Key Differences Between House and Senate Health Reform Bills

Posted on by Karina

This week, Senator Reid and other Senate leaders introduced their merged health reform bill, the Patient Protection and Affordable Care Act. Speaker Pelosi said this morning, “I like what I see in their bill. I think we have — as we have suspected, that we would have a great deal in common.” While the Senate bill is another major step toward making affordable, quality health care available to all Americans and the House and Senate will work together to achieve historic reforms, here are some of the key differences between the House and Senate bills:


According to the latest CBO analysis of deficit reduction, the House bill reduces the deficit by $139 billion in the first 10 years, and by as much as $650 billion in the second 10 years.

According to the latest CBO analysis of deficit reduction, the Senate bill reduces the deficit by $130 billion in the first 10 years, and by about $650 billion in the second 10 years.


The House bill covers 36 million currently uninsured Americans.

The Senate bill covers 31 million currently uninsured Americans.


Under the House bill, major coverage provisions go into effect in 2013.

Under the Senate bill, major coverage provisions go into effect in 2014.


The House bill fully closes the prescription drug donut hole for seniors.

The Senate bill does not fully close the prescription drug donut hole for seniors.


The House bill lowers premiums and cost sharing for the middle class through 25 percent more generous affordability credits for the average person going into the Exchange.


The House bill offers a public health insurance option nationwide to promote competition.

The Senate bill also contains a public option but allows states to opt-out.

The House bill eliminates the health insurance company anti-trust exemption.

The Senate bill does not eliminate the health insurance company anti-trust exemption.


The House bill increases enrollment in private employer-provided coverage by 6 million Americans.

The Senate bill reduces employer-sponsored coverage by 5 million Americans. (These individuals will go into the Exchange because their employers dropped coverage.)


The House and Senate bills take different approaches on paying for reform. The House bill includes a surcharge on income above $500,000 for an individual and $1 million for couples. Payfors in the House bill are strongly supported by the American people–a new AP poll found 57 percent support a surcharge on those earning more than $250,000 per year to help pay for health care.

You can learn more about the House health reform bill, the Affordable Health Care for America Act, and its key provisions from what’s in it for you to the top 14 provisions that take effect immediately at or with the following links:

Legislative Text and Summaries

Complete Bill Text (.pdf) »
Complete Bill Text (.html) »
Manager’s Amendment »
Manager’s Amendment Summary »
Top Line Changes »
Top 10 Changes to the Health Insurance Reform Bill »
4 Page Bill Summary »
10 Page Bill Summary »
Side by Side Chart of H.R. 3200 and the Affordable Health Care For America Act »
Section by Section »

What’s In It For You?

What Health Insurance Reform Means for You »(Brochure)
A Guide for Seniors »
Young Americans »
Women Have the Most to Gain »
Meeting Women’s Health Care Needs »
Children »
Small Business Guide »
How Health Insurance Reform Helps Small Businesses »
Rural Communities »
Health Care Disparities »
Indian Health »
Problems That Would Be Solved By Health Insurance Reform »


What You Need to Know About Health Insurance Reform »
Supporters of the Affordable Health Care for America Act »
Top 14 Provisions That Take Effect Immediately »
Top 10 Ways Health Insurance Reform Works for You »
Myths vs. Facts »
The Cost of Inaction »
Health Care by the Numbers »
Impact of Health Insurance Reform in Congressional Districts »
Immediate Investments on the Road to Reform »
Implementation Timeline »
Pocket Card»

Fact Sheets – Health Reform at a Glance

Public Health Insurance Option »
The Health Insurance Marketplace »
Shared Responsibility »
Guaranteed Benefits »
Making Coverage Affordable »
Consumer Protections and Insurance Market Reforms »
Employers and Health Reform »
Strengthening the Nation's Health Workforce »
Lowering Health Care Costs »
Prevention and Wellness »
Delivery System Reforms »
Preventing Waste, Fraud and Abuse »
Strengthening Medicare »
Improving Medicare Part D Drug Program »
Closing the “Donut Hole” »
Maintaining and Improving Medicaid »
Medicare Advantage »
Health Care Surcharge and Households »
Health Care Surcharge and Small Businesses »
Paying for Reform »
Summary of Revenue Provisions »
Joint Committee on Taxation: Estimated Revenue Effects »

Around the Web

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Energy and Commerce Committee »
Ways and Means Committee »
Education and Labor Committee »

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