Monday, December 21, 2009

Health reform on the horizon

Is it really possible? Will the Senate actually pass a healthcare bill this week?

It looks like they will pass the legislation on Christmas Eve, the WSJ reports. The Senate’s bill would extend health insurance coverage to some 30 million Americans, create a national insurance exchange, and include subsidies for low- and middle-income to comply with an insurance mandate.
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It also is tough on insurers, barring them from denying coverage to children with pre-existing conditions (and adults with pre-existing conditions starting in 2014).

But it also includes cuts of $480 billion over a decade in payments to Medicare providers.

Meanwhile, new, last minute provisions hiked the cost of the bill up by $23 billion to $871 billion over ten years. Reasons for the increase include expanding the small business tax credit and deleting provisions for increase payment rates under Medicare.

Senators scrapped a one-year fix to the Medicare payment rates because doctors don’t just want a temporary fix, Reid told MedPage Today. This leaves the door open for Congress to permanently repeal the flawed SGR-based payment formula. Last week, the House and the Senate passed two-month fixes, delaying the cuts until March 2010 or until a more permanent solution can be passed.

The Senate’s healthcare bill does raise some revenue by increasing the payroll tax on higher income individuals and families (from 0.5 percent to 0.9 percent for individuals making $200,000 and families making $250,000), according to HealthLeaders Media.

And unsurprisingly, the bill includes funding benefiting specific constituencies, inserted to clench certain lawmakers’ support, the NY Times reports, such as “victims of environmental hazards,” i.e. people exposed to asbestos from a mine in Montana – home state of Finance Committee chairman Sen. Max Baucus.

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