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A Handy Guide to Congress' Health Care Bills

October 20, 2009 - by Donny Shaw

If you’ve been following the health care reform effort in Congress even casually over the past few months, you’ve likely seen a lot of news alerts come across your screen announcing the arrival of important new health care bills. We’ve been posting these announcements on this blog since June, when the first draft of the HELP Committee health care bill was released. Our most recent such announcement came just last night when the official version of the Finance Committee bill was introduced into Congress.

Keeping track of all these different bills can be difficult, and unless you want to follow the path of certain provisions in each of these 1,000+ page bills, the announcements might not really matter to you. But, in case you’re curious, here’s a quick guide to the different health care bills that are making their way through Congress

  • H.R. 3200 — America’s Affordable Health Choices Act of 2009

    This is the base bill in the House of Representatives that the three House committees with jurisdiction over health care have amended and approved. It is sometimes referred to as the “Tri-Committee bill.” The three committees that have approved versions of this bill are the Energy and Commerce Committee, the Ways and Means Committee and the Education and Labor Committee. The differences between the three versions of this bill are relatively minor. For example, they all contain a public option, they all require individuals to have insurance and they all levy a surtax on the rich. Th biggest sticking point between the three version is whether the public option will be tied to Medicare reimbursement rates or whether it will require the HHS Secretary to negotiate rates. Two of the versions use the Medicare formula; the Energy and Commerce version requires rates to be negotiated. Later today, the full House Democratic Caucus will meet to review scores from the Congressional Budget Office for the three versions and start finalizing decisions on what to include from each version in a final that will brought to the full House floor for debate and votes, likely as a completely new bill.

  • S. 1796 — America’s Healthy Future Act of 2009

    This is the Senate Finance Committee’s health care as approved by the Committee on October 13th. It’s the legalese version of the plain English draft that was released on September 15th and amended by the committee during their mark-up session from September 22nd to October 13th. This bill is generally considered more conservative than all the others. It’s the only major health care overhaul bill in Congress that does not contain a public option. It is also cheaper with its subsidies for helping low and middle-income people buy insurance and it does not require employers to provide insurance for their employees. A full summary can be downloaded here. It is currently being reconciled with the HELP Committee bill (described below) in behind-the-scenes negotiations with Majority Leader Sen. Harry Reid [D, NV], Finance Committee Chairman Sen. Max Baucus [D, MT], former stand-in HELP Committee Chairman Sen. Chris Dodd [D, CT] and White House officials. You can view a chart of the differences between the two bills here.

  • S. 1679 — Affordable Health Choices Act

    This is the Senate Health, Education, Labor and Pensions Committee’s health care bill that was approved by the committee on July 15th. It is sometimes referred to as the “Kennedy Health Care bill” because former Senator Ted Kennedy [D, MA] was technically the chairman of the HELP Committee when it was being developed, though Sen. Chris Dodd [D, CT] was actually filling in due to Kennedy’s illness. It is generally considered the more liberal of the health care bills in the Senate. It contains a slightly toned down public option plan that requires the HHS Secretary to negotiate reimbursments rates. It doesn’t include any revenue-raising provisions, as they falls strictly under the jurisdiction of the Finance Committee in the Senate. A complete summary can be downloaded from the Committee here.

These are the three bills — actually five when you consider that H.R. 3200 exists in three different version — that will be combined to form the health care reform bill that is expected to be signed into law later this year by President Obama. There are a few things they all have in common. For example, they all would require individual to get qualifying insurance coverage or pay a fine, they all would set up exchanges for people to comparison shop insurance policies, and they all ban insurers from denying coverage based on pre-existing conditions.

There are other health care bills in Congress — alternative overhaul bills and bills focused on specific areas of health care reform — but they are only tangentially related to the big health care reform push. You can see some of them on our page of “hot” health care bills and our health care costs and insurance issue area.

There will likely be more versions of these health care bills introduced in the near future as both chambers finish reconciling their separate bills and prepare final versions to be brought to the floor for debate and votes in early November. It’s not clear yet if the versions that will serve as the basis for the floor debates will be introduced as stand alone bills or if they will only exist as substitute amendments to other bills. The Heritage Foundation is reporting that it’s “likely” that the Senate will use H.R. 1586, a bill to claw back executive bonuses at TARP-recipient banks, as the legislative vehicle for their health care bill. It’s entirely possible — TARP, after all, was passed as a substitute amendment to a mental health parity bill.

