Today, Nancy Pelosi unveiled the House’s health care reform bill (you can download the read the whole thing here) The bill will cost $894 billion over the next ten years, but will be fully paid for. It will expand coverage to an additional 36 million Americans and eventually close the Medicare Part D doughnut hole.
Thanks to the successful efforts by the Blue Dog caucus, the bill will not contain the “robust” public option, one that pays Medicare rates plus 5%. The bill will still contain a national public option run by the HHS, but will pay rates negotiated by region instead. This move will increase the cost of the bill by roughly $85 billion.
To make up some of the reduced saving by going with the less robust public option, the bill will expand Medicaid to cover people making below 150% of the federal poverty level (FPL) instead of 133%. It is much cheaper to cover individuals with government insurance programs (Medicare or Medicaid) than through private insurance.
The bill will not contain the excise tax on employer provided health insurance found in the Senate Finance Committee bill. Most of the money to pay for the bill will come from savings from Medicare and Medicaid and a new “millionaire’s tax.” It will be a surtax on individuals making over $500,000 and couples making over a million a year. This should create a real showdown during the conference committee. A large number of House Democrats are strongly against the tax on health insurance benefits while many senators are against the new “millionaire’s tax.”