U.S. House approves national health care bill
The U.S. House of Representatives approved a broad and potentially costly plan to create a national health care plan that would seek to provide health care insurance to an estimated more than 40 million uninsured Americans.
The vote followed often heated debate on the House floor with the final vote on HR 3950 pulling 219 votes for and 210 votes against. The measure needed 216 votes to pass, and all 219 votes were from Democrats. The bill saw 34 Democrats and all 178 Republicans vote against it. There are now four vacancies in the 435-member House.
The bill will now head to the U.S. Senate where Democratic leaders say they have the votes to pass it.
Several news reports suggested President Barack Obama would sign the bill into law in the next few days.
U.S. Sen. Blanche Lincoln, D-Ark., issued this statement after the vote.
“I am pleased that the House approved the Senate Health Insurance reform bill that I helped craft and which I supported last year. Even with its imperfections, this bill represents the most morally and fiscally responsible approach to health reform.
“Now that the Senate bill has passed both houses and the President will be signing it into law, the Senate will consider additional changes this week that were adopted by the House tonight as Budget Reconciliation. The Reconciliation package devised by the House includes matters unrelated to health care and employs a legislative process that wasn’t subject to the same transparency and thorough debate that we used in the Senate. I cannot support this process.
“I have fought for health care reform to reduce costs for small business owners and the self-employed so they can reinvest the savings in their companies and hire more workers. I am pleased that we will now force insurance companies to cover pre-existing conditions, preserve Medicare for future generations and reduce the deficit by more than one trillion dollars over the next 20 years. I now look forward to ensuring that Arkansans benefit the most from health insurance reform.”
U.S. Rep. John Boozman, R-Rogers, voted against HR 3950 and issued this statement after the vote:
“Arkansans and all Americans want health care reform that gives them access to quality and affordable care. Unfortunately, I can’t say this legislation accomplishes those goals. This bill still spends an unimaginable amount of money, raises new taxes and cuts Medicare programs without doing anything to contain costs. No matter how you look at this it’s not a good deal for America.
“It’s unfortunate that President Obama, Speaker Pelosi and Senator Reid ignored the will of the American people. I heard them loud and clear and this government takeover of health care is not the health reform they want, need and deserve. The fight is not over. I have started working to fix the damage this legislation will do to our country and will continue to offer solutions for real health reform through free market principles.”
• A Democratic summary of the bill:
The Patient Protection and Affordable Care Act will ensure that all Americans have access to quality, affordable health care and will create the transformation within the health care system necessary to contain costs. The Congressional Budget Office (CBO) has determined that the Patient Protection and Affordable Care Act, as amended, is fully paid for, provides coverage to more than 94 percent of Americans, bends the health care cost curve, and reduces the deficit by $118 billion over the next ten years, with additional deficit reductions in the following years.
The Patient Protection and Affordable Care Act includes immediate changes to the way
health insurance companies do business to protect consumers from discriminatory practices and provide Americans with better preventive coverage and the information they need to make informed decisions about their health insurance.
Uninsured Americans with a pre-existing condition will have access to an immediate
insurance program to help them avoid medical bankruptcy and retirees will have greater
certainty due to reinsurance provisions to help maintain coverage.
New health insurance Exchanges will make coverage affordable and accessible for
individuals and small businesses. Premium tax credits and cost-sharing assistance will help those who need assistance.
Insurance companies will be barred from discriminating based on pre-existing conditions, health status, and gender.
A substantial investment in Community Health Centers will provide funding to expand
access to health care in communities where it is needed most.
• The Republican summary of the bill:
H.R. 3590 is intended to expand access to health insurance, reform the health insurance market to provide additional consumer protections, and improve the health care delivery system to reduce costs and produce better outcomes.
While the bill would expand insurance coverage to 94 percent of the legal population (24 million Americans would still be without coverage) and could improve the functioning of the individual and small group insurance markets, many experts question whether it will effectively control costs or reform the health-care delivery system.
The Congressional Budget Office (CBO) estimates that the coverage provisions in the bill will cost $848 billion over 10 years (fiscal years 2010-2019). However, the major provisions in the bill would not take effect until January 1, 2014, meaning the bill uses 10 years of revenue to pay for six years of coverage. Republican staff on the Senate Budget Committee estimates that the total spending in the bill over 10 years of full implementation (FYs 2014-2023) would exceed $2.5 trillion.
To pay for the expansion of insurance coverage, the bill increases taxes by $493.6 billion, and reduces Medicare spending by $464.6 billion. Specifically, the bill would cut $134.9 billion from hospitals, $120 billion from Medicare Advantage (MA), $14.6 billion from nursing homes, $42.1 billion from home health agencies, and $7.7 billion from hospices.
Among the more prominent taxes, the bill includes a new 40 percent excise tax on health insurance plans that exceed $8,500 for individuals and $23,000 for families, raising $149.1 billion over 10 years; a new Medicare payroll tax on higher-income individuals that raises $53.8 billion; a $60.4 billion tax on health insurers; a $22.2 billion tax on drug manufacturers; and a $19.3 billion tax on medical device manufacturers.
The bill would create a tax on employers with more than 50 full time workers if their
employees receive a subsidy through the exchange. This so-called “free rider” mandate would increase taxes on employers by $28 billion.