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The massive health care draft released by House Democratic chairmen Friday gave liberals new reason to hope that a dramatic overhaul could still emerge this year and Republican critics a big new target to shoot at.
Committees will begin hearings on the bill this week, and numerous changes are expected before the bill hits the floor next month.
But the basic structure seems likely to survive the House intact, including a robust new Medicare-like public health plan that would compete with private companies in a national health insurance exchange.
The plan would also reward businesses and individuals if they buy insurance and tax them if they dont. And insurance companies would no longer be able to exclude the sick.
A new subsidy would provide credits to people purchasing insurance that would phase out at 400 percent of the federal poverty level $88,000 for a family of four. Medicaid would be expanded to families up to 133 percent of the federal poverty level although the feds would pick up the extra tab to avoid burdening cash-strapped state budgets.
The plan would be paid for by a new 8 percent payroll tax on employers that do not provide health insurance to their employees, a new 2 percent tax on individuals who do not buy health insurance, other taxes still to be determined, and cuts within the Medicare and Medicaid programs.
Energy and Commerce Chairman Henry Waxman (D-Calif.) also said the bill will create a new benefit for small businesses who buy insurance for their employees and cap out-of-pocket costs to curtail medical bankruptcies. It would fill in the doughnut hole in the Medicare prescription drug plan paid for by insisting on rebates from the drug companies. And money would be poured into prevention, wellness, community health centers and the training of doctors and nurses.
Democrats said they are waiting on the Congressional Budget Office to score their bill, but Republicans said it would easily surpass $1 trillion over 10 years.
But Democrats said their plan would ultimately result in lower costs by reforming a system that they argue is full of waste. There is no question that we will be saving trillions of dollars in the industry, Ways and Means Chairman Charlie Rangel (D-N.Y.) said. Is this going to bring down the cost of health insurance? You bet your sweet life.
Rep. John Dingell (D-Mich.), who, along with his father before him, has been seeking universal health care for more than a half-century, called the bill a good, practical program of national health care.
And Dingell strongly defended the public health insurance option that is at the heart of the bill. Dingell said not having a public option would leave it up to the private insurance companies alone to fix the system. Theyve had 50 years to do it and more, he said. Thats a terrible thought to me.
Blue Dog Democrats are the biggest hurdle for getting the bill through the House, and Rep. Mike Ross (D-Ark.) said the bill fell short on cost-cutting. He said Blue Dogs are still uncomfortable with a public plan based on Medicare, although they are happy the proposal does not force doctors and other providers to participate. Ross said Blue Dogs continue to support the idea of including a trigger that would create a public plan only if private insurers fail to cut costs.
But the inclusion of a trigger is a nonstarter with Democratic chairmen and liberal Members, who have threatened to vote against any bill that does not include a robust public plan at the start.
Republicans, who released a four-page outline of their health care alternative Wednesday, ripped the plan minutes after it was released.
This plan is nothing less than a government takeover of health care, and families and small businesses who are already footing the bill for Washingtons reckless spending binge will not support it, House Minority Leader John Boehner (R-Ohio) said.
Rep. Dave Camp (R-Mich.), the ranking member of the Ways and Means Committee, said he feared tens of millions of Americans would lose their existing coverage under the Democratic plan and put the federal government in charge of determining what doctors and treatments are available to patients.
Camp said the new taxes would also cause the loss of millions of jobs.