House Speaker Nancy Pelosi unveiled her long-awaited health-care bill today. There aren't any real surprises. Most of the newsy provisions have been well known for weeks now. The bill will likely extend coverage to 36 million Americans, and it will prevent insurers from dropping or denying coverage. It also won't add to the deficit, thus satisfying one of the president's primary objectives. The CBO estimates the cost at under $900 billion. Here are a few of the key points you need to know about the bill:
- The change that will perhaps have the most impact on Americans is the expansion of Medicaid. Under Pelosi's bill, anyone earning up to 150 percent of the poverty line will be eligible for Medicaid. This is an increase on previous iterations─and the Senate bill─which only covered people up to 133 percent of the poverty line.
- The bill includes a public option but not the so-called robust plan. Hospitals and providers will be able to negotiate their rates with the government insurer.
- A surtax will be leveled on wealthy Americans─those earning over $500,000 for individuals or $1 million for families─to help offset costs. This differs from the Senate bill which relies on a tax on "Cadillac," or expensive, insurance plans. Medical-devices companies will also be subject to a new tax.
- The bill removes the health-insurance industry's exemption from antitrust laws, which will no doubt upset insurers.
- Like her Senate colleagues, Pelosi won't be offering a "doc's fix," that is, she won't offer a long-term solution to a problematic Medicare formula that causes reimbursement rates for physicians treating Medicare patients to decrease.
- Medicare expenditures will be cut by approximately 1.3 percent, with the pharmaceutical industry bearing the brunt.
The bill currently has no Republican support. Abortion remains a sticking point for some Democrats, like Bart Stupak of Michigan, who want to see the language tightened to prohibit any federal funds being used to fund abortions, meaning that government subsidies can't be put toward plans that cover abortion.
Politico reports that Pelosi has reneged on a deal she made with Anthony Weiner of New York to allow a vote on a single-payer system on the floor. The vote would have failed by a large margin, but its symbolism was important to liberals who feel that they've already compromised enormously in backing a public option over single payer.