The Senate came out of conference with its version of health reform. The 2,074-page bill contains two key differences from the House version that affect employers and employees.
1. Employer contribution
- Senate: Would not require employers to offer coverage, but employers with 50 or more full-time workers would pay a penalty — $750 for each worker in the firm — if any of their workers receive federal subsidies to buy insurance through the exchange.
- House: Would require most employers to provide insurance to workers or pay a tax equal to 8% of payroll.
2. Employee payments
- Senate: Would impose an excise tax on high-cost insurance plans provided by employers — so-called “Cadillac plans.” The Senate proposal would levy a 40% tax on the premium amounts that exceed $8,500 for individuals and $23,000 for families. And the Medicare payroll tax rate would increase 0.5% for individuals with annual incomes over $200,000 and couples over $250,000. A person without insurance would be required to pay a financial penalty, starting at $95 in 2014 and rising to $750 in 2016, up to a maximum of $2,250 for a family.
- House: Would impose a 5.4% surtax on high-income people.
The two bills contain some other differences on controversial topics:
- Senate: Individuals and families making up to 400% of the federal poverty level — $88,200 for a family of four — would receive a subsidy.
- House: Essentially the same as the Senate version, but the subsidies would be offered on a sliding scale.
- Senate: Would allow people who receive insurance subsidies to choose a plan that covers elective abortions, but insurers must use premium money or co-payments contributed by consumers, and not subsidy money, to cover the cost of the abortions. Would also require that every state offer at least one insurance plan that covers abortion and one that doesn’t.
- House: Would bar low- and middle-income people who receive federal subsidies to buy insurance from choosing a plan that covers elective abortions.
Coverage for illegal immigrants
- Senate: Would bar illegal immigrants from buying insurance from a national exchange, even if they could pay the full cost and didn’t receive subsidies.
- House: Would allow illegal immigrants to buy coverage from a national insurance exchange, but they wouldn’t be eligible for federal subsidies.