Health bill would cover 32M, beef up Medicare drug benefit

After a prolonged wait, lawmakers and the public finally got a glimpse at the legislative package that embodies the compromises between the House- and Senate-passed healthcare reform bills and a cost estimate showing Democrats achieved their deficit reduction targets.
 
The budget reconciliation package, which would effectively amend the Senate’s version of the healthcare reform, would extend health insurance coverage to 32 million people by 2019 at a gross cost of $940 billion over the 10-year period, according to a preliminary Congressional Budget Office analysis released Thursday. That would constitute 95 percent of legal U.S. residents covered by the end of the decade.
 

Through a combination of nearly $500 billion in Medicare spending reductions and new tax revenue, the new spending would be more than offset, resulting in $138 billion in deficit reduction over a decade – and potentially more than $1 trillion in deficit reduction from 2019 to 2029.
 
The reconciliation package tracks closely to President Barack Obama’s proposed changes to the Senate bill, a reflection of the negotiations between the White House and House and Senate Democratic leaders. The House is set to vote on the measure Sunday with the Senate to begin shortly thereafter.
 
According to a Democratic summary, the reconciliation bill would beef up the health insurance tax credits for lower-income individuals, reduce the penalties paid by people who fail to obtain health coverage and increases the penalties on employers who either fail to provide health benefits or whose employees receive federal tax credits to purchase insurance on their own.

The summary is dated March 15 so the details could have changed since then.
 
The bill also would phase out the Medicare drug benefit coverage gap known as the “donut hole” and eliminate it by 2020.
 
The reconciliation bill also makes key changes to the proposed excise tax on high-cost health insurance plans. At the urging of House Democrats nervous that the Senate’s version of the tax would hit middle-class households – and labor unions that saw their negotiated benefits threatened -- more people have been exempted from the tax and it has been delayed until 2018. The bill makes up for the lost revenue by hiking the Medicare payroll tax on individuals earning more than $200,000 and families with incomes above $250,000.
 
As expected, the reconciliation bill would not alter the Senate provisions on abortion coverage or immigrants’ access to health insurance plans. In addition, the package leaves intact the Senate language on Food and Drug Administration approval of generic biological drugs and does not include a ban on “pay to delay” deals under which generic drug makers accept money for brand-name companies in exchange for putting off the release of cheaper generic drugs.

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