The Senate has a health care bill. What's in it?
Posted on November 19th, 2009 by Jason Rosenbaum in Congress Watch
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Last night, the Senate unveiled their health care bill. You can read the full bill here [pdf], or the summery documents here.
On the whole, the Senate bill looks very much like the House health care bill. It ends insurance company abuses like denying care for those with pre-existing conditions and it sets benefit standards to make sure the coverage people receive - both on their own and through their employer - actually covers the care they need. It gives people the choice of a public health insurance option like the one in the HELP bill, though states would be able to opt-out of the public option if they passed a law saying so. And it sets up a health insurance "Exchange" that would provide tax credits (subsidies) to make health care affordable, as well as helping business afford health care for their employees.
On the budgetary front, the Senate bill would cost $849 billion over 10 years, and reduce the deficit by $127 billion over the same period. You can read the CBO's projections on the bill here [pdf].
Of course, there are major differences. Igor Volsky at the Wonk Room has a handy comparison chart:
Senate Bill ($849 billion/10 years) House Bill ($894 billion/10 years) Individual Mandate Yes, penalty of $750 by 2016 for those don’t purchase coverage. ($95 penalty in first year) Yes, penalty of 2.5% of income for those who remain uninsured Employer Mandate Free rider provision. Employers would have to pay whichever is lower: $3,000 per every employee who receives a subsidy in the Exchange, or $750 for every employee (not just the subsidized worker). Yes, employers who don’t’ offer coverage would pay a fee equal to 8% of their payroll Medicaid Expansion Up to 133% FPL. 100% federal funding for the first 3 years, then revert to Senate Finance language. Up to 150% FPL Subsidies Between 133 – 400% FPL on sliding scale; spend 2%-9.8% of income on premiums Between 133 – 400% FPL on sliding scale; spend 2%-12% of income on premiums Public Option National public plan, states can opt-out by 2014. Co-ops are also available. Yes, HHS secretary negotiates rates Financing Excise tax on policies above $8,500 (individuals) and $23,000 (families), increases the payroll tax by .5% (increases to 1.95%) on individuals who earn more than $200,000 and families earning more than $250,000 a year, tax on insurers, pharmaceuticals, and medicare devices; Medicare savings 5.4% surtax on individuals earning > $500,000, couples earning more than $1 million; Medicare savings
The New York Times also has a great comparison.
Overall, the fact that Majority Leader Harry Reid did the right thing and listened to the American people by including things like a public health insurance option and a tax credit level that goes a long way towards making health care affordable means that this bill deserves a debate and a fair, majority up-or-down vote.
Republicans and the insurance companies will try to block this bill any way they can, even going so far as to recommend the Senate not even talk about this bill, let alone vote on it. These tactics only preserve the status quo. The American people deserve health care reform - reform that delivers affordable coverage, a choice of a public health insurance option, and fair financing - and this bill deserves a fair vote by the full Senate so it can meet the House bill in conference.
What about that free rider provision? Any chance it can get stripped in conference?
I want to know a couple of things:
Why does this still look like a money grab by insurance companies?
Why is it that, if Medicare-for-All is what a majority of Americans want, it is considered "politically impossible" and this cobbled-together bail-out is the best the damned Congress can do?
Stop flogging these stupid, convoluted plans. Stop trying to make us not realize that Obama and the Congress do not want to reform health care to make it available to all, but want to enrich their insurance company campaign donors. More than most things lately, we're reminded that we have the best congress and president money can buy.
Majority of Americans want single payer? Proof?
Because in the latest polls, the public option is doing very well….
most americans want an insurance they can afford and not to make the insurance companies richer. prove that we have the best president and congress. don't let our children and grandchildren suffer any more. leave are social security in place. and revirse what al gore did.
It appears that people living in purple states like Florida may not have the benefit of a public option if governors decide against it. Not Good. Services through the public option may cost more than through private plans. Not good. Plans won’t start for another 4 years. Not good. Bills are likely to be watered down even further to please conservative democrats. Not good. Let’s quit this fake Bill and regroup before the next congressional elections. Then we should go all out for a real single payer health care system like the UK has.
The majority of Americans want a strong single payer public option that covers everyone universally, such as an expansion of Medicare for all. Why is Congress ignoring what the people want? Could it be because of the campaign contributions that health insurance lobbyists provide?
Congress is working out the ransom payments demanded by Washington Lobbyists on the new "Medical Reform Bill". Lobbyists demand the medical industry cover only ALL of the young and healthy at astronomical prices while the old and sick stay a burden on society or DIE YOUNG while they continue their financial rape of America. Congress allowed The stock market and the insurance companies to make their own rules and police themselves and look at the devastation they reeked on America.
In 1965 the Medicare bill didn't create as much opposition because ith had the blessings of the insurance companies. They didn't want to insure those over 65 because they cost them money. They wanted taxpayers to take on that burden–which we did so successfully that it was expanded to cover America's disabled. If Medicare was expanded to cover the young and healthy, we could have the best medical care in the world at less than it is costing taxpayers today.
If your legislators vote against the single payer option, please vote them out of offfice in numbers to big to erase. They have the best single payer in the world, it's time their constituents have a right to medical too.
How does it address increased costs for those currently on Medicare Advantage programs? They currently don't have to pay the deductibles and %s required by Medicare and don't have to pay for additional drug coverage and supplemental to cover the additional costs.
All I have heard is that Med. Adv. programs will be dropped but not how ppl are going to come up with the extra $$ for the extra costs of straight Medicare.
