The Details Of The New Merged Senate Bill
The Details Of The New Merged Senate Bill
Moments ago, Senate Majority Leader Harry Reid (D-NV) released the merged Senate health care bill. According to preliminary CBO analysis, the Senate bill costs $849 billion over 10 years and reduces the deficit by $127 billion over 10 years. The legislation could further reduce the deficit by up to $650 billion cut over the following decade, the budget office says.
The bill –which includes a national public health insurance plan with the option for states to pass a law and opt-out — reduces the uninsured by 31 million Americans and covers 98% of Americans by 2019.
The bill increases the threshold for the so-called Cadillac tax, raises the payroll tax by 0.5% on individuals who earn more than $200,000 and families earning more than $250,000 a year, and cuts waste from Medicare. The payroll tax increase would only apply to employees (not employers) and generate $54 billion.
The bill maintains the Senate Finance Committee’s immigration language and preserves much of the more moderate Capps-abortion compromise. Federal dollars can only be used to pay for abortions when the pregnancy threatens the life of the mother or results from rape or incest; private premiums must be used to pay for any other type of abortion, including those for health reasons. Each plan in Exchange will decide whether to cover additional abortion services and at least one plan in each market must offer abortion services and one plan must not. In the public option, the Secretary can cover abortion only if the procedure is financed with private funds.
Since the Exchanges don’t open open until 2014, the bill offers immediate insurance reforms for Americans purchasing coverage in the individual market. Insurers will no longer be allowed to rescind coverage or impose life-time or annual limits and will be required to meet a medical-loss ratio of 85 percent. Americans who are denied coverage because of a pre-existing condition would participate in a national high-risk pool program until the Exchanges are established. Young Americans can stay on their parents’ policies until they turn 26. Small businesses will receive a tax credit.
Below is a comparison of the relevant provisions in the House and Senate legislation:
| Senate Bill ($849 billion/10 years) | House Bill ($894 billion/10 years) | |
| Individual Mandate | Yes, penalty of $750 by 2016 for those don’t purchase coverage. ($95 penalty in first year) | Yes, penalty of 2.5% of income for those who remain uninsured |
| Employer Mandate | Free rider provision. Employers would have to pay whichever is lower: $3,000 per every employee who receives a subsidy in the Exchange, or $750 for every employee (not just the subsidized worker). | Yes, employers who don’t’ offer coverage would pay a fee equal to 8% of their payroll |
| Medicaid Expansion | Up to 133% FPL. 100% federal funding for the first 3 years, then revert to Senate Finance language. | Up to 150% FPL |
| Subsidies | Between 133 – 400% FPL on sliding scale; spend 2%-9.8% of income on premiums | Between 133 – 400% FPL on sliding scale; spend 2%-12% of income on premiums |
| Public Option | National public plan, states can opt-out by 2014. Co-ops are also available. | Yes, HHS secretary negotiates rates |
| Financing | Excise tax on policies above $8,500 (individuals) and $23,000 (families), increases the payroll tax by .5% (increases to 1.95%) on individuals who earn more than $200,000 and families earning more than $250,000 a year, tax on insurers, pharmaceuticals, and medicare devices; Medicare savings | 5.4% surtax on individuals earning > $500,000, couples earning more than $1 million; Medicare savings |
14 Responses to “The Details Of The New Merged Senate Bill”
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Hello,
November 19th, 2009 at 12:08 amI really like your article regarding Senate bill
Great breakdown! Now lets get this thing passed.
November 19th, 2009 at 1:46 amThe individual mandate states a $750 penalty. Is that once a year or monthly? Because my health care premimum is $4400 a year ($1100 every 3 months) so the penalty would be cheaper than insurance.
November 19th, 2009 at 2:39 amI would surmise that any state that opts out will find itself losing citizens and businesses, therefore, while this may seem an option that appeals to conservatives, it will ultimately be a non-issue. (or am I stating the obvious?)
November 19th, 2009 at 4:29 amI notice in both these bills they mandate coverage, I thought this was a public option? I’m all for some kind of single payer system, but not if we’re going to parade it around as an option. If the government wants to force all 300 million of us to get coverage the fine should pay for coverage as it seems in a single payer system that the amount fined for not having coverage should be enough to cover people. If defeats the purpose of calling it a public option, but I guess it’s only mandatory you participate in buying a health care plan, it doesn’t have to be the government but for many people, the government will be the only choice, and if they don’t choose it, the government will fine them. Sure it might help, but it’s defiantly not an option, this is just silly.
