The House and Senate bills both require that insurance include doctor visits, hospitalization, maternity care, prescription drugs and lab work, chronic disease management and pediatric care. "That's solid stuff," Runyon said.
The bills also contain $10 billion to $14 billion to expand sliding-scale community health center services.
Critics say that the bills will not control costs, and future generations will end up with much higher taxes. "That could happen, but it's guaranteed to happen if nothing is done," said Perry Bryant, director of West Virginians for Affordable Health Care. "The difference is, 31 million people get health care."
Under the Senate bill, insurance companies can no longer charge older people more than three times what they charge younger people. That would raise the amount young people pay on paper, Bryant said, but the subsidies would limit what they actually pay.
With the subsidies, people who make less than $27,000 would get a substantial discount, and the discounts grow more modest up to $43,000. People making more than $43,000 will pay market rates, but most likely not as much as they would have paid, he said.
"The number of people who can't pay their medical bills will drop dramatically under these bills," he said, "and that will lower the cost of health care for everyone.""It's all very complicated," Taylor Books owner Ann Saville said. "I get very attached to these young people and their dreams, and I wish I could give them all insurance, but I'd have to close if they made me. As it is, I'm getting up at 5 a.m. most mornings to make scones and soup to sell in the store, trying to keep it going."
Under both bills, small businesses are not required to provide insurance, unless they have a payroll of $500,000 or more. "I wish they'd tell us these kinds of details," Saville said. "I see the politicians on TV beating their breasts and blustering, and I get so annoyed at them, I tune it all out."
One other thing should appeal to young people who dream of starting their own business, Bryant said. "They will be able to get insurance that isn't tied to a job."
The government will set up an Internet insurance exchange, through which individuals can join a pool with other individuals for collective buying power.
About 25 percent of employees stay in jobs because their health insurance is tied to that job, according to a 2007 study in the Quarterly of Business Economics. "Once people can get good, affordable insurance on their own through the exchange, you'll see more business startups," Bryant said. "If that happens, this whole effort will help people follow their dreams, and that's worth a lot too."
More young adult West Virginians are uninsured than any other age group
Age # uninsured % uninsured
0 - 18 44,000 10.5%
19-29 73,300 29.9%
30-49 84,200 17.2%
50-64 40,300 11.9%
Source: Families USA
Want to see how the subsidies would work?
Kaiser Family Foundation has a subsidy calculator at http://healthreform.kff.org/
Reach Kate Long at katel...@wvgazette.com or 304-348-1798.