This morning, during an appearance on Fox News Sunday, Sen. Kent Conrad (D-ND) stressed that the final health care bill will have to reflect the language in the existing merged Senate legislation, suggesting that moderate Sens. Ben Nelson (D-NE) and Joe Lieberman (I-CT) would vote against the bill if the conference committee loosened the Senate’s abortion restrictions or inserted a public option:
I think any bill is going to have to be very close to what the senate has passed because we’re still going to have to get 60 votes. Anybody who has watched this process can see how challenging it has been to get 60 votes….It is very clear that the bill, the final bill, to pass in the United States Senate is going to be — have to be very close to the bill that has been negotiated here. Otherwise you will not get 60 votes in the United States Senate.
While the Senate has surpassed the all-important 60 vote hurdle, the process of reconciling the Senate bill with the House legislation may create new problems for Democrats and force many progressives to swallow the Senate’s weaker affordability standards and tax provisions:
|Senate Bill ($871 billion/10 years)||House Bill ($894 billion/10 years)|
|Abortion||States can elect “to prohibit abortion coverage in qualified health plans offered through an Exchange in such State if such State enacts a law to provide for such prohibition.”||Public dollars cannot fund an insurance plan that covers abortion, even if the woman pays for the abortion with private premiums. Effectively, no plans in the Exchange would cover abortion services.|
|Employer Mandate||No mandate, a free rider provision. Employers would have to pay penalties for employees who receives subsidies in the exchanges.||Large employers who don’t offer coverage would pay a fee equal to 8% of their payroll.|
|Medicaid Expansion||Up to 133% FPL||Up to 150% FPL|
|Affordability||Between 133 – 400% FPL on sliding scale; spend 2.8%-9.8% of income on premiums. Cost sharing is only available for individuals and families with incomes between 100-200% FPL.||Between 133 – 400% FPL on sliding scale; spend 1.5%-12% of income on premiums. Cost=sharing credits are available to individuals and families with incomes up to 400% FPL|
|Public Option||No public option but the Office Of Personnel Management will offer national health insurance plans.||Yes, HHS secretary negotiates rates|
|Financing||Excise tax, increases the payroll tax on individuals who earn more than $200,000 and families earning more than $250,000 a year, taxes on insurers, pharmaceuticals, and medical devices, tax on tanning booths; Medicare savings; Medicare Commission||5.4% surtax on individuals earning > $500,000, couples earning more than $1 million; Medicare savings|
Rep. Bart Stupak (D-MI), a co-sponsor of the restrictive abortion language in the House, has already promised to oppose the Senate’s abortion language while Reps. Diana DeGette (D-CO) and Louise Slaughter (D-NY) are raising the possibility that the the Senate’s abortion language may be unconstitutional. In the past, House Democrats have argued that the Senate’s excise tax on so-called Cadillac plans would disproportionately affect union workers or Americans in high-risk professions and claimed that the weaker employer responsibility provision could discourage employers from bringing on new lower income hires.