--Individuals have a "personal responsibility" requirement to obtain health care coverage with certain exceptions, including religious prohibitions or if the lowest cost option available exceeds ten percent of their adjusted gross income. Those individuals who do not obtain coverage will be subject to a penalty based upon the individual's income-as an example, if an individual's income is between 100 and 300 percent of the poverty level, the penalty is $750 per year.

--Employers are not required to offer health insurance to employees, but those employers with more than fifty employees and not offering coverage will be required to reimburse the government for each full time employee receiving a health care affordability tax credit in the exchange equal to 100 percent of the average exchange subsidy, up to a cap of $400 per total number of employees.


Affordable Coverage

--The Chairman's Mark has four benefit categories to be available: bronze, silver, gold and platinum. All plans must provide the following: preventive and primary care, emergency services, hospitalization, physician services, outpatient services, day surgery and related anesthesia, diagnostic imaging and screenings (including x-rays), maternity and newborn care, pediatric services (including dental and vision), medical and surgical care, prescription drugs, radiation and chemotherapy, and mental health and substance abuse services. Plans would have out-of-pocket limits at least equal to the limits for Health Savings Accounts (HSAs): $5,950 for an individual and $11,900 for a family in 2010.

--These plans may not charge cost-sharing for preventive care services, and can not include lifetime limits on coverage or annual limits on benefits.

--A Cafeteria Plan would be created where small businesses can offer tax-free benefits to employees, and expands participation eligibility. Qualified long-term care insurance can be provided under a cafeteria plan.

--Consumer Owned and Oriented Plans (CO-OPs) may be established and operate at a state, regional or national level. These CO-OPs would be non-profit, member-run health plans to compete in the market and offer alternatives to consumers. Federal money would be provided for start-up costs for the CO-OPs.

-- Small Business Health Options Program (SHOP) exchanges will be available on the web for small businesses to compare and purchase health care coverage.

--Low and middle income persons will be provided an advanceable, refundable tax credit to subsidize purchasing health insurance. These credits will be on a sliding scale based on the federal poverty level. To prevent illegal immigrants obtaining health care tax credits, verification of name, social security number, and date of birth will be required.

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