CQ TODAY PRINT EDITION
July 14, 2009 – 9:57 p.m.
House Health Care Plan Released
By Drew Armstrong and Alex Wayne, CQ Staff
House Democrats plan to push ahead with their health care overhaul after unveiling a bill Tuesday, with promises to pass it before the August recess.
Democrats still lack an official cost estimate for their bill (
According to senior House Democratic aides who briefed reporters on the 1,018-page bill, the coverage expansion represented the bulk of the bill’s costs, along with some additional spending on Medicare and Medicaid programs. “We’ll try to get it under a trillion,” said a senior House Democratic aide.
The Medicare and Medicaid sections will also include cuts to those programs that will help pay for the bill, along with a surtax on the wealthy that would raise $544 billion over a decade, according to the Joint Committee on Taxation. Other tax provisions raise the revenue total to $581 billion.
“What we expect to see when we get the Medicare and Medicaid tables this week is that we’ll have a gross of more than $500 billion in savings from those programs,” said the House aide.
House Ways and Means Committee Chairman Charles B. Rangel , R-N.Y., noted that CBO scores will not reflect “the actual savings that people would feel in their pocketbooks, in their bank accounts.”
House Speaker Nancy Pelosi , D-Calif., said Democrats were on track with their timeline for the bill. “We are still on schedule to do what we had planned and vote for this legislation before we leave for the August recess,” Pelosi said.
The House bill was released as the Senate Health, Education, Labor and Pensions (HELP) Committee neared completion of its markup of a health bill. The Senate Finance Committee has yet to produce a bill.
Concessions Made on Rural Hospitals
Pelosi and other Democrats have been working hard to keep their caucus together on the House bill, especially fiscally conservative “Blue Dog” Democrats who demanded changes to the legislation and succeeded in delaying its release.
One concession to the Blue Dogs was the inclusion of $8 billion to help make sure rural hospitals and doctors are paid adequately by Medicare. The Blue Dogs had threatened not to support any bill that they thought would treat unfairly health care providers in their mostly rural districts.
The three committees with jurisdiction over the bill will mark it up this week. The Education and Labor Committee will begin Wednesday. The Ways and Means and Energy and Commerce committees will start their markups Thursday.
“Quite frankly, we can’t go home for recess unless the House and Senate both pass bills to reform and restructure our health system,” said Energy and Commerce Chairman Henry A. Waxman , D-Calif.
Democrats said their legislation would cover 97 percent of Americans, by expanding private insurance coverage through employers and through a new government-organized marketplace.
It also features new regulations for the existing insurance market to prevent insurers from dropping sick patients from coverage, and it moves to standardize and streamline administrative processes.
According to a summary of the bill, most of the proposed coverage expansions would not begin until 2013. By that year, a government-run “public option” for insurance would be available for people to buy through a health insurance “exchange,” essentially a government-organized marketplace where private plans would compete with the public option.
Most people in the exchange are expected to purchase private plans, said senior House Democratic aides. They said that by 2019, CBO estimates that about 9 million people would be in the public plan, while 21 million who bought coverage through the exchange would choose private plans.
Republicans have slammed the Democratic bill as a “government takeover” of health care that would result in most people ending up in the government-run plan. The CBO estimate appears to contradict those claims; the number of people covered through their employers would increase over the implementation of the bill, according to the estimate.
By 2013, there would be a mandate for individuals to buy coverage or pay a fine of 2.5 percent of their income — but the fine would be capped at the cost of the average plan in their area. Businesses would face a similar mandate, with a requirement to offer insurance coverage to employees or pay a fine equal to 8 percent of their payroll costs.
With the opening of the exchange, the government would provide subsidies to help buy coverage. People with incomes below 400 percent of the federal poverty level and down to the eligibility level for Medicaid would get the credits, on a sliding scale.
According to a CBO analysis, there would be five “tiers” of subsidies to help people buy at least a “basic” insurance plan on the exchange. People in the poorest tier, with incomes between 133 percent and 150 percent of the federal poverty level, would have to spend no more than 3 percent of their income on insurance premiums. At the highest level, 400 percent of federal poverty, spending on insurance premiums would be limited to 11 percent of income.
According to the CBO estimate, the government would contribute, on average, $4,600 for each person getting a subsidy in 2014, rising to $6,000 by 2019.
Baucus Meets with GOP’s Snowe
In the Senate, meanwhile, Finance Chairman Max Baucus , D-Mont., spent nearly two hours Tuesday talking about his health overhaul proposal with a moderate Republican on his committee, Olympia J. Snowe of Maine.
Snowe, seen as the most likely Republican supporter of Democrats’ health plans in the Senate, spoke to reporters jointly with Baucus after the meeting. They said they had come to agreement on “about half” of a 10-point list of policy items related to the bill. They offered no specifics, but said the items were a mix of proposals to raise revenue to pay for an overhaul and to expand coverage.
Baucus said that he hopes to have his committee begin formal debate on the bill next week, but would not commit to a schedule. He did say that he still plans to advance a bill from his committee and through the Senate by August, in part so that opponents of the measure don’t have an opportunity to “work their mischief over the August recess and later” and potentially dampen Senate support for the bill.
“I think we have to move expeditiously,” he said.
Richard Rubin, John Reichard and Jane Norman contributed to this story.
Comments
The runway premiums might explain why the middle class and housing market collapsed. Today the costs running out of control have led the people worrying about losing their job, coverage, and denial of care to save the stimulus money increasing the unemployment index.
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