Key details of the bill
The plan, according to CBO projections, will cut budget deficits by more than $1 trillion in its second decade.
It will subsidize insurance for a family of four making up to about $88,000 annually, or 400 percent of the federal poverty level.
It also creates a series of health insurance exchanges designed to make it easier for small businesses, the self-employed and the unemployed to pool resources and purchase less expensive coverage.
Medicaid will be significantly expanded, ensuring coverage to those earning up to 133 percent of the poverty level, or just over $29,000 for a family of four.
The bill cuts projected Medicare spending by roughly $500 billion, in part through reductions in the Medicare Advantage program. Democratic leaders have promised the reductions will not affect service to Medicare recipients.
The bill hikes Medicare payroll taxes on families making more than $250,000.
Starting in 2013, it also imposes a 40 percent tax on insurance companies providing "Cadillac" health plans valued at more than $8,500 for individuals and $23,000 for families.
Proponents of the tax on high-end plans say it's one of the most effective ways to curb medical inflation. However, many Democrats oppose taxing such policies because it would hurt union members who traded higher salaries for more generous health benefits.
If the compromise bill becomes law, the threshold for imposing the Cadillac tax will be raised to health plans valued at more than $10,200 for individuals and $27,500 for families.
The tax won't kick in until 2018.
Buy insurance or pay a fine
Under the plan now headed to Obama, individuals are required to purchase health insurance coverage or face a fine of up to $750 or 2 percent of their income -- whichever is greater. It includes a hardship exemption for poorer Americans.
Companies with more than 50 employees that don't provide coverage are required to pay a fee of $750 per worker if any of its employees rely on government subsidies to purchase coverage.
The compromise package would drop the individual fine to $695 or 2.5 percent of income, whichever is greater. The fine on companies failing to provide coverage would jump to $2,000 per employee.
Federally funded abortion coverage for people purchasing insurance through the exchanges will be banned under the bill now passed by Congress. Exceptions will be made in cases of rape, incest, or danger to the life of the woman.
Individuals receiving federal assistance who want abortion coverage will have to purchase the coverage using private funds.
Illegal immigrants will be barred from buying insurance in the health insurance exchanges.
Parents, however, will be entitled to keep their children on their health care plans until age 26.
While passage of the Senate bill is a major win for Democrats on a major party priority, Pelosi had to take a number of steps in recent weeks to assuage House members unhappy with the measure.
A deeply unpopular special exemption for the state of Nebraska from all new Medicaid expenses -- known as the "Cornhusker kickback" -- would be eliminated under the compromise plan. The federal government will instead assist every state by picking up 100 percent of the costs of expanded Medicaid coverage between 2014 and 2016, and 90 percent starting in 2020.
The speaker also tried to sweeten the deal for some progressive members of her caucus partly by adding additional subsidies and a major student loan overhaul measure to the compromise plan.
The measure -- a priority for Obama -- would end the practice of having private banks offer student loans and would expand direct lending from the government.
Last edited: 22-Mar-10 07:23 AM