Sunday, December 20, 2009

Health Care Reform: Ben Nelson Signs On To The Democrats' Bill

Ben Nelson announced yesterday that he'll support the Senate health care bill; this means that the Democrats have 60 votes and can defeat the Republican filibuster. The vote is currently scheduled for 7 PM on Christmas Eve.

The primary concession given to Nelson is stricter limits on federal funding (even if indirect) for abortion. I do not understand the compromise position, and according to Robert Pear in the Times this morning, it's not making either side happy:

Under the agreement, states could choose to prohibit abortion coverage in the insurance exchanges, where most health plans would be sold. But if a health plan did cover the procedure, subscribers would have to make two separate monthly premium payments: one for all insurance coverage except abortion and one for abortion coverage.

The compromise was denounced by advocates of abortion rights, including Planned Parenthood. “We have no choice but to oppose the Senate bill,” said Cecile Richards, president of Planned Parenthood.

The United States Conference of Catholic Bishops and the National Right to Life Committee reached a similar conclusion for very different reasons. “This bill should not be supported in its current form because it would allow federal money to go to health insurance plans that cover elective abortions,” said Richard M. Doerflinger, a spokesman on abortion for the bishops’ conference.

It sounds like Harry Reid was very generous to Nelson, and I assume that a critique will arise that his vote was -- essentially -- purchased.

For instance, Nebraska's Medicaid structure will be different from all the other states':
Nelson also secured full and permanent federal funding for his state to extend Medicaid eligibility to everyone below 133 percent of the federal poverty level. The bill would require all states to do so, but Nebraska alone would not be required to pay a portion of the additional cost after 2016.
Here are some of the other facts about the Senate bill:
  • It's estimated (by the CBO) to cost $871 billion over 10 years.
  • It will provide coverage to an additional 30 million Americans.
  • There will be a mandate to purchase health insurance on all Americans, with penalties of up to 2% of income. Interestingly, the speaker at the CABA luncheon this past Thursday said that the penalty will only be $95 per year; as he pointed out, this is not enough of a penalty to actually influence people's behavior given that the per-person average for one year of insurance coverage is currently $4,000.
  • Employers who don't offer insurance to their employees will face financial penalties from the government.
  • There will be an increase in the Medicare payroll tax for individuals with incomes above $200,000 (or families above $250K) -- from 1.45% to 2.35%; this is bound to generate heated criticism from the Republicans.
  • And -- in the recent detail that will get lots of media coverage -- tanning salons will have to charge an extra 10% tax on users, but there will not be a tax on plastic surgery (as had been proposed by some legislators).

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