News

US House, Senate Health Care Bills Contain Similarities, Differences

Multimedia

Audio
David Dyar

When lawmakers in the U.S. Senate and House of Representatives return to work in January, they will face the task of working out differences between major health care reform legislation.  Informal talks were expected to get underway even earlier, and President Barack Obama has pledged to remain fully engaged in the process of achieving his major domestic priority. 

Legislation the Senate passed and the version the House of Representatives approved earlier have both been estimated by the independent Congressional Budget Office to cost in the upper $800 billion range.

Democrats and Republicans continue to argue what the true longer-term costs will be, with 10-year costs of the House measure put at more than $1 trillion.

Lawmakers who will negotiate the differences for the Senate and House will have to ensure that a final bill is below the $900 billion the president set as a maximum figure.

Senate Democrats were forced to make concessions to some of their members and to Independents, the most significant being the elimination of a government-run insurance option to compete with private companies whose practices have been the focus of sharp criticism for decades.

Both bills seek to make health-insurance coverage accessible to between 94 and 96 percent of Americans, compared to the current 83 percent - adding about 30 million people.  Most Americans would be required to obtain some form of insurance or face financial penalties.

Both would also use tax increases on higher-earning Americans, various other taxes, and reductions in payments to medical-care providers under the government Medicare and Medicaid programs to pay the costs of expanded insurance.

While the House bill would immediately bar private insurance companies from denying coverage or raising insurance premiums based on age or gender, the Senate would wait until 2014 for this to take effect, except for children who would be covered immediately.  There would be no lifetime limits on coverage beginning immediately upon President Obama signing legislation.

Under the House bill, the prohibition on denying coverage would begin one year earlier in 2013, with similar prohibitions on higher premiums based on pre-existing conditions or gender.

Of course, the biggest difference between the two bills, and one likely to cause the most friction in House-Senate negotiations, involves the so-called "public option" or competing insurance the government would offer.

Using new public exchanges or marketplaces, a feature found in both bills, House lawmakers included such a government option in their bill, with rates to be negotiated by the government.

In the face of opposition from Independent Senator Joe Lieberman, and to gain his vote, Senate lawmakers first dropped the government insurance option and then an alternative plan to decrease the eligibility age for the existing government Medicare program.

The Senate measure relies on the new exchanges with emphasis on U.S. states retaining flexibility, to expand coverage to self-employed Americans, to small businesses and others currently without insurance.

In the year-long battle over reform, President Obama stressed the importance of billions of dollars in longer-term savings from reducing waste in the current health care system. 

The Congressional Budget Office estimates the Senate and House bills would save $132 billion and $138 billion respectively.

Republicans who opposed both bills assert that President Obama and Democrats manipulated savings projections to conceal the true cost of reforms, while Democrats defended their figures.

"At the same time [the bill] cuts costs, the waste, the fraud, the duplication, endemic to our system and at the same time it covers 31 million people.  Who would have thought we could do both in the same bill?," said New York Democrat Charles Schumer.

"The idea that the bill is going to create a situation to reduce debt is just not true," said Alabama Republican Jeff Sessions.

On new taxes, House lawmakers have proposed a 5.4 percent surtax on individuals earning more than $500,000 per year and families with incomes exceeding $1 million, along with with new fees for insurance companies, drug-makers, medical device manufacturers.

But there is pressure on the House to accept Senate provisions that would increase Medicare payroll taxes for individuals earning more than $200,000 annually, and families earning more than $250,000, with other taxes on so-called high-value insurance plans.

Both measures expand coverage under Medicaid, the existing government program servicing low income Americans, between 133 and 150 percent of the government's official poverty level, for the Senate and House plans respectively.

House-Senate negotiations will also focus on other issues, including provisions regarding abortion services, and those involving participation for illegal immigrants.

In advance of formal talks, Democratic leaders are stressing the need to come up with a consensus that can deliver health care security and quality while controlling short and longer-term costs.

Republicans have made clear they will continue to underscore what they call the long-term deficit and debt risks for the economy of the legislation President Obama hopes to be able to sign not too far into the new year.

