Senate Dems Close In On Reform: Details Of Health Care Bill Revealed

Read the bill (PDF). Senate Democrats have posted the legislation on their web site.

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Senate Democrats made a big step toward comprehensive health care reform Wednesday night as Sen. Majority Leader Harry Reid (D-Nev.) unveiled a bill that merges the two plans that passed the health and finance committees.

With the House having already passed its own bill, Congress is now closer to achieving health care reform than it has ever been in the six decades that Democrats have pursued it.

"We're now down to the week we've been waiting for for a long time," said Sen. John Kerry (D-Mass.) after emerging from a meeting of Senate Democrats.

Democratic leadership expressed confidence that the votes would be there by Saturday for a motion to proceed to a floor debate on the bill. Three Democratic senators -- Ben Nelson of Nebraska, Mary Landrieu of Louisiana, and Blanche Lincoln of Arkansas -- have yet to commit to vote for the motion to proceed.

During the meeting, the fence-sitting members spoke to the caucus, but didn't commit one way or another on the motion to proceed, said one Democratic senator who spoke not for attribution.

The bill presented by Reid is stronger than pundits ever thought possible in the summer months, when centrist and conservative Democrats worked to kill a public health insurance option. A loud round of applause could be heard toward the end of the meeting -- unusual for Senate gatherings.

Reid's bill includes a national, government-run insurance plan that would be available to consumers within the health insurance exchanges that the reform effort establishes. States could opt out of the plan.

The bill is being posted online Wednesday night, Senate Majority Whip Dick Durbin (D-Ill.) said. "I would hope [Republicans] would take this opportunity to post their health care bill online," Durbin teased. The GOP has no health care bill.

The Senate bill does not go as far as the House bill does in restricting access to abortion. The House bill would block a woman's ability to purchase health insurance that covers abortion even with her own money in many instances. The Senate package, several senators said, makes crystal clear that no federal funds could be used to pay for abortion. But at least one plan within the exchange would have to offer abortion coverage -- and one plan would not.

An aide who saw the specific language said the bill authorizes the secretary of Health and Human Services to audit plans to make certain no federal funds are being used to pay for abortion services.

House conservatives have threatened to block the reform bill if their more restrictive provision isn't included. Kerry acknowledged that there could still be negotiations, "but that's where the Senate is starting."

Instead of taxing the rich to pay for a significant piece of the bill, as the House does, the Senate plan would tax "Cadillac" health plans. But the value of plans that would be taxed is higher than in previous versions: $8,500 for an individual and $23,000 for a family of four. Even higher values are allowed in high-cost states and workers in high-risk jobs -- such as coal miners -- are given an exemption.

Reid's bill also alters the formula by which businesses would be assessed a fee for not insuring their workers. But the new formula was unclear. Kerry called it "convoluted" and Durbin dubbed it "complex."

Reid on Wednesday also presented to his colleagues a preliminary Congressional Budget Office analysis, which finds that the bill will cost $849 billion over the next decade. It would cover 94 percent of eligible Americans, including 31 million currently uninsured Americans. The bill would also lower the federal budget deficit by $127 billion over the next decade and by $650 billion during the decade after that. Kerry cautioned that the numbers were still being finalized and could change slightly.

By keeping the total cost of the bill under $900 billion, Reid met one of the conditions set by the Obama White House. The bill is also expected to drastically bend the cost curve in the health care system -- another major Obama objective -- by achieving "almost a trillion dollars in cost savings" within the health care system.

Reid will file a cloture motion Thursday, which will be followed by an intervening day, by Senate rules, leaving Saturday for the vote.

Comments

[Hopeforu]

12:32 AM on 11/20/2009

My husband and I have just joined the ranks of the un-insured. I am self employed and he is a contracted worker for the state. He has a preexisting condition and I have just been turned down for a reason that is not explained in terms that I understand because it is in code. Oh Yeah.....We are both over 55------No insurance company wants to insure anyone over 55. Therefore they will turn you down for anything they can and send you an explanation in code. These people have no morals.......And they call it Golden Rule Insurance. (United Health Insurance) No one really cares anymore what happens to anyone. We just got through paying 18 months of COBRA-----They took our money willingly. Thanks United Health Insurance!

[utd]

01:09 AM on 11/20/2009

I'm sorry to hear that. My wife and I are equally screwed and it's difficult, stressful, and it just plan sucks. Hang in there though it's almost over and help is on the way, we just need to keep fighting another month or two.

