Democrats chart goals for new health-care plan

WASHINGTON - House Democrats are crafting a plan that would require all Americans to carry health insurance and would help families making less than $88,000 pay the premiums. Employers, too, would have to help foot the bill.

It is the latest development in President Obama's push to fix the ailing U.S. health-care system by getting the government more deeply involved. Obama has said the final legislation must rein in costs, guarantee choice of health plans and medical providers, and ensure affordable coverage for all Americans.

A document obtained by the Associated Press shows where House Democratic leaders are headed as they try to meet a July 31 deadline for passing their version of the legislation. The Senate is working on a similar plan, with some key changes.

The plan by the House Energy and Commerce Committee would build on the current system in which employers, government, and individuals share responsibility for health insurance. But it would make major changes: Individuals and employers would face new obligations to help pay for coverage. Insurers would operate under stricter consumer protections. And the government would take added responsibilities for setting insurance rules and providing financial help to low- and middle-income families.

It's a sensible, mainstream proposal," said Rep. Jim Cooper of Tennessee, a member of the fiscally conservative group of Democrats known as the Blue Dogs.

The House also calls for a new government insurance plan to compete with private companies, to be financed by premium payments, not taxpayer dollars. Insurers are strongly opposed to a government-sponsored plan, saying it would drive them out of business. Democrats say a public plan would help everyone by injecting competition into the health-care market.

The House proposal says a main goal is to "minimize disruption" for people who already have coverage by allowing them to keep what they have. All Americans would be protected by an annual limit on out-of-pocket costs. Individuals would be required to get coverage, either through an employer or government plan, or on their own. Employers would be required to provide coverage or pay the government a percentage of payroll.

Individual subsidies for health insurance would be offered on a sliding scale to those earning up to four times the federal poverty level, or $88,200 for a family of four, according to the plan.

The proposal would also set up an insurance-purchasing pool called an "exchange" to help make private coverage more affordable for individuals and small businesses. In its first year, the exchange would be open only to employers with fewer than 10 workers. Health-insurance plans that participate in the exchange would have to follow new consumer-protection rules.

Obama has proposed a downpayment of $634 billion over 10 years to pay for expanding coverage, money obtained through a 50-50 mix of tax increases and spending cuts.