WASHINGTON — Here is a summary of the seven major health care reform proposals before Congress:
President Clinton’s Health Security Act, with 100 House co-sponsors. It provides health care to every American. Employers are required to insure all workers and pay at least 80 percent of premium costs, with workers paying the rest. Employer costs are capped at 7.9 percent of total payroll. Health care programs are administered by state alliances.
This plan is opposed by retailers and small business groups that primarily rely on minimum-wage labor.
Health Equity and Access Reform, S 1770, HR 3704, sponsored by Sen. John Chafee (R., R.I.) and Rep. William Thomas (R., Calif.), with 20 Senate co-sponsors and three House co-sponsors. It has no employer mandates, but employers must make enrollment in qualified health plan available to workers. It would create individual and small employer purchasing groups, limited to employers with less than 100 workers. It offers tax breaks for self-employed insurance costs.
Retailers object to the proposal that every person buy health insurance on the grounds it would be burdensome.
Affordable Health Care Now Act, sponsored by House Republican leaders Robert Michel of Illinois and Newt Gingrich of Georgia, with 139 House co-sponsors, all Republicans. It would require employers to offer insurance, but not pay for coverage. It includes small group insurance reform for employers with 50 or less workers and offers tax breaks of 100 percent for self-employed insurance costs. It would create Medisave accounts — tax-free family savings accounts dedicated to health care expenses.
Retailers like the plan overall, and favor Medisave accounts on the grounds they make consumers more responsible for health care costs.
Comprehensive Family Health Access and Savings Account, sponsored by Sen. Phil Gramm (R., Tex.) and 11 Senate co-sponsors. It allows continuation of existing health insurance arrangements, health maintenance organizations and creation of Medisave accounts. It would create small business purchasing pools for health care coverage.
It is the plan most favored by retailers.
American Health Security Act, HR1200, sponsored by Rep. Jim McDermott (D., Wash.) and 92 House co-sponsors. It provides universal coverage by 1995 in a federally financed health insurance program. It is employer-funded by a 7.9 percent payroll tax, along with unspecified “sin” taxes. It is similar to the President’s plan in that it creates a national health board to enforce a national health care budget. If states exceed their budget, they must fund the extra spending.
Retailers and small business groups oppose it because of payroll taxes and strong government intervention.
The Managed Competition Act, HR 3222, sponsored by Rep. Jim Cooper (D., Tenn.) and 60 House co-sponsors. It guarantees access to health care, with no employer mandates. It creates Health Plan Purchasing Cooperatives, which will offer group rates with lower administrative costs. Employers with less than 100 workers can buy coverage through local HPPC. Employers would be able to deduct the cost of most efficient health plans.
Retailers won’t oppose it, but don’t plan to support it because of similarities to the President’s plan.
Consumer Choice Health Security Act, sponsored by Sen. Don Nickles (R., Okla.) and 25 Senate co-sponsors. It guarantees access to health care, creates Medical Savings Accounts, has no employer mandates and no new taxes. It gives tax credits for health expenses and is paid for by savings in Medicare and Medicaid.
Retailers favor this plan.