[evekendall]

08:39 PM on 11/19/2009

While driving in my car this evening, I heard the following story on my public radio station. It's a report produced by "Marketplace" about what the financial impact of the new health insurance reform would be for a family of four making $66,000 per year, based on the Senate bill that was passed this week:

http://marketplace.publicradio.org/display/web/2009/11/19/pm-healthcare-family/

Here it is in a nutshell:
Most people would be required to purchase a policy from a health insurance company or face a penalty. Premiums for a family of four making $66,000 would run about $15,000 per year. However, a family at that income level would qualify for the government to pay over half ($8,700) of that premium, leaving the family with a total premium bill of about $6,300 per year or $525 per month. If the family decides not to buy the insurance, the penalty would be $285 the first year and would quickly go up in a couple years to $750 per adult and $375 per child. There was no mention of what co-pays and deductibles would be under a policy with these premiums.

This sounds like a huge taxpayer-funded giveaway to the insurance companies whose overhead runs around thirty percent versus a single-payer system like Medicare whose overhead runs about three percent.

We need single-payer Medicare for all. Don't ever stop fighting for it.

Physicians for a National Health Program: http://www.pnhp.org/

[Billl]

07:03 PM on 11/19/2009

This 2000 page travesty will bring unspeakable hardships to individuals and businesses forced to purchase questionable insurance to pay for expensive services in a system that has failed so many.

A pure public option, with government sales tax funding replacing insurance, along with distributing all government funded care free to everyone requesting it only through government owned and operated hospitals, staffed by government employed doctors and health care providers, using proven VA systems, is the most cost effective and morally correct way for fixing half of the health care problem.

Using these “unfair government advantages” as President Obama calls them would save hundreds of billions of dollars annualy while leaving no one without care.

Everyone choosing public care could have it no restrictions, no insurance, no co pays, free period.

Employers who select public care for their employees would not be required to pay for or have any further involvement with health care.

The second half of the solution is to have a pure private option of insurance and hospitals that would not be subjected to any government mandates.

Going back and forth between free public, and user purchased private care, would allow unlimited choices, ultimate freedom, and always free public care would be available.

This is real health care reform that would be helpful and highly efficient for individuals, employers, taxpayers, and the United States economy.

Unfortunately there is no lobbyist loot to spread around “to get a bill” that makes so much sense.

[ldmason45]

06:23 PM on 11/19/2009

Here we go again with "fuzzy" math. The "doctor fix" isn't included and the "supposed" savings from Medicare/Medicaid included. And what about the tax increases to businesses. This sounds a lot like the "stimulus" jobs created and saved. I'd rather they just come out and say how much a program will really cost. Look how high the government costs went over planned budgets with SS and Medicare/Medicaid. Those with private insurance will still be paying higher premiums. All of this on top of having to tell one of my Medicaid patient's family last week that Medicaid is not going to pay for their mother's tube feeding. Meaning she will not be allowed her only form of nutrition and that she'll starve to death before she has a chance to die from cancer. I can give Medicaid horror stories all day long. You never see those on this site.

[jws2346]

05:57 PM on 11/19/2009

I was just reading this article and the article in the NYT's. In both articles it mentions the unpopularity of taxing the Heath care plans labeled as "Cadillac Heath plans". With peeps going broke, peeps dying and being disabled, peeps having no Health insurance at all and peeps having to use the emergency rooms at hospitals don't you think that this debate about taxing the "Cadillac plans" and such for stopping the Health care plan as a little disingenuous?

[up420oz]

05:50 PM on 11/19/2009

HEY HEY HEY!

Anybody out there dying because of being denied health insurance?

I see a list of politicians here that have taken a personal interest in making you suffer.

If I was in that situation, I know what I would do.

But I live in Canada, & we have UNIVERSAL HEALTH CARE FOR EVERYBODY!!!

[utd]

01:14 AM on 11/20/2009

Not dying but I have suffered from 3 different instances where my insurance specifically caused me to have permanent damage and disability because they wouldn't approve treatments I needed. As a consequence they will end up paying out more for me to address the problems they caused and I have lost ability and partial mobility forever.

[Wisconsin Dave]

05:28 PM on 11/19/2009

DEMOCRACY NOW.org

"Reid Unveils Senate Healthcare Reform Bill

On Capitol Hill, Senate Majority Leader Harry Reid has unveiled an $849 billion healthcare reform bill.

