Sunday, January 10, 2010


As we begin 2010, Congress will continue to work on health system reform.  The Senate approved the "Patient Protection and Affordable Care Act" by a party line vote of 60-39 on December 24, 2009. A nice Christmas present for the President, but probably one of the worse pieces of legislation that has ever come from the Senate.  The "Affordable Health Care for America Act" passed by the House 220-215 on November 7, 2009 must now be negotiated with the Senate bill to come up with a consensus. Both bills would extend coverage to most Americans by imposing more government mandates on business and enacting new government coverage subsidies.  Neither bill addresses mal-practice reform, nor does either bill address the 21.2% Medicare formula based cut in Medicare re-imbursement scheduled to take place in March.   Areas that will be hotly debated include the following:
(1) The Public Plan:  The House bill implements a national health insurance plan offered by the federal government; The Senate bill  would implement "private plans" sponsored by the federal Office of Pesonal Management.
(2) Federal Taxation:The House would impose a 5.4% tax on individuals with incomes exceeding $500,000; The Senate would impose a 40% tax on certain health plans for individuals and families.
(3) Employer Mandate: The House would require larger employers not offering enough coverage to pay a tax of up to 8% of payroll; The Senate would require larger employers not offering enough coverage to pay a $750.00 penalty per worker.
(4)  Individual Mandate:  The Senate would require individuals to obtain health coverage or to face an annual penalty of 2.5% of income (higher than a certain amount); The House would make individuals pay an annual phased-in penalty of at least $750.00 if they did not have health insurance.
(5) Medicaid Expansion:  Both the Senate and House would expand Medicaid coverage for everyone earning up to 133% (Senate) & 150% (House) of the federal poverty level. (6) Abortion Funding: Both the House and Senate would bar the use of federal subsidies to pay for abortions, but would allow subsidy recipients to choose a plan covering abortion if it were paid for with segregated private funds (Senate) or to purchase separate coverage with their own money (House).

The final compromised version will be forthcoming - stay in touch and get in touch with your elected officials to express your views and concerns.