| Each of the two ratified versions of the health care bill | | | | does the House. |
| currently waiting in Congress was barely passed, by | | | | The House bill covers 5 million more people than the |
| virtually the slimmest margin possible, in a hectic | | | | Senate bill by expanding Medicaid to those earning up |
| last-minute stampede. Dozens of harsh compromises | | | | to about $2,000 more than in the Senate bill. |
| had to be hammered out to cobble together the fragile | | | | The Senate version gives $100 million to Nebraska for |
| framework now standing in each chamber. | | | | indefinite coverage of all new Medicaid enrollees in the |
| The two bills are like delicate Jenga towers, swaying | | | | state (to buy Ben Nelson's vote). The Senate bill gives |
| nerve-wrackingly in the breeze, that must now be | | | | $300 million to Louisiana for Medicare increases (for |
| reassembled by a team of 535 clumsy | | | | Mary Landrieu's vote); $10 billion to Vermont for new |
| attention-seekers into a tower twice as tall. But | | | | public health centers (for Bernie Sanders' vote); billions |
| legislators across the two chambers-and even within | | | | to Nebraska and Michigan to waive nonprofit insurers' |
| them-are not even speaking the same language. | | | | excise taxes (for Ben Nelson and Carl Levin's votes); |
| Here are a few of the myriad discrepancies legislators | | | | millions to Massachusetts and Vermont for Medicaid; |
| must reconcile to ensure that their monument to | | | | and millions to Florida, New York, and Pennsylvania for |
| Obama's greatness doesn't fall: | | | | Medicare Advantage. None of these provisions is in |
| In the House version of the bill, a government-run | | | | the House bill. |
| insurance exchange is created on a national level and | | | | The Senate version includes, per the insistence of |
| includes a public option. In the Senate version, | | | | construction unions, an important exception to the |
| exchanges are created on the state level and do not | | | | employer mandate. As an article in the New York |
| include a public option. Virtually identical! | | | | Times titled "In Health Bill for Everyone, Provisions for a |
| The House completely bans the practice 0f charging | | | | Few" reports, "Under the Senate bill, businesses with |
| those with preexisting conditions higher premiums. The | | | | fewer than 50 employees would be exempt from the |
| Senate allows insurers to offer unlimited discounts for | | | | penalties in every industry but construction." In the |
| customers who engage in subjectively defined | | | | construction industry, the mandate holds for employers |
| wellness activities: say, exercising, eating healthy, "not | | | | with as few as 5 employees. The House includes no |
| having contracted lung cancer"... | | | | such provision. |
| Insurance exchanges are implemented in 2013 in the | | | | Restrictions on abortion funding are tight in the House, |
| House bill and 2014 in the Senate bill. | | | | with no federal funding allowed; and loose in the |
| In the House version, employers are forced to provide | | | | Senate, with mere separation of federal and private |
| insurance for their employees and pay a fine if they do | | | | money, and states allowed to make up whatever rules |
| not. In the Senate version, employers are not required | | | | they want regarding abortion funding. |
| to provide insurance, but pay a fine for employees | | | | Coverage for illegal immigrants is not disallowed in the |
| who opt for government-run insurance and receive | | | | House; it is explicitly banned in the Senate. |
| federal subsidies. The House has higher penalties than | | | | It should be sobering for Democrats to realize that if |
| the Senate. | | | | just one Senator or two Representatives decide they |
| The House version funds the bill by imposing a surtax | | | | can't tolerate the alternative version of even one of |
| on families making over $1 million a year. The Senate | | | | these provisions, that will be enough to topple the |
| version establishes a tax on those with "Cadillac" plans, | | | | whole health care reform edifice. |
| which includes not only many union members, but | | | | It's no wonder, then, that Congressional Democrats |
| millions of families who will unexpectedly find | | | | now plan to merge the bills behind closed doors, |
| themselves unlucky Cadillac owners over the next 10 | | | | shutting out all Republicans from discussion of the |
| years due to the non-inflation-adjusted nature of the | | | | reconciliation process and preventing them from using |
| provision. | | | | parliamentary procedures to slow consideration of the |
| The House version does not tax insurance offered by | | | | bill and allow the public to digest the proposed changes. |
| employers; the Senate version taxes employer | | | | Talking Points Memo cites one Democratic House aide |
| insurance above a threshold. | | | | who proudly admits, "This process cuts out the |
| The House version charges older people a maximum | | | | Republicans." The House will simply take the Senate's |
| of twice the premiums as younger people; the Senate | | | | bill, amend it, vote on it, and send it to the Senate; who |
| version sets a maximum ratio of three-to-one. The | | | | will then amend the bill, vote on it, and send it to the |
| House offers fewer insurance subsidies for the middle | | | | House; and back and forth until some hideous, lopsided, |
| class than does the Senate. The Senate offers | | | | structurally unsound blueprint garners enough votes in |
| weaker measures to limit out-of-pocket costs than | | | | both chambers. |