November 19th, 2009 at 5:25 amI don’t see what the big hold up is they should have already passed the damn Health Care Bill these people are out of control and need to get a life lesson of how other people are depending on having some type of hope for a better health care system America is so jacked up I swear.
November 19th, 2009 at 12:04 pmChris, an individual mandate is an important part of any kind of reform. Lack of a mandate is what causes insurance companies to deny people based on pre existing conditions.
November 19th, 2009 at 12:12 pmThe Public Option is that, it’s an option in the Exchange, if you don’t have insurance from your employer, you go to the Exchange and you can choose from a number of different plans, one of which is the govt run Public Option. Every plan must take you if you apply and they all have to offer the same basic coverage, so people will never have the Public Option as their only choice.
They that can give up essential liberty to purchase a little temporary safety (government provided healthcare), deserve neither liberty nor safety.
November 19th, 2009 at 3:17 pmColton: what is the hurry since the “benefits” won’t kick in until 2013? Or, weren’t you aware of this? There is much in these bills that you have *no clue* about.
Major Domo: Yes. The fine would be cheaper than your insurance, but won’t provide any *coverage*. Is this making any sense?
Chris: There will be no *option*. Everyone will be forced into the public plan within 5 years (well, except politicians and union members) RTFB!
Mike Bates: You seem like the product of the public school system. That is to say that you have no critical thinking skills, no grammatical skills, and are completely ignorant to the truth about what is *in* these bills. What grade are you in BTW?
November 19th, 2009 at 3:27 pmThere are two issues that are of concern. First, while the bills do extend coverage to many more folks, the delay seems worrisome. Second, I am not sure that relief to the middle/working class is all that quick and beneficial. One of the big hardships is the expense of coverage. I see that some level of subsidy is available up to 400% of FPL, but does this really do it for the middle class? If I am paying $1,000 or $2000 per month, which I consider a major cost, where is the help for the middle class and when? Especially, since with some of the new requirements and no exchange for the near future, it looks like I will be paying even more than I do now, which is going to be very tough.
November 19th, 2009 at 4:13 pmExcellent summary but I would like more details on how the small business tax credit is computed. If someone knows, please answer here.
November 19th, 2009 at 7:23 pmHi Carol85719,
Section 1421 provides a sliding scale tax credit to small employers with fewer than 25 employees and average annual wages of less than $40,000 that purchase health insurance for their employees. The full credit will be available to employers with 10 or fewer employees and average annual wages of less than $20,000. To be eligible for a tax credit, the employer must contribute at least 50 percent of the total premium cost or 50 percent of a benchmark premium. In 2011 through 2013, eligible employers can receive a small business tax credit for up to 35 percent of their contribution toward the employee’s health insurance premium. Tax-exempt small businesses meeting the above requirements are eligible for tax credits of up to 25 percent of their contribution. In 2014 and beyond, eligible employers who purchase coverage through the State Exchange can receive a tax credit for two years of up to 50 percent of their contribution. Tax-exempt small businesses meeting the above requirements are eligible for tax credits of up to 35 percent of their contribution.
November 20th, 2009 at 6:50 amWell, that’s as good or better in most of the provisions! Any chance we could just pass it as is?
Although I am curious how anyone can draw a line between an abortion necessary for health reasons and one to save a life, at least our rights are not totally being trampled…not that having them “just a bit trampled” is really acceptable.
How about we say that Viagra and other similar prescription drugs are NOT covered? Wouldn’t that be a fair quid pro quo? This bill wants to endanger poor women’s health if they can’t find a cheap provider–or if they have to travel to find one. I think the sex that is really responsible for pregnancy should suffer some, too. After all, Viagra is not life-saving or even health benefiting, it’s what should be considered “discretionary” and paid for by the user, like cosmetic surgery.
This is a pretty good bill, but why should it just be women who have to give up something for it? Men should give up something, too. With all its dangerous side effects, I don’t think Viagra is too much to ask.
November 21st, 2009 at 7:07 pmI’ve been involved in taxes for longer then I care to admit, both on the personal side (all my working life!!) and from a legal standpoint since passing the bar and pursuing tax law. I’ve provided a lot of advice and righted a lot of wrongs, and I must say that what you’ve posted makes perfect sense. Please keep up the good work – the more people know the better they’ll be equipped to deal with the tax man, and that’s what it’s all about.
November 22nd, 2009 at 12:26 pm