Thread: Three Big differences in House and Senate Healthcare Bill

Three big differences between House and Senate healthcare bills

Even if the Senate healthcare bill is approved, reconciling it to the House bill will take a concerted effort on three major points: who bears the cost, the public option, and abortion funding.


By Peter Grier Staff writer / December 21, 2009
Washington

At heart, the House and Senate versions of healthcare reform legislation are very much the same. Both require virtually all Americans to have health insurance, while offering low- and middle-income people subsidies to make that mandate more affordable. Both would establish new marketplaces, called "exchanges," where individuals who don't get insurance from employers could buy coverage.

Both would cost about $1 trillion over 10 years and pay for themselves via cuts in projected Medicare spending and tax and fee increases. Both would ban insurance firms from denying anyone coverage due to pre-existing health conditions.

But though their frameworks are the same, the two bills are very different in some of the details. So different, in fact, that harmonizing the bills could be a daunting task for a conference committee of House and Senate negotiators.

Here are three of the biggest obstacles to melding the bills together:

Financing.

The largest source of new revenue in the House version of healthcare reform legislation is a tax on wealthy Americans. It consists of a 5.4 percent surcharge on families with annual incomes over $1 million and on individuals with incomes over $500,000. It's estimated to bring in $461 billion over the next decade.

In contrast, the largest source of new revenue in the Senate version of the bill is an excise tax on high-cost health insurance plans. The Congressional Budget Office estimates this would raise $149 billion over 10 years. The Senate raises another $238 billion over the decade via a mix of fees on insurers and some health device manufacturers, and other provisions.

Public option.

The House version has a public option – a government-run insurance plan that would negotiate payment rates with doctors and hospitals. (Liberals would have preferred that it use the Medicare rates set by the government, which would probably have been lower.)

The House bill allocates $2 billion for public option start-up money. But premiums from beneficiaries would have to pay for the full cost of the plan after it got up and running.

The Senate bill ... well, that was kind of a struggle, wasn't it? The Senate bill has no public option, following objections from Sen. Joseph Lieberman (I) of Connecticut and moderate Democrats about government intervention in the marketplace.

Instead, under the Senate bill, the federal Office of Personnel Management would oversee two national health plans from private firms offered through the exchanges to individuals, families, and small businesses. At least one of those plans would have to be operated on a nonprofit basis.

Abortion.

Under the House bill, health plans, in general, could choose whether to cover abortion or not. But federal money couldn't be used for abortions, except in cases of rape or incest, or if the life of the pregnant woman was in danger.

The public option plan would not provide abortion coverage, for instance, in the House version of the bill. Nor could individuals who received federal subsidies to buy insurance choose a plan that covers elective abortions.

Abortion language in the Senate bill is different in important details. As in the House version, the Senate language allows health plans, in general, to choose whether to cover abortion or not. But states could block plans that cover abortion from being offered through the new insurance exchanges.

The Senate would allow people who receive federal subsidies to buy insurance to enroll in plans that cover abortion. But they would have to make two separate monthly payments: one for abortion coverage, and one for all other health coverage.

http://www.csmonitor.com/USA/Politics/2 ... care-bills[/b]

I hope they fight like cats and dogs over this and come to a complete stand still. In fact I am going to pray that they do.

Originally Posted by April

I hope they fight like cats and dogs over this and come to a complete stand still. In fact I am going to pray that they do.

ME TOO! This is one of the worst bills ever!

What both of these bills seem to be lacking is the impetus to break up the insurance cartels.

UTICA, N.Y. (WKTV) - Congressman Michael Arcuri said he believes there will be a compromised bill for President Obama to sign by the end of January.

Congressman Arcuri said it may take a while but believes representatives from the house and the senate will work together to come up with a unified bill.

"I have been using a sports analogy," Arcuri said. "When the house passed its bill, it was sort of like a first down. I think the senate has it past mid-field. Now, the hard work starts - realistically getting it across the end zone. There are a lot of differences between the senate bill and the house bill. We have our work cut out for us as soon as we get back after the first of the year."

Arcuri said he believes the main sticking point in the bill will come down to whether the government option is included.

http://www.wktv.com/news/local/79849052.html

Originally Posted by butterbean

Originally Posted by April

I hope they fight like cats and dogs over this and come to a complete stand still. In fact I am going to pray that they do.

ME TOO! This is one of the worst bills ever!

Obama will be livid if this is not done by Christmas, however it would be a huge gift to us if it were stalled.

Originally Posted by vortex

What both of these bills seem to be lacking is the impetus to break up the insurance cartels.

