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How health reform may affect a family

Nancy Marshall-Genzer Nov 19, 2009

How health reform may affect a family

Nancy Marshall-Genzer Nov 19, 2009


Kai Ryssdal: We have known the broad outlines of the Senate’s health-care bill for a while now. But we figured now that we have the specifics — it was officially released last night — it might be good to figure out what consumers are going to get for the bill’s $849 billion price tag. What’ll it do for your average family of four with no insurance? That was today’s assignment for Marketplace’s Nancy Marshall Genzer.

NANCY MARSHALL GENZER: So, we’ve got a fictional family of four with no insurance. We’ll put 45-year-old George at the head of the family. He works at a restaurant. Let’s say he earns $66,000 a year. George had a heart attack a few years ago. To get an idea of how his family would fare under the health-care overhaul, I called the Center for American Progress.

Ellen Marie Whelan is the center’s associate director of health policy. She used an online benefits calculator to crunch the numbers for George and his fictional family.

ELLEN MARIE WHELAN: And he works in a restaurant and let’s say he works in a restaurant that has less than 50 employees. And we’re going to put that he has to purchase his own insurance because his employer has not chosen to offer him health insurance.

By Whelan’s calculations, George would be able to insure his family for $15,000 a year under the health-care overhaul proposals. The government would pay almost half of that, leaving George with a bill of about $6,300. Where would George buy his insurance? Because of his income and the fact that his employer doesn’t insure him, George can shop for a policy in an insurance exchange.

Elizabeth McGlynn of the Rand Corporation explains how the exchange works. She says there’ll be a Web site to log onto.

ELIZABETH MCGLYNN: So people could go on and compare the different plans that are being offered in their state. They’ll all have standard benefit packages, so it’ll be easier than it often is to know what you’re getting from the different health-insurance companies who are offering the policies.

But what if George decides not to buy insurance? Whelan says he would pay a fine under the Senate plan.

WHELAN: So he’d have to pay $285 the first year. And that quickly goes up in a couple years to $750 per person, half for kids.

George’s employer wouldn’t be fined, because his restaurant has fewer than 50 workers.

Sara Collins is an economist with the Commonwealth Fund. She says our fictional family is pretty typical of today’s uninsured.

SARA COLLINS: Right now if you don’t have coverage through an employer, there are few places for you to turn to, except the individual insurance market, and if you’ve had a heart attack or other pre-existing health conditions, it’s really tough to get an affordable policy or maybe not a policy at all.

It’s not clear when our fictional family can get their insurance. The debate over the legislation is likely to drag into next year.

In Washington, I’m Nancy Marshall Genzer for Marketplace.

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