Health Care In The News
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• Senate OKs health care measure, reaching milestone December 24, 2009
• Obama urges spirit of compromise on healthcare October 3, 2009
• Seeking to Woo the Insured, Obama Cites Risk of Losing Coverage September 12, 2009
• Did Kennedy’s Dream Need Kennedy’s Presence? August 26, 2009
• Obama to Hold Online Meeting on Health Care August 18, 2009
• Senate Considers Alternative to Public Healthcare Option August 3, 2009
• Costs and Benefits In Health Care Reform July 20, 2009
• Mass. Panel Backs Radical Shift in Health Payment July 16, 2009
• The Only Public Health Plan We Need- June 24, 2009
• Obama presses doctors to back health care overhaul- June 15, 2009
• The Many Hidden Costs of High-Deductible Health Insurance- June 1, 2009
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Health
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HEALTH CARE REFORM
Outlets like AP,
Bloomberg, Newsweek, The New York Times, and the Kaiser Family
Foundation have taken on the daunting task to compare the two versions
of the health care reform in both the Senate and the House proposals.
Below, three charts with an overview, key similarities, and key
differences between the Senate and House proposals. These charts were
provided by yahoo The Buzz
Senate vs. House Health Care: Overview
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| |
Senate |
House |
Notes |
| Bill Size |
2,074 pages
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1,990 pages
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|
| Reform cost |
$871 billion (over 10 years)
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$1.05-$1.2 trillion (over 10 years)
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Health care cost Americans $2.4 trillion in 2008 and could balloon to $4.4 trillion by 2018.
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Where's the money coming from to pay for this?
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Taxes
on fancy health plans (40% excise tax); fees on medical-device makers
($2 billion/year starting 2011, then $3 billion/year in 2018); higher
Medicare payroll tax for high-income folks; Medicare and Medicaid cuts;
fines. Strangest of all—10% tax on indoor tanning.
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Surtax on
high-earners (5.4% on incomes $500k and up); taxes on Cadillac plans
(40% excise tax); Medicare and Medicaid cuts, fees on medical-device
makers ($20 billion over 10 years); various penalties, corporate taxes
and fees; limits on flexible spending account contributions. |
The tanning bed tax has pleased some doctors
— using fake UV rays before age 30 has been correlated with a huge
melanoma cancer risk. Rejected: The "Bo-Tax," a tax on cosmetic
surgery.
|
| Who gets covered? |
94% of legal residents under age 65 |
96% of legal residents under age 65 |
Currently, 83% of Americans are covered.
|
| Who gets left out? |
24 million people under 65 (including illegal immigrants) |
18 million people under 65 (including illegal immigrants) |
Currently, 50 million (one in six Americans) are not insured.
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| When would reform kick in? |
2014, with some protections starting sooner. |
2013, although rules for insurance companies would start in 2010 |
Some worry a later start allows insurance companies to jack up premiums in the meantime.
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| Senate vs. House Health Care Similarities |
| |
Senate |
House |
Notes
|
| Individual mandate (get insurance or pay a penalty) |
Small penalties start in 2014 ($95), then hit 2% of taxable income in 2016. |
2.5% of adjusted gross income of a certain level. |
Both plans have aid for low-income people. Online sites will let consumers shop for group policies.
|
| Employer mandate (insure employees or pay a penalty) |
Optional, but larger companies whose employees get any insurance help from Uncle Sam would pay a penalty. |
Payroll size determines the penalty. |
Polls shows a divided public, but people generally support the policy that bosses should provide coverage.
|
Medicaid (federal program for low-income)
|
Expanded, but leaves 23 million "non-elderly" uninsured |
Expanded, but leaves 18 million uninsured |
California governor Arnold Schwarzenegger, who supports health care reform, sent a letter with Medicaid concerns.
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| Pre-existing medical conditions |
Insurance companies banned from using pre-existing conditions as a reason to reject coverage. Effective immediately for children.
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Bans insurance companies from this tactic. |
12.6 million people have been rejected in the past three years for insurance because of "pre-existing" conditions. |
How long are the kids covered (under mom & dad's insurance)?
|
Up to age 25 |
Up to age 26 |
People 19 to 29 make up the biggest chunk of the uninsured. |
| Senate vs. House Health Care Differences |
| |
Senate |
House |
Notes |
Abortion funding
|
Beneficiaries need to pay for coverage separately, and insurers
have to keep that money separate from federal funds. States can block
such health plans.
|
Public plans don't cover the procedure, but private insurers can offer "rider" policies. |
Abortion funding has been the sticking issue for both branches of Congress. |
| Pharmaceutical industry drug costs |
No change. |
Companies would have to dicker over how much they can charge in the Medicare prescription drug program.
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Health care lobbyists have spent about $400 million so far on the reform effort. |
| Public option (government alternative to private plans) |
No.
The Office of Personnel Management, which runs policies for federal
employees, would partner up with insurers to offer two national plans
(with at least one operating as a nonprofit).
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Yes, to compete with private plans and encourage lower costs. |
Considered dispensable by the president and unlikely by key senators, public option appears doomed.
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| Antitrust exemption for insurance companies |
Status quo.
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By ending insurers' special status, the feds can penalize companies for price rigging, false advertising, and similar issues.
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Health insurance companies have enjoyed the McCarran-Ferguson exemption since 1945. |
Of course, these charts cover only what has been proposed.
Among the health care professionals who want to see real reform, the
National Nurses Union lists 10 fundamental flaws with the Senate proposal. A seasoned physician decries the lack of portability, accountability, and affordability, and the Harvard Medical School dean rates the debate process an F. The American Medical Association, however, has given its thumbs-up.
The
job of reconciling the House and Senate bills will fall to a conference
committee. That'll take some time: As Politico notes, there's winter
break
(ending January 11 for the House, January 17 for the Senate), and the
committee will want the White House to weigh in.
Then
the Congressional Budget Office will do the math, after which the
House and Senate vote on the final bill, and Obama must sign off. There
may be a holiday truce, but the debate will come back in the new year.
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