This forum has been closed.
Comments
     
There are no comments in this forum. Be first and add one

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Turkey's Main Opposition Party Hopes for Election Breakthroughi
X
May 22, 2015 10:23 AM
Turkey’s main opposition Republican People’s Party has sought an image change ahead of the June 7 general election. The move comes after suffering successive defeats at the hands of the Islamist-rooted AK Party, which has portrayed it as hostile to religion. Dorian Jones reports from the western city of Izmir.
Video

Video Turkey's Main Opposition Party Hopes for Election Breakthrough

Turkey’s main opposition Republican People’s Party has sought an image change ahead of the June 7 general election. The move comes after suffering successive defeats at the hands of the Islamist-rooted AK Party, which has portrayed it as hostile to religion. Dorian Jones reports from the western city of Izmir.
Video

Video Europe Follows US Lead in Tackling ‘Conflict Minerals’

Metals mined from conflict zones in places like the Democratic Republic of Congo are often sold by warlords to buy weapons. This week European lawmakers voted to force manufacturers to prove that their supply chains are not inadvertently fueling conflicts and human rights abuses. Henry Ridgwell reports from London.
Video

Video Class Tackles Questions of Race, Discrimination

Unrest in some U.S. cities is more than just a trending news item at Ladue Middle School in St. Louis, Missouri. As VOA’s Kane Farabaugh reports, it’s a focus of a multicultural studies class engaging students in wide-ranging discussions about racial tensions and police aggression.
Video

Video Mind-Controlled Prosthetics Are Getting Closer

Scientists and engineers are making substantial advances towards the ultimate goal in prosthetics – creation of limbs that can be controlled by the wearer’s mind. Thanks to sophisticated sensors capable of picking up the brain’s signals, an amputee in Iceland is literally bringing us one step closer to that goal. VOA’s George Putic reports.
Video

Video Afghan Economy Sinks As Foreign Troops Depart

As international troops prepare to leave Afghanistan, and many foreign aid groups follow, Afghans are grappling with how the exodus will affect the country's fragile economy. Ayesha Tanzeem reports from the Afghan capital, Kabul.
Video

Video Poverty, Ignorance Force Underage Girls Into Marriage

The recent marriage of a 17-year old Chechen girl to a local police chief who was 30 years older and already had a wife caused an outcry in Russia and beyond. The bride was reportedly forced to marry and her parents were intimidated into giving their consent. The union spotlighted yet again the plight of many underage girls in developing countries. Zlatica Hoke reports poverty, ignorance and fear are behind the practice, especially in Asia and Africa.
Video

Video South Korea Marks Gwangju Uprising Anniversary

South Korea this week marked the 35th anniversary of a protest that turned deadly. The Gwangju Uprising is credited with starting the country’s democratic revolution after it was violently quelled by South Korea’s former military rulers. But as Jason Strother reports, some observers worry that democracy has recently been eroded.
Video

Video California’s Water System Not Created To Handle Current Drought

The drought in California is moving into its fourth year. While the state's governor is mandating a reduction in urban water use, most of the water used in California is for agriculture. But both city dwellers and farmers are feeling the impact of the drought. Some experts say the state’s water system was not created to handle long periods of drought. Elizabeth Lee reports from Ventura County, an agricultural region just northwest of Los Angeles.
Video

Video How to Clone a Mammoth: The Science of De-Extinction

An international team of scientists has sequenced the complete genome of the woolly mammoth. Led by the Swedish Museum of Natural History in Stockholm, the work opens the door to recreate the huge herbivore, which last roamed the Earth 4,000 years ago. VOA’s Rosanne Skirble considers the science of de-extinction and its place on the planet
Video

Video Blind Boy Defines His Life with Music

Cole Moran was born blind. He also has cognitive delays and other birth defects. He has to learn everything by ear. Nevertheless, the 12-year-old has had an insatiable love for music since he was born. VOA’s June Soh introduces us to the young phenomenal harmonica player.

VOA Blogs