The measure is similar to the House version in imposing mandates on Americans to obtain insurance and establishing so-called “exchanges” where insurance is sold.

The bill would be partly funded by an increase in payroll taxes for high-income Americans and cuts to Medicaid. Reid says the measure would expand health coverage to 31 million people.

On abortion, Reid excluded a House-backed amendment that would bar federal subsidies to women who enroll in an insurance plan that covers abortion and also rule out abortion coverage under the proposed government-run insurance plan.

But his measure would preserve a law that bars federal funding for abortion coverage."

http://www.democracynow.org/2009/11/19/headlines

[CIA-FAN]

05:27 PM on 11/19/2009

• Sec. 202 (p. 91-92) of the bill requires you to enroll in a "qualified plan." If you get your insurance at work, your employer will have a "grace period" to switch you to a "qualified plan," meaning a plan designed by the Secretary of Health and Human Services. If you buy your own insurance, there's no grace period. You'll have to enroll in a qualified plan as soon as any term in your contract changes, such as the co-pay, deductible or benefit.

You will lose your current health care plan

[Lavafalls]

08:15 PM on 11/19/2009

All plans offered will be qualified plans. Otherwise they wouldn't be able to sell them.

Why do you fear change so much. Change can be good, and NOTHING stays the same.

[youhavebeenhad]

05:12 PM on 11/19/2009

This is what America thinks of Barrycare

http://www.zogby.com/news/ReadNews.cfm?ID=1764

[CIA-FAN]

05:26 PM on 11/19/2009

How come this bill is good enough for us but not for members of congress?

[socalgal38]

05:29 PM on 11/19/2009

All Government employees including Congress and Senate will be on this.

[abby4ever]

08:04 PM on 11/19/2009

'President Obama still holds a healthy positive approval on the issue of healthcare among his base - 74% positive among Liberals and 73% positive among Democrats.' (from your Zogby link)

Weird. The '74% positive among Liberals and 73% positive among Democrats' makes it sound as if Liberals are not Democrats, as if they are two entirely different things.. I've always thought that Liberals were a kind of subset, a particular branch, if you will, of Democrats.

Anyway, thanks for the link. I don't put much stock in polls but, like everyone else, I am strangely drawn to them. They are like car accid.ents, i.e. are what many people say of the latter: you know you shouldn't look and yet you can't make yourself turn away.

[StuManChu]

05:04 PM on 11/19/2009

Section 1303(a)(2)(C) describes the process in which the Health Benefits Commissioner is to assess the monthly premiums that will be used to pay for elective abortions under the government-run health plan and for those who are given an affordability credit to purchase insurance coverage that includes abortion through the Exchange. The Commissioner must charge at a minimum $1 per enrollee per month.

[liberalOrgonian]

04:55 PM on 11/19/2009

To change the subject, I just got off the phone with SAFCO (Auto) Insurance. I have a client who was in a auto accident years ago and was left with chronic pain. Then this year she was involved in a rear end accident. The auto insurance paid some claims BUT did not cover her for the years which is law in this state. I receive a letter yesterday stating her pre existing condition has caused the co to stop paying for her to have services active as of 8/15/09 and the letter arrived yesterday, dated 11 Nov 09.

Why would SAFCO even sell a policy which they will not pay for doctor ordered medical services?

I have worked with clients with MVA for years and I know SAFCO will collect from the co which insured the person who rear ended her. The PIP (personal Injury protection) coverage is specifically designed to cover medical services. This co did not tell her the pre existing condition would work against her if she was in an accident.
I am putting this out there so all are aware of this company and their policy to deny medical services ordered by a DOCTOR.
Just so no one else is denied services, and left with unpaid bills, if they have a pre existing condition prior to an auto accident.
Yet another insurance Co FAILED their policy holder.

[youhavebeenhad]

04:50 PM on 11/19/2009

The Senate should concentrate on unemployment instead of this c rappy bill. The FED predicts that unemployment will average 9.6% in 2010. Will the PROGRESSIVE keep trying to convince folks that unemployment is a lagging indicator?
One thing is for sure, if the FED prediction becomes fact, then Dems will probably lose at least one branch of Congress.

