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Baucus' outline: You in or out?

From NBC's Domenico Montanaro and Ken Strickland
Attached is the framework that Finance Committee Chairman Max Baucus sent out to the "Gang of Six." The 18-page document lays out principles for health reform, including a health insurance exchange, tax credits for small businesses, increased funding for so-called "high-risk pools" of patients, but, as expected, no public option.

The framework was sent out to the bipartisan negotiators over the weekend. They were to read it over and consider it. We'll see if Republicans Chuck Grassley and Mike Enzi stay or go -- and what they point to in this document if they decide to pull out from negotiations. They are set to meet at 2:30 this afternoon.

The framework does include co-ops, which were born in this committee. It tries to describe what they actually are. And it outlines fines for individuals and families if they fail to purchase health insurance:

For taxpayers between 100-300% of poverty, the penalty for failing to obtain health coverage is $750 per year with a maximum penalty per family of $1500. For taxpayers with incomes above 300% of poverty, the penalty for failing to obtain coverage is $950 per year with a maximum penalty per family of $3800.

There will, however, also be tax credits to help some families:

Beginning in 2013, tax credits would be available on a sliding scale basis for individuals and families between 134-300% of poverty to help offset the cost of private health insurance premiums. Beginning in 2014, the credits are also available to individuals and families between 100-133% of poverty. The credits would be refundable and advanceable and would be based on the percent of income the cost of premiums represents, rising from three percent of income for those at 100% of poverty to 13% of income for those at 300% of poverty. The share of premium enrollees pay would be held constant over time. Premium credits would be tied to the Silver plan.

And businesses with 200 or more employees will be mandated to provide health insurance:

Employers with 200 or more employees must automatically enroll employees into health insurance plans offered by the employer.

Here's part of the co-op section:

The proposal would "foster the creation of nonprofit, member-run health insurance companies that serve individuals in one or more states. ... Federal loans would be provided to assist with start-up costs, and federal grants would be provided to meet state solvency requirements. ...

CO-OPs would be permitted to enter into collective purchasing arrangements for services and items that increase administrative and other cost efficiencies, especially to facilitate start-up of the entities, including claims administration, administrative services, health information technology, and actuarial services.

Grants and loans will be awarded by the Secretary of HHS based on recommendations made by an advisory board. The advisory board will be chaired by the Secretary (or a delegate) with other members appointed by the Majority Leader of the Senate (4 members), the Minority Leader of the Senate (3 members), the Speaker of the House of Representatives (4 members) and the Minority Leader of the House of Representatives (3 members).

Priority in awarding grants will be given to statewide proposals, integrated care models, and applications with significant private support. In making awards, the Secretary, in consultation with the advisory board, shall ensure there is sufficient funding for at least one CO-OP in all 50 States and the District of Columbia. Multiple awards per state are allowed. The Secretary shall begin distribution of funds by January 1, 2012. The board will disband upon completion of its duties, but no later than December 31, 2015.

In the event that CO-OPs are not established in every state, the Secretary is authorized to use planning grants to encourage CO-OP formation or expansion of existing CO-OPs from other states.