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Key Differences Between House-Passed and Senate-Passed Health Insurance Reform Bills

Posted on by Karina

Senate passage of health insurance reform legislation last week brings Congress closer to providing quality, affordable health insurance to every American. As we move forward through the legislative process, we will produce a final bill that is founded on the core principles of health insurance reform: affordability for the middle class, security for our seniors, responsibility to our children, and accountability for the insurance industry. House leaders are committed to working with Members of the House, Senate, and Obama Administration to reconcile the House and Senate bills and send the final legislation to the President's desk as soon as possible.

While both the House-passed and Senate-passed bills are a critical step forward, the House bill has quicker reform, is more affordable, and covers more people. Read a side-by-side comparison prepared by Tri-Committee staff on similarities and differences between the House-passed and Senate-passed health reform bills>>

Key Differences Between House-Passed and Senate-Passed Health Insurance Reform Bills

Middle Class Affordability:

The House bill lowers premiums and cost sharing for the middle class through significantly more generous affordability credits for the average person going into the national insurance exchange, compared with the Senate bill.

Coverage:

The House bill covers 36 million currently uninsured Americans.

The Senate bill covers 31 million currently uninsured Americans.

Effective Dates:

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

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

Seniors:

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.

Insurance Exchange:

The House bill creates uniform and strong consumer protections through a national insurance exchange for those without access to affordable employer-sponsored health insurance and for small business employees — increasing the leverage of these millions of Americans by creating a nationwide pool.

The Senate bill creates state-based exchanges for those without access to affordable employer-sponsored health insurance and for small business employees.

Promoting Competition/Public Option:

The House bill offers a public health insurance option nationwide on the exchange in order to promote competition.

The Senate bill does not offer a public health insurance option; instead it calls upon the Office of Personnel Management to contract for two nationwide health insurance plans (one of which would have to be nonprofit) that would be offered on the state exchanges.

To promote competition, the House bill eliminates the health insurance company anti-trust exemption.

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

Paying for Reform:

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.

The Senate bill includes a surtax on so-called Cadillac insurance plans, those costing an individual more than $8,500 a year and any family plan costing more than $23,000 a year. The Senate bill also increases the Medicare payroll tax on individuals with incomes above $200,000 and couples above $250,000.

Employer-sponsored Insurance Coverage:

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

The Senate bill reduces employer-sponsored coverage by 4 million Americans. (These people will go into the exchanges because their employers dropped coverage.)

Deficit Reduction:

According to CBO, the House bill reduces the deficit by $138 billion between 2010 and 2019.

According to CBO, the Senate bill reduces the deficit by $132 billion between 2010 and 2019.

Payment Physician Reform:

The House supports a permanent fix of the sustainable growth rate and increases reimbursements for primary care physicians in both Medicare and Medicaid.

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