First, there's an article on the countdown to the big vote itself. Here are some excerpts (emphasis added):
WASHINGTON -- After months of maneuvering, the Senate stands at the brink of a historic battle over health care with President Barack Obama and his allies on one side and Republicans, outnumbered but unflinching, on the other.
"Now it's America's turn, and this will not be a short debate," Sen. Mitch McConnell of Kentucky, the Republican leader, warned after Majority Leader Harry Reid unveiled long-awaited legislation Wednesday night to extend coverage to 30 million more Americans and force insurance companies to take all comers.
"Higher premiums, tax increases and Medicare cuts to pay for more government. The American people know that is not reform," McConnell said.
The Congressional Budget Office targets the 10-year cost of the health care bill at $848 billion, funded with new and higher taxes and Medicare cuts -- CBO says the measures ultimately reduce the deficit by $130 billion in that window.
Reid, D-Nev., wrote the legislation with White House aides during weeks of secretive negotiations, selecting elements from two committee-passed bills with the aim of securing the necessary 60 votes in a Senate debate that will be decisive for Obama's health care agenda.
"From Day One, our goal has been to enact legislation that offers stability and security to those who have insurance and affordable coverage to those who don't, and that lowers costs for families, businesses and governments across the country," Obama said. Reid's bill "meets those principles," the president said.
Aides said the mammoth, 2,074-page bill would reduce deficits by $130 billion over a decade, citing estimates by the Congressional Budget Office. For the first time most Americans would be required to carry health insurance, and the bill would provide hundreds of billions of dollars in subsidies to help those with lower incomes afford coverage.
Employers would not be required to offer coverage, but medium and large companies would pay a fee if the government ends up subsidizing employees' insurance.
Reid released his legislation more than a week after the House approved its more expensive version of the health care bill on a near party-line vote of 220-215.
Reid pointedly declined to claim the 60 votes needed to clear a must-pass procedural hurdle before debate can begin. That vote could take place Saturday.
Democrats hold 58 seats in the Senate and two independents generally vote with them, but several moderate Democrats -- Mary Landrieu of Louisiana, Ben Nelson of Nebraska and Blanche Lincoln of Arkansas -- have yet to commit to allowing debate to begin. Reid met privately with the three before releasing his bill Wednesday, and Nelson later issued a statement strongly suggesting he would support fellow Democrats on the procedural vote.
Landrieu said she wanted more information about the bill before making a final decision, while Lincoln, the only one of the three who faces re-election next year, told reporters, "We'll wait and see."
If this weekend's vote succeeds, it would be followed by weeks -- if not more -- of unpredictable maneuvering on the Senate floor, where Reid and his allies will seek to incorporate changes sought by Democrats and repel attempts by Republicans to defeat the legislation and inflict a significant political defeat on the president.The AP via FoxNews also provide a nice run-down comparing the two bills proposed by the House and the Senate:
The Senate Democratic bill (Patient Protection and Affordable Care Act):
WHO'S COVERED: About 94 percent of legal residents under age 65 -- compared with 83 percent now. Government subsidies to help buy coverage start in 2014. Illegal immigrants would not receive assistance.
COST: Coverage provisions cost $849 billion over 10 years.
HOW IT'S PAID FOR: Fees on insurance companies, drugmakers, medical device manufacturers. Medicare payroll tax increased to 1.95 percent on income over $200,000 a year for individuals; $250,000 for couples. New 5 percent tax on elective cosmetic surgery. Cuts to Medicare and Medicaid. Excise tax on insurance companies, keyed to premiums paid on health care plans costing more than $8,500 annually for individuals and $23,000 for families. Fees on employers whose workers receive government subsidies to help them pay premiums. Fines on people who fail to purchase coverage.
REQUIREMENTS FOR INDIVIDUALS: Almost everyone must get coverage through an employer, on their own or through a government plan. Exemptions for economic hardship. Those who are obligated to buy coverage and refuse to do so would pay a fine starting at $95 in 2014 and rising to $750
REQUIREMENTS FOR EMPLOYERS: Not required to offer coverage, but medium and large companies would pay a fee if the government ends up subsidizing employees' coverage.
SUBSIDIES: Tax credits for individuals and families likely making up to 400 percent of the federal poverty level, which computes to $88,200 for a family of four. Tax credits for small employers.
GOVERNMENT-RUN PLAN: A new federal insurance plan would be offered to compete against private carriers. The government would negotiate -- not dictate -- payment rates for medical providers. Unlike the House bill, states could opt out of the plan. It's not clear the proposal commands enough votes to survive, and it could be replaced by a standby system pushed by moderates that would not go into effect until it was clear individual states were experiencing a lack of competition among private companies.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Self-employed people, uninsured individuals and small businesses could pick a plan offered through new state-based purchasing pools. Employees would be generally encouraged to keep their work-provided coverage.
CHANGES TO MEDICAID: Income eligibility levels likely to be standardized to 133 percent of poverty, which is $29,327 a year for a family of four, for all parents, children and pregnant women. Federal government would pick up the full cost of the expansion during the first three years. States could negotiate with insurers to arrange coverage for people with incomes slightly higher than the cutoff for Medicaid.
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The House bill (Affordable Health Care for America Act):
WHO'S COVERED: About 96 percent of legal residents under age 65 -- compared with 83 percent now. Government subsidies to help buy coverage start in 2013. About one-third of the remaining 18 million people under age 65 left uninsured would be illegal immigrants.
COST: The Congressional Budget Office says the bill's cost of expanding insurance coverage over 10 years is $1.055 trillion. The net cost is $894 billion, factoring in penalties on individuals and employers who don't comply with new requirements. That's under President Barack Obama's $900 billion goal. However, those figures leave out a variety of new costs in the bill, including increased prescription drug coverage for seniors under Medicare, so the measure may be around $1.2 trillion.
HOW IT'S PAID FOR: $460 billion over the next decade from new income taxes on single people making more than $500,000 a year and couples making more than $1 million. The original House bill taxed individuals making $280,000 a year and couples making more than $350,000, but the threshold was increased in response to lawmakers' concerns that the taxes would hit too many people and small businesses. There are also more than $400 billion in cuts to Medicare and Medicaid; a new $20 billion fee on medical device makers; $13 billion from limiting contributions to flexible spending accounts; sizable penalties paid by individuals and employers who don't obtain coverage; and a mix of other corporate taxes and fees.
REQUIREMENTS FOR INDIVIDUALS: Individuals must have insurance, enforced through a tax penalty of 2.5 percent of income. People can apply for hardship waivers if coverage is unaffordable.
REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payrolls under $500,000 annually are exempt -- a change from the original $250,000 level to accommodate concerns of moderate Democrats -- and the penalty is phased in for companies with payrolls between $500,000 and $750,000. Small businesses -- those with 10 or fewer workers -- get tax credits to help them provide coverage.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Beginning in 2013 through a new Health Insurance Exchange open to individuals and, initially, small employers. It could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.
GOVERNMENT-RUN PLAN: A new public plan available through the insurance exchanges would be set up and run by the secretary of Health and Human Services. Democrats originally designed the plan to pay Medicare rates plus 5 percent to doctors. But the final version -- preferred by moderate lawmakers -- would let the HHS secretary negotiate rates with providers.
CHANGES TO MEDICAID: The federal-state insurance program for the poor would be expanded to cover all individuals under age 65 with incomes up to 150 percent of the federal poverty level, which is $33,075 per year for a family of four. The federal government would pick up the full cost of the expansion in 2013 and 2014; thereafter the federal government would pay 91 percent and states would pay 9 percent.
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