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Read the Senate Health Care Bill

November 19, 2009 - by Donny Shaw

Senate Majority Leader Harry Reid [D, NV] last night released his health care bill, which is expected to get a first initial vote in the Senate as soon as Friday. From its major features and topline numbers, the bill clearly has a lot of the attributes Senate Democrats need to meet the political challenges facing their health care reform effort. It includes a dramatically pared-down public option, greatly expands insurance coverage, reduces the deficit, maintains the status quo on abortion funding and bans many of the most egregious insurance industry practices.

But, as in most everything Congress does, the details of the bill are crucial. The OpenCongress team worked through the night to convert the 2,074-page .pdf file of the bill into HTML so we could post it online and help people dig in to find the important details. Since the bill was released as a.pdf and not filed alongside other legislation on the Library of Congress’ THOMAS website, our version is the only online copy of the bill — view it here:

The Patient Protection and Affordable Care Act>>

…We’ll be working throughout the day to build our inline commenting and section-by-section permalinking tools into the page.

The bill is a blended version of the two health care bills that were approved by the Senate Finance Committee and the Senate HELP Committee earlier this year. Those bills overlapped in several areas and had some major differences that had to be reconciled by Majority Leader Reid in the final bill released last night. Here’s an outline of some of the choices Reid was facing between the two bills.

We already know about some of his decisions. Instead of going with the HELP Committee’s public option plan with reimbursement rates tied to Medicare or the Finance Committee’s bill that eschewed the public option altogether, Reid chose a plan that would require the government to negotiate rates with providers and would allow individual states to opt out of participating. The CBO has estimated that Reid’s opt-out public option would have higher premiums on average than private plans, would insure between 3 and 4 million people and would be unavailable to about one-third of Americans, who would be residing in states that chose not to offer the plan to its residents.

All of Reid’s final decisions can be found be found by digging into the bill. We’ll be posting about them on this blog as they are discovered. Also worth looking for are provisions that are aimed at specific states to win support from wavering Democrats whose votes will be needed to overcome Republican filibusters. We know that the bill contains some new items that weren’t in either of the previous versions. There’s a new Medicare payroll tax for people making above $200,000 annually and a new 5% tax on elective cosmetic surgery.

The bill is in the form of an amendment to a House-passed veterans’ housing credit bill, H.R. 3590. That means the Senate’s first vote to break a filibuster and begin debate will not technically be on the health care bill, a fact the Dem leadership is hoping will help win support for the motion from hesitant moderates. According to Congress Daily ($), Majority Whip Dick Durbin [D, IL] is planning on arguing that all Democrats should vote to move the bill to debate so they can hash out their difference through the amendment process. That vote could take place as early as Friday, but it will likely not happen until Saturday or later. If the filibuster is overcome (it will take 60 votes), the Senate will then begin debate and amendment of the Patient Protection and Affordable Care Act.

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