Blair-Kingpoleon Healthcare Plans

Option 1:
1. The creation of health insurance cooperatives, which would be member-controlled, non-profit forms of health insurance that would compete with private insurers. It does not include a public insurance plan. The co-operatives would receive $6 billion in federal funding on November 31, 2016, to start off, but they would operate independently after that point. The introduction of the co-ops is intended to drive health care costs downward.

2. Individuals would be able to buy their insurance from an exchange created in their state, which would be created in December 2016. Premiums would be capped at 13% of the buyer's income, with the rest of the costs paid by subsidies. Insurance companies would be required to cover certain services such as hospitalization, maternity care, newborn care, chemotherapy, and pediatric care. Their plans would be presented as either bronze, silver, gold, and platinum options, sorted by the least to the most expensive. Only individuals and firms with fifty or fewer employees would be eligible to use the exchanges until January 2017, when states would bring in larger employers. In February 2017, they would become open to all. Persons who are not lawfully in the United States would not be permitted to participate in the exchange, either with or without subsidies.

3. Businesses with more than fifty employees are required to pay fees going towards the aforementioned subsidies. The maximum possible fee would either be $400 per full-time employee or the average cost of the subsidies a firm's employee's take in multiplied by the number of those receiving them. The proposal forbids insurance companies from restricting coverage based on 'pre-existing conditions'. The insurance premiums can take into account tobacco use, age, family size, and geographic location. Insurance companies would also be forbidden from setting up lifetime or annual caps that specify a maximum amount of care that customers can receive.

4. Create a  new excise tax on so-called 'Cadillac' health care plans that are more expensive and comprehensive than the majority of plans. Any plan costing over $8,000 for an individual and $21,000 for a family would be subject to a 35 percent tax on the amount past those levels. The proposal would create $215 billion in the next ten years from the tax.

5. Another $93 billion in funds will come from new annual fees imposed on groups such as pharmaceutical companies and medical device manufacturers. Additionally, there will be provisions that would lump Flexible Spending Accounts (FSAs) together with high-cost insurance plans and subject them to the excise tax, which would likely cause many employers to reconsider offering FSAs altogether.

6. Other funds come a reduction in future Medicare spending, which would be over $400 billion in the next year. Specifically, payments under the Medicare Advantage system would be decreased by $113 billion in the next year. The so-called 'doughnut hole' in prescription drug coverage would be closed. In the long term, the proposal would set up an independent commission that could alter payments further.

7. A small portion of funds would come from a new cap imposed on Flexible Spending Accounts (FSAs), pre-tax health benefits that enable millions of Atlasians to manage their out-of-pocket health care costs. This would impose a $2,500 limit on contributions to FSAs. Unfortunately, 7 million Atlasians have FSAs above $2,500, and those with the highest out-of-pocket health care costs- the sickest – would be hit the hardest by the restrictions.

Option 2:
1. Administration of the program is by new region-sponsored "Health Help Agencies" (HHA). Regions must establish these organizations, which will approve health plans from private insurers, provide for enrollment in plans, and act as a conduit for premium payments from the federal government to individual insurance carriers.

2. All citizens and permanent residents would be required to pay for coverage as part of their federal tax liability. Payment would be made via tax withholding by employers. Individuals would effectively pay the federal government, which would channel the funds to the appropriate HHA and from there to the insurers. Employers would no longer provide basic coverage in most cases.

3. Taxpayers would have a large healthcare standard deduction, which would increase with inflation. This would help taxpayers pay the tax liability that has now replaced insurance premiums. This essentially replaces the tax exclusion for health care benefits presently paid by employers. Certain low-income taxpayers would be eligible for premium assistance.

4. The size of the standard deduction for December 2016 would range from $6,000 for individuals to $15,210 for couples with children, with incremental amounts for additional children. As a standard deduction, this reduces the income reported as subject to tax. However, this deduction would phase out for higher-income taxpayers, reducing to zero for couples earning over $250,000.

5. Mandates that employers provide salary and wages increases over a two-year period essentially equal to the amount paid previously for basic healthcare insurance premiums, as employers no longer have to provide basic healthcare coverage.

6. Employers pay a new tax equal to between 3 percent and 26 percent of the national average premium for the minimum benefits package for each employee, depending on their firm size and amount of gross revenues per employee.

7. The basic plan would be equal to the Federal Employee Health Benefits (FEHB) Program, with some exceptions. For example, Medicare and military healthcare recipients would be outside the scope of this bill.

8. Premiums can vary only to reflect geography and smoking status.

9. Individuals can have more expensive (i.e., non-basic) coverage plans paid directly to insurers.

10.Certain individuals would be phased out of the Medicaid program, via participation in their state's HHA.