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Where We Stand

As Congress is in recess this week, I thought it would be useful to lay out where we are right now in the health reform legislative process. So as not to be too long winded, the descriptions here are rather brief but a closer look at each proposal will be available in my first e-newsletter, soon to be published. Here are the three drafts in the works:

1) The House Tri-Committee draft: The relevent Committees in the House (Ways & Means, Energy & Commerce, and Education & Labor) have drafted an 800 page proposal with the the most tangible legislative language of the three. This is somewhat predictable as a bill will most likely emerge from the House first, with mark ups following the recess and floor action expected the week of July 27th. The bill will almost surely include: an individual mandate, guaranteed issue, employer “pay or play,” a public plan option, medicaid expansions, and low-income subsidies for those who can’t afford to pay premiums in full.

2) The Senate Finance Committee Proposal: The language in the Finance Committee remains the most unclear of the three proposals, and currently is described in a series of papers as opposed to a formal draft. Senator Baucus (D-Mont.) has been committed to achieving bipartisan legislation, and continues to work closely with the key Republican players on the Committee in Senators Grassley, Enzi, Hatch, and Snow. One of the most contentious elements of reform is the possible creation of a new public plan option, and it is unclear if the Finance Committee draft will ultimately include this provision. Sen. Baucus has pledged to keep the cost of the bill at less than $1 trillion over 10 years, significantly lower than the $1.6 trillion estimate from the Congressional Budget Office, though details are still absent (more on the price tag and financing in a future post).

3) The Senate HELP Committee Affordable Health Choices Act: The bill in this Committee does not appear to be a bipartisan effort, as it includes provisions such as a public plan option, individual mandate, Medicaid expansions, and low-income premium subsidies. It also emphasizes state-based insurance exchanges, where the alternatives describe national exchanges. The Committee hopes to have a full mark up of the bill by July 10. It also contains the strongest provisions on public health and prevention efforts, elements paramount to President Obama’s proposal.

The Senate Committees hope to ultimately combine their efforts for a single bill, and many are optimistic in meeting the August recess “deadline.” It is also important to note that I have not described the Republican alternative, The Patient’s Choice Act, though I hope to include it in the e-newsletter comparison.

In other news, President Obama held a digital-age Town Hall Q&A today on health reform, which you can peruse here.