If you've been following the health debate, nobody could blame you if you were confused today to hear that there is a new health bill that senators will vote on Monday morning. By our count, today's draft, with the so-called manager's amendment, is the ninth version of health reform to emerge from this process.
Nobody said passing legislation was easy, but we're here to help you make sense of it all. Below is a breakdown of what the big changes are today, what's ahead for health reform in Washington, and what it means for you.
What's New in Today's Announcement:
* The Public Option was officially dropped from the Senate bill and was replaced with a plan to create two national or multi-state health insurance exchanges, which will be run by the Office of Personnel Management. Although senators had talked about replacing the public option with an expansion of Medicare for uninsured Americans over 55, objections from Joe Lieberman, Ben Nelson and other Democrats kept that from happening.
* New abortion funding language now separates federal funding from private funding for abortion services on the exchanges, and lets states choose not to allow insurance companies to cover abortion on their health exchanges. This change left both pro-life and pro-choice groups unhappy, with the National Right to Life Committee and NARAL Pro-Choice America vowing to work to defeat the bill without changes.
* To raise revenue, the Medicare payroll tax increase went up from 0.5 percent, as was proposed, to 0.9 percent for income over $250,000 for a family.
* To save money, senators will cut reimbursement rates for doctors from the federal government by 21 percent, beginning in 2010.
What Stays the Same:
* Insurance reforms stay the same as the first Senate bill. Insurers will be prohibited from denying or stopping coverage based on the cost of care or the health of the customer.
* Children up to 26 years old will be able access coverage through their parents' insurance.
* The mandate that all individuals purchase health insurance by 2014 remains the same, as do penalties for employers who do not offer insurance to their workers. Businesses with fewer than 50 workers are exempt.
* The 40 percent "Cadillac" tax on high-dollar insurance plans does not change and will go into effect in 2013.
* The federal government will subsidize the cost of insurance for families who make between 133 percent and 400 percent of poverty level.
* New federal insurance for Long Term Care will be offered.
* With Sen. Ben Nelson's announcement that he will support the bill, Democrats will have votes from 60 senators and can defeat Republicans' ongoing efforts to filibuster the health reform. That means the Senate will move quickly through a series of procedural votes on the bill, beginning at 1 a.m. Monday morning, and likely finishing at 7 p.m. on Christmas Eve.
* After the Senate passes its bill, Democratic leaders from the House and Senate will negotiate a compromise between their versions of health reform. Major differences remain, with the most significant being the creation of a public option (the House does it, the Senate does not), and who will pay higher taxes to pay for the expanded coverage. The House raises taxes on the wealthy with a five-percent income tax increase on people making more than $500,000. The Senate increase the Medicare payroll tax and creates the "Cadillac tax," which could hit middle-class workers by taxing expensive health plans.
* If the conference committee reaches a compromise, the House and Senate will both vote on the new and final version of the bill. Democrats have said they want President Obama to sign the measure before his State of the Union address at the end of January.
All told, the Congressional Budget Office estimates the bill will cost $871 billion over 10 years, but the CBO also says the bill could actually reduce the deficit by $132 billion in the same time frame because of tax increases and lower payments to doctors, if the Senate sticks to its commitment to enforce those changes.
To read more about health care reform legislation on your own, you can read the full manager's amendment HERE, the underlying Senate bill HERE, the House bill HERE, and the CBO analysis of them all HERE.