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January 24, 2015

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The Health Care Debate:

The skinny on the health care reform bills in each chamber of Congress

What started as five health care bills — three in the House, two in the Senate — are now two. Here are some highlights of the House bill, which passed on Nov. 7, and the Senate bill, which was introduced for debate Saturday. The Senate bill faces many amendments during the upcoming weeks of debate. Eventually, if the Senate passes health care reform, the two bills would need to be reconciled into one, and passed by both chambers before being sent to the president to be signed into law.

Price tag

House: $1.1 trillion over 10 years

Senate: $849 billion over 10 years


Both: Insurance companies would no longer be able deny coverage for preexisting conditions or set lifetime limits on the amount of care they will cover.

Individual insurance mandates

Both: All Americans would be required to carry health insurance or face fines, with exemptions for those with religious objections or financial hardship.Subsidies would be provided to help some people pay insurance costs. A new health insurance exchange would be established to offer individual and small business policies. Children would be able to be carried on their parents’ policies until they are 26 years old.

The uninsured

House: The bill would reduce the number of uninsured by 36 million over 10 years, leaving 4 percent without coverage.

Senate: The bill would reduce the number of uninsured by 31 million over 10 years, leaving 6 percent without coverage.

New taxes

House: A new 5.4 percent income tax on those with high incomes, more than $500,000 for individuals or $1 million for couples. The tax is on the amount earned above the threshold. Also includes a new 2.5 percent tax on medical device makers.

Senate: A new 0.5 percent Medicare payroll tax on those with incomes exceeding $200,000 for individuals or $250,000 for couples. A new 40 percent tax on high-end “Cadillac” health plans valued at more than $8,500 for individuals or $23,000 for families. Taxes on medical device makers, pharmaceutical companies and the “Botax,” 5 percent tax on providers of elective cosmetic surgeries.

Penalties for going uninsured

House: A tax of 2.5 percent on the adjusted gross income of individuals without health insurance. A tax of 8 percent on the annual wages of companies that fail to provide insurance, exempting those earning less than $500,000 annually.

Senate: Individuals would be fined up to $750 a year for going without insurance, half that for children under 18. Businesses with 50 employees or more would be fined $750 for each employee they do not cover, with a maximum fine dependent on company size.

Subsidies for buying insurance

Both: Affordability credits would be offered to individuals with incomes of less than $43,320 or $88,200 for a family of four. Tax credits of up to 50 percent of insurance costs would be offered to small businesses.

Medicare and Medicare Advantage

Both:Reduces funding for both Medicare and Medicare Advantage. Begins to close the “doughnut hole,” the gap in prescription drug coverage for seniors.

Public option

House: A government-run plan would be one of the options offered to those without health insurance.

Senate: States could opt out of a government-run plan, which would be one of the options for those without health insurance.


House: No federal subsidies would be used to buy policies with abortion coverage, but private funding could be used to buy abortion coverage through a rider. No public or private funds could be used to buy abortion coverage in the public plan.

Senate:Every state must offer one insurance plan with abortion coverage and one without. No federal subsidies would be used to buy policies with abortion coverage, but abortion coverage could be offered in the public plan if public and private funding are segregated.

Illegal immigrants

House: No federal subsidies could be provided to help illegal immigrants buy insurance, but those here illegally could use their own money to buy policies on the new health insurance exchange.

Senate:No federal subsidies could be provided to help illegal immigrants buy insurance, and those here illegally would not be allowed to use their own money to buy policies on the health insurance exchange.

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