Medicare Advantage is nothing but a government subsidy to private insurance:
http://articles.latimes.com/2009/aug/19/nation/na-medicare19
So your care won't be cut, and your costs won't increase, you just won't have to get health care through a private company that skims off the top anymore.
I'm just as frustrated as most others seem to be about this issue and I think that some sort of universal health care is truly the answer to our dilema, i.e., national Medicare for all US citizens but elimination of the Medicare Advantage to the insurance companies.
I've been following T. R. Reid's documenteries which are extremely revealing about healthcare around the world. Google his name & check it out for yourself. Really revealing stuff. Actually, Switzerland went through the same sort of thing we're facing now & they solved their problem. Of the countries Reid investigated, Switzerland had the best kind of healthcare program for its citizens. I think we need to do the same thing!!!
Major obstacles - we all know - are the insurance & pharmaceutical industries & all of their lobbying efforts. We all know that many members of Congress - - and even Obama - - have received $$$ from these sources. So, in my mind, the only real solution, which is what Switzerland did - - is a national referendum by US citizens to enact REAL REFORM. I believe that if Americans got to vote on this directly, it would pass overwhelmingly. Now, I'm not talking about the bill currently in the Senate, because it has so much extraneous fluff and BS in it, it's riduculous and is also why it has such a huge price tag attached.
Problem is, (I did some homework) we don't have the constitutional right or option, if you will, to do it. There is no provision in the US Constitution to allow for us - - US citizens to vote & decide on something (or anything) like this.
So - — what to do??? Keep fighting the good fight unless someone can figure out how we can have a national referendum on this issue. Seriously, if there is a way to do it, please speak up.
I agree we do need REFORM but what are so called leaders are doing to us is not reform but to inslave the populus. when this bill passes {against the will of the people} we wil see more and more control taken away from us. Is it really worth inslavement of are childern and are childerns childern. I for one can not live in a world were we are not free and that is what this in truth comes down to CONTROL of the people.
Why a tax on medical devices? If I have my knee replaced do I pay on the artificial knee? Would you rather I be in a wheelchair?
The tax on medical devices won't be paid by you, it's paid by the company.
yet another weapon used by the government to collaps the economy. as for the Individual Mandate, what of those who due to religious and other beliefs do not wish to have health care? some feel that when it is time to go, it is time to go. being pentalized for doing your part to keep the world from becoming over populated and/or a hinderance to society should be comendable, not another way to go broke. as for the small business owners that can barely keep their heads above water in this economy as it is, are noww going to have to charge more for their products and sevices ultimately driving them out of business, yet another bonus for few corporate monsters that wish to corner the market on all goods and services known to man. when are we going to say, "enough iss enough?" when we are dead and gone and our children dont know any better because they've been raise in a world where total control by the few elite is the norm? i will always vote 3rd party from here on out. those running are govorners, senators, etc just like the republicrats. its a party that has always existed and in thwe early days of this contry when it was a little more "pure", the 3rd party actually got elected once in a while. if we dont change it, no one else will. everyone including the government and big business is "in it for themselves" these days. united we stand, divided we fall!
Folks who have religious objections are exempt from the mandate.
Has anybody looked at the unemployment rate? Most people cannot afford health insurance. Stop picking on the seniors. I don't think getting pentalized for not getting insurance is the solution. This is long time coming. I recently went to 2 specialists and one I seen for 20 minutes and the bill was 499.00 an hour and the other one was 15 minutes and the bill was 405.00 an hour.WHAT? We need this health reform. This has gotten out of hand.
Thank you for your time.
Thes bills are outrageous - UNDER NO CIRCUMASTANCE IS IT ETHICAL TO FINE PEOPLE WHO CAN NOT AFFORD INSURANCE!
ANY MANDATE MUST BE APPLIED TO THE PERSONS INSURANCE PREMIUM, AT MINIMUM.
We all know the proper way to do this is take out the premium in peoples taxes and apply it to their Medicare for All payment.
THIS IS CRAP, AS A DEDICATED PROGRESSIVE I HOPE THESE BILLS FAIL!
Folks who can demonstrate financial hardship don't have to pay a fine.
The individual mandate is an outrage.
It is the equivalent of a regressive tax, only it is paid to for profit insurance companies whose use and retention of these funds is subject only to their shareholders' demands for profits and their executives' demands for compensation that exceeds that of the POTUS.
It was hard to imagine anything worse than our current system. This is!
If insurance is affordable, the mandate isn't that much of an issue.
How can there be a mandate if there isn't a public option?!
The Senate bill as introduced has a public option.
We really need to focus on the future generations of this country throughout this debate; an aspect I feel has been completely neglected. Any form of public option is necessary. Of the 45+million Americans without insurance more than have of that number is comprised of young people fresh out of college many of whom, in this harsh economic time, are not able to gain employment that offers benefits. I read an article recently by a group of doctors and medical professionals, and there was a statistic in the article that places the U.S. as #37 regarding health care.http://www.ourblook.com/component/option,com_sectionex/Itemid,200076/id,8/view,category/#catid107
The entire health care structure needs an overhaul, not just provider care. Spending within health care needs to be questioned and we need solutions to some of the smaller issues as well as the national necessities.
your all going to be slaves to the Government. you are a fool to think that a government that runs everything it controls into the ground is going to do a good job with your health. well your a fool then and cant see that this is another way of control of us as a people. There is no refrom here it is just another form of slavery.