03/18/2010 05:12 am ET Updated May 25, 2011

Senate Health Care Bill Offers Less Immediate Help Than House Version

If the Senate has its way with health insurance reform, Sandra Ingram, a 63-year-old cancer patient undergoing intensive chemotherapy treatments in Iowa, would lose her health insurance next July.

That's when the temporary health benefits she gets from her former employer will expire. Ingram, who knows no private insurer will sign up a cancer patient at an affordable rate (if at all), will have to wait half a year before she can apply for a temporary public insurance plan, and it'll be another year after that before she's eligible for Medicare.

"The metastasis has reached the bone, the liver and what they're doing is keeping me alive as long as possible," Ingram told the Huffington Post. She said she'll keep doing one chemo treatment or another until either the cancer is gone or she's tired of fighting it. She doesn't know what to expect in six months -- but for now, she's not giving up.

"I'm fighting this booger," said Ingram, who lost her job in January. "I hate cancer. It's a monster."

Ingram wouldn't lose her benefits under the House plan. While the Senate bill does not extend health benefits for laid-off workers, the House version would keep Ingram covered through next year and until 2013, when the big reforms -- the exchange, through which people can choose from a range of affordable policies, including a public option -- are up and running. The bill allows any laid-off worker who continued his or her employer's health care plan under the government's COBRA law to keep that coverage until the exchange is in place. (The Senate bill pushes the start date of the big reforms back to 2014.)

COBRA gives fired workers 18 months during which they can pay full price for their policy under their former employer's group plan -- not very affordable, but typically less than it would cost to buy insurance on the individual market. The stimulus bill provided for 65 percent reduced COBRA payments, and it's likely that Democratic leaders in Congress will try to renew that benefit for another year before the Christmas break.

Ingram said her reduced COBRA payment is $270 a month. There is a program in Iowa for people who've been denied insurance, but she said she thought it would cost more than $800 a month. Under the House plan, she'd get a much better deal.

"The Senate is selling us out," Ingram said. She's been calling Sen. Chuck Grassley, the Iowa Republican who opposes the bill altogether, and urging him to flip his position.

Both bills create a $5 billion temporary public insurance option for people who have been denied insurance due to a pre-existing condition. The Senate bill gives the Health Secretary 90 days to set up the "high-risk pool," whereas the House bill wants that pool ready for swimming on New Year's Day.

And the Senate bill is stingier about how soon some people can jump in.

Mary Duffy is a 60-year-old three-time cancer survivor in California whose COBRA benefits will expire in December. Under the House version, Duffy will be eligible for the high-risk pool as soon as a private insurer refuses to cover her or offers her a bad deal -- she does not also have to wait six months. Under the Senate version, a person must both wait six months and have a pre-existing condition to qualify.