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$940 Billion Democratic Healthcare Bill In Final Lap Ahead Of House Vote

Fri, 19 Mar 2010 18:11:1

Kris Alingod - AHN News Contributor

Washington, D.C., United States (AHN) - The public has until the end of the week to review the healthcare bill House Democrats plan to pass using a procedure critics warn is unconstitutional, but that Republicans used when they held the majority in Congress. Democrats are still gathering the required votes for the measure, which also needs a Senate vote before it is sent to the White House.

Democrats need the support of 216 lawmakers in the House for the crucial vote on Sunday. President Barack Obama has moved his trip to Asia to June to help rally support for the top legislative priority of his administration.

Reps. Dale Kildee (D-MI) and Dennis Kucinich (D-OH) said this week they would vote for the legislation. But a number of other Democrats have dropped their support, including Floor Whip Stephen Lynch (D-MA), who is against new taxes and the "disingenuous" approach in passing the bill.

House leaders unveiled the final healthcare bill late Thursday after receiving a preliminary score from the Congressional Budget Office. The measure costs $940 billion over 10 years. It provides coverage to 95 percent of Americans by extendng coverage to 32 million uninsured.

The CBO said the net cost of the measure would be $794 billion, after offsets from provisions that tax high-end insurance plans, dubbed "Cadillac" plans, and fines from employers and individuals who do not purchase coverage.

The legislation calls for "individual responsibility," and all Americans will be required to have coverage or pay an annual fine, except for the very poor. The penalties begin in 2014 and are phased, with fines at $495 in 2015 and at $695 the following year.

Government subsidies to ease the cost of premiums are provided for families of four with incomes of as much as 400 percent of federal poverty level, or $88,200 annually.

Employers are not required to provide coverage to workers, but businesses with more than 50 employees and that do not offer coverage will be charged with a $2,000 fine per worker.

Provisions in the Senate bill exempting Nebraska from sharing costs of an expansion of Medicaid have been removed in the reconciliation proposal. The provisions were believed to have been added to gain the support of Sen. Ben Nelson (D-NE), a pro-life lawmaker who sought stronger language ensuring abortions are not publicly funded by the bill.

The reconciliation bill keeps the Senate measure's 40 percent excise tax on high-premium plans. But the cap has been raised from 8,500 for individuals and $23,000 for families, to $10,200 and $27,500. Retirees and those employed in high-risk jobs have higher thresholds, at $11,850 and $30,950 respectively.

The implementation of the tax on what has been dubbed as "Cadillac plans" has been moved to 2018. The delay reduces revenues by 80 percent.

Unions and a number of Democrats had expressed concerns about the tax, saying cost would be passed on to consumers. But the AFL-CIO President Richard Trumka on Thursday said, "After 60 years of fighting for health care reform, we are convinced that now is the time to say 'Yes'... It is not a perfect bill. But we are realistic enough to know it's time for the deliberations to stop and for progress to begin."

The Cadillac tax is one of many provisions Republicans say would raise healthcare costs and hurt families and businesses trying to recover from the recession.

"Congress' Joint Committee on Taxation, on February 24, said that a 40 percent excise tax will raise $7 billion, almost all of which will be passed along to consumers in the form of higher insurance premiums," Senate Republican Conference Chairman Lamar Alexander (R-TN) wrote in an op-ed column on FOX's website on Thursday.

Republicans have also focused their attacks on the process Democrats plan to pass the measure.

The House and Senate have been working to reconcile differences between legislation each chamber passed last year. Under normal circumstances, each chamber must approve the reconciled bill separately a final time before it is sent to the White House.

To ensure passage of the final health bill, House Democrats plan to use a process called the self executing rule to vote for revisions in the Senate measure, called the reconciliation proposal. The Senate bill has no public option and is considered less liberal than the one passed by the House, and therefore more likely to pass. The procedure in the House would let Democrats pass healthcare reform without directly voting on the underlying bill.

The Senate is expected to use an equally controversial process called reconciliation that would let them pass the reconciled bill with a simple majority or 51 votes, instead of the usual two-thirds majority or 60 votes used for major legislation.

"If Democrats are giddy about this CBO score, then they must get a kick out of higher taxes and Medicare cuts - because that's what this bill will mean: even higher taxes and deeper Medicare cuts than the Senate bill," Senate Minority Leader Mitch McConnell (R-KY) said in a floor speech.

"The President shouldn't scrap his trip to Indonesia," McConnell added. "He should scrap this bill and start over on a bill that Americans can embrace and that lawmakers from both parties will actually be proud to vote for."

Pundits have also warned about the legal implications the approach Democrats are taking.

Former U.S. Attorneys General Ed Meese and Bill Barr have raised concerns about the constitutionality of the process, which they say would at best result in protracted litigation.

"Many individuals will have standing to challenge any health reform legislation," they warned in a statement, "that restructures one-sixth of the American economy, and the contemplated use of the 'deem and pass' maneuver in this instance may be combined with questionable procedural steps in the Senate that render it much more subject to challenge."

American Medical Association president James Rohack, however, argued that while the legislation is "imperfect," it contains provisions "desperately needed by millions of Americans who are struggling to get or keep health insurance coverage."

"By extending health coverage to the vast majority of the uninsured," Rohack added, "improving competition and choice in the insurance marketplace, promoting prevention and wellness, reducing administrative burdens, and promoting clinical comparative effectiveness research, this bill will help patients and their physicians."

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