The Senate Health Care Bill Is Out-How Does It Stack Up?

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Upon hearing the news Senate Majority leader Harry Reid released the Senate version of a health care reform bill last night, I quickly brewed some tea, snuggled into bed, and settled myself in for a long read. I've made it about 400 pages in and I can tell you already, there are some notable differences between the Patient Protection and Affordable Care Act and the House bill. The New York Times reports,

Though broadly similar to the House bill, Mr. Reid’s proposal differs in important ways. It would, for example, increase the Medicare payroll tax on high-income people and impose a new excise tax on high-cost “Cadillac health plans” offered by employers to their employees. Mr. Reid’s bill would not go as far as the House bill in limiting access to abortion. And while he would require most Americans to obtain health insurance, he would impose less stringent penalties on people who did not comply. Many provisions of Mr. Reid’s bill, including the creation of insurance markets, or exchanges, would take effect in 2014, a year later than similar provisions of the House bill.

Of course, despite the bill's many nuances...it all comes down to money. Think Progress has a handy-dandy chart to show the budget differences between the House and Senate bills. The bottom line? The Congressional Budget Office report says the Senate bill would extend coverage to 31 million uninsured people while reducing the federal deficit by nearly $130 billion over 10 years. The Washington Post's Ezra Klein says there's more to it than that though,

If this piece of the bill was passed on its own, it would be the most important cost control bill ever considered by the United States Congress. But you could never have passed it on its own. You needed the coverage to make the grand bargain work. Republicans like to call this bill a trillion-dollar experiment to expand the health-care system, and in some ways, it is. But it's also a multitrillion-dollar experiment to cut costs in the health-care system, and it deserves credit for that, and support from fiscal conservatives. It's easy to talk about cutting costs, but this is the chance for people to actually do it.

But it's not only about money. Carrie Budoff Brown at Politico reports one of the significant differences in this bill is the delay of reform until 2014.

This is bad news for lawmakers who will need to explain to constituents why the elements that have attracted the most attention -- the public plan, the Medicaid expansion and the insurance exchanges -- won't be available for four years. Some reforms would kick in earlier, Senate aides explained, but the big pieces would still be a ways off.

And then there is, of course, the abortion question. With both sides still debating the ramifications of the Stupak amendment, the Senate bill seems to incorporate a variety of ideas. While TalkingPointsMemo reports key Democrats are onboard with the abortion language in the Senate bill, others aren't so happy. Shakesville writes,

Of course, Azzy's earlier post outlines why "allowing a woman to use her own private funds" for an abortion is a pretty pathetic solution in a healthcare bill ostensibly designed to serve people who don't have the funds to pay for their healthcare out of pocket. Again I will note that this fuckery only flies in a culture that treats women's healthcare and abortion as mutually exclusive concepts.

So now the real work begins. Debate over the bill is expected to last through December with every nook and cranny of these over 2-thousand pages discussed. OpenCongress has the bill for your tea-drinking, snuggle in bed, reading needs. Join me, won't you? Contributing Editor Erin Kotecki Vest also blogs at Queen of Spain Blog.

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