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  • Anonymous 10/21/2009 7:54am
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    This is an emotional issue for many Americans. This so-called “public option” in Government run health care presents serious challenges for us. As Consumers we should be able to compare the cost and quality of health care services. How much is a specific surgery at one hospital, as compared with another?

  • Anonymous 10/21/2009 12:05pm

    Currently the U.S. is rated number one in the world for health resource availability – meaning, if you have the money, you can get the service. That is common knowledge, pay to play. So why would we want to overhaul the entire system, when only the financial end needs reform?

    Compare it to a Lamborghini – it is a great car if you can afford it. Why would you want to change the design of the car if the only problem is the pricing?

  • Anonymous 10/21/2009 2:47pm

    That’s a rather interesting analogy of comparing health care to a Lamborghini and yet an accurate appraisal of our current system. The distinction we need to make in this country is that health care is unlike other consumable products or services. We can choose not to buy the top of the line HD TV settling instead for a cheaper model. Those of us unable to afford a Lamborghini buy the car we can afford. But medical care, especially in time of crisis, is not a personal choice. At some point in each of our lives we will need care and perhaps a great deal of it and there is no escaping this. Does it seem humane and civilized for an advanced and educated nation such as ours that the amount of treatment one receives is predicated on what they can afford or that one is saddled with massive debt and often forced into bankruptcy when the inevitable medical crisis happens?

  • LucasFoxx 10/21/2009 5:30pm
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    + -1

    Calling H.R. 1586 a “Shell Bill” for Health Care is a stretch even for a group that throws around words like “Obamacare.”

    H.R.1424 was also a Genetic Information Nondiscrimination Bill, an Energy Improvement Bill, a Disaster Tax Relief Bill,….

    Maybe they will address some of it in other legislation. We’ll see. But it does appear we will get some kind of reform.

  • jdoziertx 10/21/2009 5:59pm

    Can we get a 50 page synopsis to read for those of us real people paying for this thing and working +80 hours per week just to tread water?

  • Anonymous 10/21/2009 9:03pm
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    + -1

    It’s all socialized health care, and it all destroys the freedom of self-determination. We must fight tyranny from every angle to preserve our dedication to our precious freedom and to sustain the way of life we have enjoyed since the Revolution from the tyranny of the British Empire.

  • pinky 10/21/2009 10:19pm

    That’s funny, I don’t see HR676 or S703. Why?

  • Comm_reply
    Anonymous 10/22/2009 12:21pm

    Self determination applies to deciding where to live, what career to pursue, or buying the car you can afford. A human life and our well being is not a consumable commodity with a price tag. Getting sick and needing care is not a path of self-determination but a fact of life. Medical care based on what you can afford versus what you need is not self-determination. Over a year ago my brother passed away from cancer. Self employed his insurance was based on what he could afford. The insurance company denied payment of the care he had received saddling his widow with over $200,000 in bills forcing her into bankruptcy. This is not self determination but the causality of a faulty system. Companies deciding care based on what you can afford versus what you need is not self-determination but corporate tyranny.

  • Anonymous 10/22/2009 6:08pm

    Socialized medicine is a system in which doctors and hospitals work for and draw salaries from the government. Doctors in the Veterans Administration and the Armed Services are paid this way. The health systems in Great Britain and Spain are other examples. But in most European countries, Canada, Australia and Japan have socialized health insurance, not socialized medicine. The government pays for care that is delivered in the private (mostly not-for-profit) sector. This is similar to how Medicare works in the US. Doctors are in private practice and are paid on a fee-for-service basis from government funds. The government does not own or manage medical practices or hospitals. The term socialized medicine is often used to conjure up images of government interference in medical care. That does not describe what happens in countries with national health insurance where doctors and patients often have more clinical freedom than in the U.S.,

  • Anonymous 10/29/2009 10:30pm

    The hospitals in Canada ARE owned by the government. There is no PRIVATE sector anything. THe government owns and runs all healthcare in Canada. Believe me, who lives there, it is NOT what you want for America!

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