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3 pain points to watch as health reform moves to Senate

Christian Schappel
by Christian Schappel
November 18, 2009
2 minute read
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The latest healthcare reform bill just passed the House. But making it through the Senate will be even harder as a few rough edges still need some smoothing.
Three things both the House and Senate do agree on:

  • Requiring most people to carry health insurance or pay a penalty
  • Providing “affordability credits” to lower-income individuals, and
  • Expanding Medicaid by reducing thresholds for eligibility.

But that’s pretty much where the similarities end. There’s still a lot to be resolved in both bills.
Three must-watch points of contention:
Public option
The House bill includes the creation of a government-run insurance plan, which is meant to spark competition with private insurers.
The Senate is working to combine two different proposals — one from the Senate Finance Committee and one from the Health Education, Labor and Pension Committee — into a single bill.
And while the exact provisions of the merged bill are being kept under wraps, it is also expected to include a public option — but it could allow individual states to opt out.
Cost
$1.1 trillion – that’s what the House version is expected to cost over 10 years. The Senate version is expected to be less expensive.
President Obama has already said he’d like reform to cost no more than $900 billion, which could improve the Senate bill’s chances.
Funding
The House wants to impose a 5.4% income surcharge on individuals with an adjusted gross income of more than $500,000 a year and on couples with more than $1 million.
The Senate Finance Committee has proposed charging an excise tax on high-end health plans – “Cadillac Plans” – and charge new annual fees to various industry sectors.
The fees would look something like this:

  • $6.7 billion from insurance companies
  • $4 billion from manufacturers of medical devices, and
  • $2.3 billion from drug makers.

Info: Click here to view a side-by-side comparison of the House and Senate proposals.

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