A good thing for America

[youhavebeenhad]

04:34 PM on 11/19/2009

I just wrote both of my Senators and politely asked them tho tell Harry Reid to shove it

[billhodges]

04:39 PM on 11/19/2009

A Zogby Poll this week illustrates the stark choice facing Senate Democrats as they have to decide whether or not to vote for ObamaCare. The poll shows that Arkansas Sen. Blanche Lincoln, high up on the list of vulnerable Senate Democrats seeking reelection in 2010, literally faces a choice between being reelected and voting for the bill.

The Zogby Poll shows Arkansans opposed to the Obama/Reid bill by 28-64, with 50 percent "strongly opposed" to the legislation. To swim in the face of such a current of public opinion is risky business for a U.S. senator.

Lincoln's most likely Republican opponent, state Sen. Gilbert Bennett, is hot on her heels in the poll, trailing by only 41-39. But asked who they would support if Lincoln votes for ObamaCare, Arkansas voters switch to Bennett, giving him a 49-36 victory. That Lincoln goes from two points ahead to 13 points behind over one Senate vote illustrates the potency of the opposition to healthcare changes.

[youhavebeenhad]

04:44 PM on 11/19/2009

I love it when REALITY slaps PROGRESSIVES right in the chops

[escribacat]

04:49 PM on 11/19/2009

Here's a poll that disproves what you are saying.

http://tpmdc.talkingpointsmemo.com/2009/10/poll-arkansas-voters-disagree-with-lincolns-public-option-skepticism.php

[Wisconsin Dave]

04:51 PM on 11/19/2009

Most in Congress paid actors, Republicans the worst of all.

[jack7576]

04:19 PM on 11/19/2009

Speaker Nancy Pelosi says she likes the senate health care bill

[imusintheevening]

04:21 PM on 11/19/2009

the version without the stuupid amendment

[youhavebeenhad]

04:36 PM on 11/19/2009

Sorry, but you will have to pay for your own abortion

[billhodges]

04:42 PM on 11/19/2009

Then that means it is not good for the majority of the people. Why pass a bill most people do not want?

[troutfan]

06:41 PM on 11/19/2009

I've read many, many polls on the subject, and people's responses depend upon how the questions are asked. The consensus seems to be that the majority of people support health care reform (or insurance reform) if it includes a Medicare-like, robust public option.

Unfortunately, polls can be used to prove just about any position on health care. I am a strong supporter of health care reform with a public option. I would rather see a single payer system, and I wish the Democrats had started from that stronger stance as a bargaining tool. That said, the way some of the polls have asked health care reform questions, even I would have a problem replying in the affirmative.

I don't think that some of the polls are in anyway representative of the way most Americans feel about health care reform, and I disagree strongly that this is a bill most Americans do not want.

[higherstrategy]

04:14 PM on 11/19/2009

Page 1432
(A) HEALTH EXTENSIONI AGENT.- The term “HEALTH EXTENSION AGENT” means any local, COMMUNITY-BASED health worker who facilitates and provides assistance to primary care practices by IMPLEMENTING QUALITY IMPROVEMENT or System redesign, incorporating the principles of the PATIENT-CENTERED MEDICAL HOME to provide high-quality, effective, efficient, and safe primary care and to provide GUIDANCE TO PATIENTS in culturally and linguistically appropriate ways, and linking practices to diverse health system resources.
(END)

When you add the above with the fact you will be ‘forced’ to buy insurance, it seems that Insurers are going to FORCE you to be healthy while they MAKE you pay them! Talk about taking ALL FREEDOM AWAY!

[imusintheevening]

04:17 PM on 11/19/2009

reading does not equal comprehension

But thanks for trying!

[higherstrategy]

04:28 PM on 11/19/2009

well it says a 'health extension AGENT' not a primary care provider, which is described in the previous pages, can 'provide assistance' in your 'patient-centered medical home', not a health care facility, which is describe differently, to provide guidance to patients by implementing quality improvement or SYSTEM redesign in a effective and efficient way.

so basically this CAN be interpreted by the Health Insurance as a person, a AGENT, who can come into your home and tell you how to 'be healthy' for the efficient PROFIT of the Insurers.

and i don't have the space to talk about the 'mental and behavioral' Community Based medical centers they mention, and HOW and WHO they determine who goes there.
and with a provision enabling them to take children away from parents who are sick for 4 to 5 years
and the 'nursing homes' with funding for 'CULTURE CHANGE'...