Pelosi Unveils Massive Health Care Bill With Public Option, Puts It Online

House Speaker Nancy Pelosi Thursday unveiled the House Democrats' version of health care reform, complete with a public option designed to provide coverage for up to 36 million uninsured Americans.

The bill is a combination of three separate measures passed by House committees this summer and is estimated by the Congressional Budget Office to cost $1.055 trillion over 10 years and to reduce the deficit by a net of $104 billion over the same period.

Here are some facts about the bill:

-- It is 1,990 pages. That's twice as long as the Bible, and longer than "War and Peace" or "Gone with the Wind."

-- It is now available online. In addition, Majority Leader Steny Hoyer committed that the "managers' amendment" -- the package of sweeteners often tacked onto a bill at the last minute to win support -- will also be available online for 72 hours before a vote.

In terms of substance, here are the most important details, although more are sure to emerge.

-- The "public option" is included, meaning there would be a government-run insurance provider for people who cannot get employer-based insurance. The rates for doctors who take public option payments would be negotiated by the Department of Health and Human Services, and would not be related to Medicare rates. (That detail appeases some moderate Democrats.)

-- Everyone would be required to buy insurance, but people who cannot afford insurance would receive subsidies from the government.

-- The bill calls for the expanded coverage to be partially paid for with a 5.4 percent tax increases on Americans making more than $500,000 (and couples making more than $1 million), but does not tax insurance plans like the Senate's proposal.

-- Expanded coverage also would be financed by sizable fees on health care companies such as drug makers and medical device manufacturers.

-- The so-called "doc fix" to fully reimburse doctors with Medicare patients has been stripped from the House bill to bring the cost down by more than $200 billion. The reimbursement issue will be voted on separately.

-- Several Democratic sources tell Politics Daily that Pelosi does not yet have firm commitments for the 218 votes that she needs to pass the bill. Language dealing with controversial matters like federal funding for abortion or access to insurance for illegal immigrants could be added to the managers' amendment to win the support of conservative, Blue Dog Democrats.

-- And finally, none of this is the final word on health care reform. Once the bill passes, it must be combined with the Senate's version, where everything from the public option to income taxes and taxing insurance benefits will be back on the table for negotiation.

Moments after Pelosi's Capitol event Thursday, Republican leaders warned that the Democrats' bill is too big, too costly and will increase the deficit, no matter what the CBO says. "Do the American people really think the deficit will not go up under this bill?" asked Rep. Eric Cantor (R-Va.). "I don't think so."

Although Republicans would not commit to putting their own health care reform bill online for 72 hours before a vote, Rep. Roy Blunt (R-Mo.) said that 72 hours with the nearly 2,000-page behemoth will not get anyone closer to understanding the bureaucracy that he says the bill creates. "It is possible this bill will collapse under its own weight," he said.

Look for a House vote on the bill next week.