts, chaired by the Surgeon General, will recommend a benefit package based on
standards set in the law. This new essential benefit package will serve as the basic benefit package
