House And Senate Conferees Will Have To Reconcile Two Bills
- Abortion: The House version includes stricter language designed to prohibit the use of federal funds for abortion coverage, except in cases of rape, incest or when the mother’s life is in danger. That helped appease House conservatives, but abortion was even more of a make-or-break issue in the Senate, so that chamber’s slightly milder language could win out.
- Taxes: The House and Senate bills would fund health reform in entirely different ways. The House bill would tax individuals making more than $500,000 a year and families making more than $1 million. The Senate bill would tax so-called “Cadillac” or high-cost health plans – an idea opposed by labor unions and many House Democrats. The Senate version would also impose annual fees on health insurers starting at $2 billion in 2011 and going up to $10 billion in 2017.
- Public plan: The House bill includes a government-run plan that progressives fought hard to include. Instead of a government-run plan, the Senate version would instruct the federal Office of Personnel Management to contract with private insurers to offer at least two national health plans for individuals and small businesses. One of those plans would have to be nonprofit. Conventional wisdom says the final, combined bill will not include a public plan, but House leaders could seek other tweaks in exchange for dropping the idea. Possibilities include increasing federal subsidies to help low- and middle-income people afford coverage, creating a single, national insurance exchange instead of one in each state, or introducing those exchanges earlier – in 2013, a year earlier than the Senate bill stipulates.
- Medicare Advantage:Each bill would cut funding for the Medicare Advantage program, but the amount differs substantially. The House bill includes cuts of $170 billion over ten years. The Senate bill would trim reimbursements by $118 billion over the same ten-year period. We didn’t mention the potential impact on Health Savings Accounts (HSA) because it is unclear what if anything will change with the final bill. As stated previously, two components of health care in this country that work are Medicare Advantage and Health Savings Accounts. Ironically these are two programs on the chopping block of both pieces of legislation. Very unfortunate how we have come to accept mediocrity in this Great Country.
For more, check out these side-by-side comparisons from the New York Times and Wall Street Journal.
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