Pelosi unveils modified House health care reform bill

House Speaker Nancy Pelosi has unveiled the long-awaited House health care reform bill that will go to the floor for debate beginning late this week. The so-called “merged bill” was negotiated by the House Democratic leadership with the leaders of the three House committees that reported different versions of health care legislation this summer: Education & Labor, Energy & Commerce and Ways & Means.

A summary of the new House bill from Speaker Pelosi shows that it would achieve several of the objectives outlined in MCN’s position statement on health care reform by expanding Medicaid coverage to make health care affordable for more low-income Minnesotans, by providing adequate federal funding without increasing the federal budget deficit, and by helping to contain unsustainable cost increases by implementing strategies such as the public option.

According to the Washington Post, the bill would provide health insurance coverage to 36 million Americans who are currently uninsured, either through private insurance, a public option, or Medicaid.

Key features of the bill include:

  • An individual mandate requiring most individuals to purchase coverage.
  • An employer mandate requiring employers to either provide coverage or pay a penalty. Small firms with annual payrolls below $500,000 would be exempt.
  • Medicaid eligibility levels would be simplified and raised to 150% of the federal poverty level (about $16,200 annual income for an individual). (The original House bill proposed raising Medicaid eligibility to 133% of the federal poverty level).
  • A new national health insurance exchange that would offer consumers a choice of private insurance plans and a federal public option.
  • New restrictions on insurance companies, including a ban on denial of coverage for pre-existing conditions and a new review process on premium increases.
  • Establishment of a new voluntary long-term care insurance program to be financed through payroll deductions.

According to Speaker Pelosi, the House bill meets President Obama’s criteria of having a price tag below $900 billion over ten years, fully paid for, and reducing the deficit in the long term. An official price tag or “score” is expected early this week.

The bill also includes improvements to make Medicare and Medicaid more efficient, including closing the gap in Medicare Part D coverage for medicines and a study on geographic disparities in Medicare reimbursements, among others.

In a bow to moderate and conservative Democrats in her caucus, Speaker Pelosi endorsed a modified public option in which reimbursement rates for health care services would be negotiated between the federal government and health care providers, instead of basing reimbursements on Medicare rates. Many representatives representing rural constituencies, including most of Minnesota’s Congressional delegation, have previously expressed strong concerns about regional disparities in Medicare reimbursement rates.

All eyes are on conservative “Blue Dog” Democrats who may hold the fate of the House bill in their hands. Initial reactions to the new House bill from some Blue Dogs seemed to be favorable. Republican House members appear to be solidly opposed to the bill. While Speaker Pelosi concedes that she may not yet have the 218 votes needed in hand, the trend is clearly moving in the direction of gaining support to pass the bill.

Your organization still has time to join our sign-on letter to the Minnesota Congressional delegation in support of comprehensive health care reform.

-Steve Francisco

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About Steve Francisco

Steve Francisco is the former federal policy analyst for the Minnesota Budget Project.
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