OF course that is part of the agenda!

Maine Senators Defend Votes on Health Care Bill
12/21/2009 Reported By: Tom Porter


Maine's two Republican senators have been defending their decisions to vote against the Senate version of the heathcare reform bill. In an initial vote carried out at 1:00 a.m. today, all 58 Democratic senators plus two independents provided the 60-40 margin needed to counter a threatened GOP filibuster. The next vote is set for around 7:20 tomorrow morning. While the Democrats are encouraged, President Obama's goal of a bi-partisan health bill was not met, despite his efforts to win over Maine's senior senator, Olympia Snowe, a moderate Republican.
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Maine Senators Defend Votes on Health Care Bill Listen
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Sen. Snowe was unavailable to provide comment for this report, but in a written statement, she said she couldn't vote for the bill because of the "artificial and arbitrary deadline," set by the president, of having it completed by Christmas, something which she says is "shortchanging the process."

In particular, she says she objected to a 400-page amendment filed over the weekend by Senate Majority Leader Harry Reid, which, because of the Christmas deadline, cannot be debated or further amended.

Meanwhile, Maine's other senator, Susan Collins, also considered a moderate Republican, told the Senate she wants health care reform, but cannot support the bill. It does little, she says, to hold down costs, and it raids the Medicare system to pay for expanded health care coverage -- something which she says puts Maine hospitals at risk.

"One out of five would be so jeopardized by these cuts that they may not survive. And what else will happen is that physicians are going to have to start turning away Medicare patients," Collins says.

Collins says the Senate needs to start over and craft a measure that reduces the cost of health care and is paid for without cuts to the Medicare system. "Medicare, which is so critically important to our nation's seniors, should not be used a piggy bank for new spending programs."

"Clearly we were disappointed that Maine's senators decided to vote 'no' on moving the bill forward," says Greg Howard, Communications Director for Maine Change That Works, an advocacy group pushing for comprehensive healthcare reform. "However they have certainly shown in the past a willingness to talk with the people of Maine and to make constructive suggestions on how to make the bill better. We think that this is a very important historic vote and that the momentum is clearly on the side of healthcare reform."

As for Sen. Collins' concerns over planned cuts to existing Medicare programs, "The issues that Sen. Collins is raising do have some merit, but there are ways of addressing those issues, and we feel that an expansion of Medicare to cover people of a younger age is exactly the right direction to go," Howard says. "It is a way that provides good, solid coverage to people who need it, and people in Maine -- over 140,000 of them -- do not have health insurance coverage at all, and many of those who do are under-insured."

While the Senate bill is expected to gain approval by the end of the week, the measure will still have to be harmonized with the House version, which was passed last month, before a final piece of legislation can be sent to the president's desk.

U.S. Rep. Chellie Pingree, of Maine's 1st Congressional District, is hopeful this will happen early next year. "There's not everything in the bill that I would like -- I'm a strong supporter of the public option, I think they've improved a couple of things in the bill. But a lot will come out in the conference report between the House and the Senate and I'll hope that we can pass a final bill that moves forward on affordable healthcare access to everybody."

Pingree thinks that wrangling over the public option - a measure missing from the Senate bill - will be among the main bones of contention when it comes to hammering out a final version.

President Obama's healthcare overhaul aims to extend coverage to 30 million people now uninsured, while bringing healthcare costs under control. The legislation would make health insurance mandatory for the first time for nearly everyone, provide subsidies to help lower-income people buy it, and induce employers to provide it with tax breaks for small businesses and penalties for larger ones.

The president also describes the bill as a financially prudent measure - one that's designed to cut the deficit by $132 billion during the first 10 years, and by over a trillion during the second.

http://www.mpbn.net/Home/tabid/36/ctl/V ... fault.aspx

I have always respected my elders, and now our seniors who built up this country may have Medicare cut for the benefit of Medicaid, some payments undoubtedly going to illegals with anchor babies.
This health care reform is the stupidest thing, since Americans will be forced to grease the pockets of the insurance lobby, how are they going to pay for it without jobs?

Originally Posted by vortex

I have always respected my elders, and now our seniors who built up this country may have Medicare cut for the benefit of Medicaid, some payments undoubtedly going to illegals with anchor babies.
This health care reform is the stupidest thing, since Americans will be forced to grease the pockets of the insurance lobby, how are they going to pay for it without jobs?

IT is SO SAD and so WRONG!!! The most vulnerable will be hurt by this travesty Bill, the elderly and the unborn, and all the Americans without jobs. We must fight on against this travesty and unseat all the traitors who have participated in this wrong doing!!!