Health Care Reform Comes Together

The details of health care reforms being considered by Congress are coming together. The Senate Finance Committee will vote as early as Friday on a health care reform bill where approval is expected. A House bill and another Senate bill from the Health, Education, Labor and Pensions Committee are also being considered. The House bill has a public option, the Senate bills do not. A floor vote in the House and Senate is planned within the next few weeks.

Health care legislation drafted by a key Senate committee would expand coverage to 94 percent of all eligible Americans at a 10-year cost of $829 billion . . . the legislation would reduce federal deficits by $81 billion over a decade and probably lead to "continued reductions in federal" red ink in the years beyond. . . .

The Finance Committee bill does not require businesses to offer coverage to their workers . . . although large firms that do not would be required to offset the cost of any government subsidies going to those employees. . . . the estimate does not include the costs of proposed payment increases for doctors serving Medicare patients, roughly $200 billion through 2019. Additionally, a so-called fail-safe mechanism to hold spending in line could result in cuts as large as 15 percent in federal subsidies designed to help the poor afford insurance . . .

Beginning in 2013, the measure would require that millions of Americans purchase private insurance for the first time, and would set up a new marketplace where policies would be available. Failure to obey the requirement would result in penalties of up to $750 per family.

Federal subsidies would be available to millions of lower-income individuals and families to help defray the cost of coverage that would otherwise be out of their reach. . . .

The legislation also would ban current insurance industry practices that deny coverage on the basis of pre-existing medical conditions, and restrict companies' ability to charge vastly higher premiums on the basis of age, gender or other factors.

The measure would be paid for through a variety of tax increases and spending cuts, including savings of hundreds of billions of dollars from Medicare, the federal health care program for seniors. . . .

It said that by 2019, "the number of nonelderly people who are uninsured would be reduced by about 29 million," either through private insurance or by enrolling in federal programs. That would leave an additional 25 million uninsured, about one-third of them illegal immigrants who are not eligible for coverage under the bill.

"Under the proposal, the share of legal nonelderly residents with insurance coverage would rise from about 83 percent currently to about 94 percent," Elmendorf said. Elderly Americans are eligible for coverage under the federal Medicare program.

The report was released as House Democrats met privately to consider ways to hold the cost of their version of the legislation to the $900 billion 10-year limit that Obama has set.

Officials said one of the options under review would add as many as 7 million lower-income individuals to Medicaid, the federal-state health care program for the poor. It would be cheaper for the government to cover costs under that program than to pay subsidies designed to make private insurance affordable for the same group. Aides put the savings at about $25 billion over 10 years.

As Drudge likes to say, the story is "developing."