Health-care reform: Senate passes health-care overhaul
Dec 24, 2009 10:11 AM
In a historic vote of 60 yeas to 39 nays the Senate passed a far-reaching health-care reform bill that would extend health insurance to more than 30 million Americans. The vote came shortly after 7 a.m. on Christmas Eve. The House passed its bill in early November.
After the Senate vote, President Obama said health-care reform would be the most important social reform since Social Security in the 1930s, and the most important medical reform since the creation of Medicare in the 1960s.
In a moment of levity, and perhaps exhaustion, Senate Majority Leader, Harry Reid (D-Nev) accidentally voted against the bill that has been his top priority for months. The Senator brought his hands to his head and then quickly changed his vote to yes.
Senators could be seen sharing congratulatory hugs in the aftermath of the vote. But the work in Congress is not done yet. The two bills will now go to a conference committee, where negotiators from each house of Congress will merge them into a single bill. Then they’ll have to vote again.
“The bill lays the groundwork for an enormous number of ways to save money and save lives in the future. It extends the life of Medicare and helps protect every insured American family from catastrophic, out-of-pocket costs. We look forward to working with policymakers as the final proposal takes shape,” said DeAnn Friedholm, director of Consumer Union’s health reform campaign.
Lawmakers are already talking tough on some of the differences between the bills. Senators Joe Lieberman (I-Conn) and Ben Nelson (D-Neb) have signaled they won’t vote for a bill that changes significantly from the one they helped shape in the Senate. They were among the final holdouts, pushing for the public option to be dropped and the inclusion of abortion restrictions, respectively. But many House members also believe that the provisions in their bill should prevail. Representatives Barbara Lee and Lynn Woolsey from California said in a joint statement that a final bill must have a public option.
The public option is just one of many sticking points between the two bills. They also differ on revenues; the Senate bill raises money by taxing high-cost insurance plans and the House from taxes on high-income earners. And as we discussed yesterday, some lawmakers are looking to tweak the timeline of when certain provisions take effect.
But there are differences in the bill that don’t get as much attention, but would have a big impact on consumers. Here’s a look at a few:
After the Senate vote, President Obama said health-care reform would be the most important social reform since Social Security in the 1930s, and the most important medical reform since the creation of Medicare in the 1960s.
In a moment of levity, and perhaps exhaustion, Senate Majority Leader, Harry Reid (D-Nev) accidentally voted against the bill that has been his top priority for months. The Senator brought his hands to his head and then quickly changed his vote to yes.
Senators could be seen sharing congratulatory hugs in the aftermath of the vote. But the work in Congress is not done yet. The two bills will now go to a conference committee, where negotiators from each house of Congress will merge them into a single bill. Then they’ll have to vote again.
“The bill lays the groundwork for an enormous number of ways to save money and save lives in the future. It extends the life of Medicare and helps protect every insured American family from catastrophic, out-of-pocket costs. We look forward to working with policymakers as the final proposal takes shape,” said DeAnn Friedholm, director of Consumer Union’s health reform campaign.
Lawmakers are already talking tough on some of the differences between the bills. Senators Joe Lieberman (I-Conn) and Ben Nelson (D-Neb) have signaled they won’t vote for a bill that changes significantly from the one they helped shape in the Senate. They were among the final holdouts, pushing for the public option to be dropped and the inclusion of abortion restrictions, respectively. But many House members also believe that the provisions in their bill should prevail. Representatives Barbara Lee and Lynn Woolsey from California said in a joint statement that a final bill must have a public option.
The public option is just one of many sticking points between the two bills. They also differ on revenues; the Senate bill raises money by taxing high-cost insurance plans and the House from taxes on high-income earners. And as we discussed yesterday, some lawmakers are looking to tweak the timeline of when certain provisions take effect.
But there are differences in the bill that don’t get as much attention, but would have a big impact on consumers. Here’s a look at a few:
- Affordability: The House bill generally makes health insurance more affordable for lower-income Americans. It makes Medicaid available to everyone earning up to 150 percent of the poverty level, as opposed to 133 percent in the Senate bill. It also provides more tax credits to those under 250 percent of the poverty level, whereas the Senate is more generous between 250 and 400 percent of the poverty level. Combining the House provisions at the lower end of this spectrum, and the Senate’s at the higher end would help more Americans afford health insurance converge.
- National exchanges: The House creates a national insurance exchange. The Senate creates exchanges in the states. But many states have not been great at regulating the insurance industry, so a national exchange would probably benefit consumers more. The Senate, on the other hand, has more explicit language requiring the exchanges to make plans comparable on cost and quality, which would help consumers choose a plan that meets their needs.
- Drug and medical device reforms: The two bills have different provisions covering the way the Food and Drug Administration regulates drug and device manufacturers. The House bill would attempt to end the abuse of brand name drug companies paying manufacturers of generics not to bring low-cost drugs to market. It would also create a registry to improve safety monitoring of medical devices, and would make the data publicly available. The Senate bill would create a consumer-friendly drug facts label that would help consumers understand the risks and benefits of medications. It also has a provision that would attempt to end the abuse of label changes meant to block generic drugs.
- Consumer representation: Both bills create many new advisory committees, from the one that looks at ways to cut costs in Medicare and recommend payment reforms, to one that helps create priorities for comparative effectiveness research. These boards will need significant consumer representation and strong conflict of interest provisions to limit the impact of industry influence.
—Kevin McCarthy, associate editor
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