(AP Photo/Susan Walsh)
The Senate Finance Committee, chaired by Democratic Senator Max Baucus, just released its $856 billion, 10-year healthcare reform bill. The plan will help reform efforts gain steam in the House.
The sweeping measure is designed to steer a more moderate course on health policy than other major bills moving through Capitol Hill, and it doesn’t propose to create a new government insurance plan to compete with private insurers, as proposed in rival House legislation and favored by many liberal lawmakers. Instead, the Montana Democrat is proposing to expand coverage by creating a network of nonprofit health-insurance cooperatives. The cooperatives would be seeded with $6 billion in federal money, enough to cover start-up costs and meet insurance solvency requirements.
The bill wouldn’t require employers to provide insurance, a break with the more aggressive House bill. But it would require businesses that have more than 50 workers and don’t offer insurance to reimburse the government for part of the cost of any taxpayer-backed insurance subsidies the workers receive.
Among other things, the bill would levy a new 35% excise tax on high-dollar insurance plans. The tax would fall on insurers offering plans with values above $8,000 for individuals and $21,000 for families. The premium tax would take effect in 2013 and raise $215 billion over 10 years, according to a preliminary estimate from the Joint Committee on Taxation.
The bill would also levy a total of $93 billion in fees on health-care-related industries over 10 years, to help offset the bill’s price tag. Pharmaceutical companies would face an annual assessment of $2.3 billion, medical-device manufacturers $4 billion and health insurers $6 billion, all apportioned according to a firm’s market share.
Some small businesses will be exempt from these taxes.
In addition, the bill would make more people eligible for Medicaid. It would create an exchange where people can buy insurance. Health insurance would be legally required. Starting in 2013, not carrying it would accrue fines ranging from $750 to $3,800.
Once again, Medicare is a contentious issue. The New York Times reports:
The Baucus plan envisions major reductions in the rate of growth of Medicare spending, by trimming payments to hospitals, nursing homes, managed-care plans and almost every other type of provider. But Democrats say those reductions will be accomplished mainly through greater efficiencies, not a reduction in benefits.
If Republican opposition continues…
…the Democrats say they have little choice but to push forward, perhaps using a hardball parliamentary tactic known as budget reconciliation, which would allow them to approve much of what is in the Baucus bill with just 50 votes in the Senate rather than the 60-vote super majority normally required to overcome filibusters.