The Senate version of the bill will extend health insurance coverage to over 30 million Americans and, according to the nonpartisan Congressional Budget Office, reduce the federal deficit by $132 billion over the next decade. The reforms are forecast to drop the deficit by another $1.3 trillion between 2019 and 2029.
%%DynaPub-Enhancement class="enhancement contentType-HTML Content fragmentId-1 payloadId-61603 alignment-right size-small"%%After the bill is passed by the Senate, the House and Senate will caucus to reconcile the differences between their two bills, and a final version will emerge that must then be voted on by both chambers. It's that final version that will determine what will happen to health care in this country.
A Public-Option Alternative
The Senate bill leaves the existing employer-based health insurance system intact. If you already get health insurance from your employer, you likely won't see any big immediate changes. But if your employer does not, you may.
Under the Senate's plan, employers with more than 50 employees must offer health coverage or pay a fine of up to $750 per employee if any employee obtains federal subsidies for coverage. Employers face stiffer penalties under the House bill. Companies with a payroll of more than $500,000 must provide insurance or pay a penalty of up to 8% of their payroll.
Here are key provisions on which the House and Senate bills agree:
- Both will subsidize insurance for a family of four making up to about $88,000 annually, or 400% of the federal poverty level;
- Both will eventually limit out-of-pocket expenses;
- Both will prevent insurance companies from denying coverage for pre-existing conditions;
- Insurers will be barred from charging higher premiums based on a person's gender or medical history.
Where the Money Comes From
The biggest remaining differences between the bills center around how health care reform will be financed. The House uses a combination of a tax surcharge on wealthy Americans and new Medicare spending reductions. Individuals with annual incomes over $500,000 -- as well as families earning more than $1 million -- would face a 5.4% income tax surcharge.
The Senate bill cuts Medicare by $480 billion through cost-control measures that will reduce payments to providers of Medicare. The bill also imposes a 40% tax on so-called "Cadillac" health plans valued at more than $8,500 for individuals and $23,000 for families. The Senate bill would also hike Medicare payroll taxes on families making over $250,000; the House bill does not.If you don't have insurance now, you will be required to purchase coverage. The House bill imposes a fine of up to 2.5% of your income. The Senate plan requires individuals to purchase health insurance coverage or pay a fine of up to $750, or 2% of their income, whichever is greater. Both versions include a hardship exemption for poorer Americans.