As the Senate begins what are sure to be fierce negotiations on the compromise health care reform bill coming out of the Finance Committee chaired by Montana Democrat Max Baucus, the general structure of the legislation on the table is coming into focus.
Baucus on Wednesday circulated an 18-page condensed version of a much larger 223-page bill that, according to Baucus, comes with a price tag of $856 billion over 10 years. The Congressional Budget Office, however, put the cost a full 10% lower, at $774 billion (also over 10 years), and estimates that the plan will cover up to 94% of Americans.
The bill was released without any GOP support from the committee, and it's not likely that Democrats will secure support from Republicans off the committee either, at least at this point in time. However, Baucus seems intent on having some semblance of bipartisan support, and has been working hard to earn the backing of one of three Senate Republicans- Olympia Snowe of Maine, Chuck Grassley of Iowa, and Mike Enzi of Idaho- the most likely to cross the aisle being Snowe. If the bill's passage is determined along party lines, Democrats will need at least one Republican Senator to avoid a possible filibuster in the Senate, or will need to wait until Governor Deval Patrick of Massachusetts can appoint a replacement for the recently deceased Senator Ted Kennedy (which may come mid-week).
The proposal includes the "universal mandate" requiring individuals to purchase insurance by 2013 or face a stiff tax penalty. Individuals refusing to obtain coverage can be charged up to US$950 annually with familities fined up to US$3,800 per year. Small businesses will not be mandated to provide healthcare to their employess but those who do will receive tax credits.
Furthermore, the bill leaves out a the "public option," a government-run insurance clause (which is included in the House version of the bill). Rather, the plan would create non-profit healthcare "co-ops" aimed at forcing insurance providers to cut premium costs in order to remain competitive. $6 billion in initial funding would be allocated to the co-ops.
Additionally, insurances companies offering pricey individual "Cadillac health plans" will be taxed at 35% only on the amount of that particular plan that exceeds $8,000 per individual or $21,000 per family . The bill includes clauses for protection against coverage suspensions due to illnesses and protections for individuals with preexisting conditions.
The bill would not pre-empt state laws on abortion, nor would it provide any federal funds to cover the abortion procedures, except in cases of rape, incest, or if the operation is required for the health of the mother. The plan also excludes coverage for illegal aliens by requiring registration with the Social Security Administration.
The program would be funded by more than $850 billion in spending reduction including cuts to Medicare (as some current Medicare recipients would be eligible for coverage under the new plan), and several new taxes and fees- like the one on "Cadillac health plans" outlined above. Because of these funding sources, the plan would comply with President Obama's wish that the program be deficit-neutral, meaning that the plan in this current form will not add to the budget deficit in any way.
The Senate Finance Committee will be the final step prior to full debate on the floor of the Senate.