Senate approves health care reform bill

[Feedmenow]

http://www.cnn.com/2009/POLITICS/12/...are/index.html

Washington (CNN) -- The Senate passed a $871 billion health care reform bill Thursday morning, handing President Obama a Christmas Eve victory on his top domestic priority.
The bill passed in a 60-39 party line vote after months of heated partisan debate. Every member of the Democratic caucus backed the measure; every Republican opposed it.
Should it become law, the measure would constitute the biggest expansion of federal health care guarantees since the enactment of Medicare and Medicaid more than four decades ago. It is expected to extend insurance coverage to 30 million additional Americans.
The bill now must be merged with a $1 trillion plan approved by the House of Representatives in November. Democrats hope to have a bill ready for Obama's signature before the president's State of the Union address early next year.
Senate Republicans failed to stop the bill despite utilizing almost every weapon in their legislative arsenal. GOP leaders have repeatedly warned the measure will raise taxes while doing little to slow spiraling health costs.
Senate Majority Leader Harry Reid, D-Nevada, was forced to cut multiple deals in recent weeks to ensure the support of every member of his traditionally fractious caucus. Top Democrats needed the backing of all 60 members in three key procedural votes over the past four days to break a GOP filibuster.
Final passage of the measure, in contrast, only requires a bare majority in the 100-member chamber.
iReport: Share your thoughts on health care reform
An exhausted Senate planned to adjourn for the holidays shortly after passing the measure, but lingered long enough to increase the federal government's debt limit by $290 billion.
The increase -- which raises the total debt ceiling to $12.4 trillion -- will cover federal expenditures for another two months. The House of Representatives has already cleared the measure.
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http://www.cnn.com/video/politics/20...te.640x360.jpgVideo: Senate health care bill passes
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http://www.cnn.com/video/politics/20...nn.640x360.jpgVideo: Eyes on House for health care
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http://www.cnn.com/video/politics/20...nn.576x324.jpgVideo: GOP: 'This is a lousy bill'
RELATED TOPICS

• Health Care Reform
• U.S. Senate
• Barack Obama

The health care debate is "about life and death in America," Reid said shortly before Thursday's first vote. "It's a question of morality, of right and wrong. It's about human suffering. And given the chance to relieve this suffering, we must take this chance."
Reid ripped the Republicans for their unanimous opposition to the bill, saying he was "sorry to say that for the first time in American history, a political party has chosen to stand on the sidelines rather than participate in great -- and greatly needed -- social change."
Senate Minority Leader Mitch McConnell, R-Kentucky, argued it is "clear that even many of the people who support this bill with their votes don't like it." Otherwise, he claimed, "they wouldn't be rushing it through Congress on Christmas Eve."
"There is widespread opposition to this monstrosity," he said. "This fight isn't over."
Passage of the Senate health care bill, which is projected to cut the federal deficit by $132 billion over the next decade, signaled majority agreement in both chambers of Congress on a broad range of changes affecting every American's coverage.
Among other things, the House and Senate have agreed to subsidize insurance for a family of four making up to roughly $88,000 annually, or 400 percent of the federal poverty level.
They also have agreed to create health insurance exchanges designed to make it easier for small businesses, the self-employed and the unemployed to pool resources and purchase less expensive coverage. Both the House plan and the Senate bill would eventually limit total out-of-pocket expenses and prevent insurance companies from denying coverage for pre-existing conditions.
Insurers would also be barred from charging higher premiums based on a person's gender or medical history. However, both bills allow insurance companies to charge higher premiums for older customers.
Medicaid would be significantly expanded under both proposals. The House bill would extend coverage to individuals earning up to 150 percent of the poverty level, or roughly $33,000 for a family of four. The Senate plan ensures coverage to those earning up to 133 percent of the poverty level, or just over $29,000 for a family of four.
Major differences between the more liberal House bill and the more conservative Senate bill will now be the focus of the conference committee that will try to merge them.
One of the biggest divides is over how to pay for the plans. The House package is financed through a combination of a tax surcharge on wealthy Americans and new Medicare spending reductions.
Specifically, individuals with annual incomes over $500,000 -- as well as families earning more than $1 million -- would face a 5.4 percent income tax surcharge.
The Senate bill also cuts Medicare by roughly $500 billion. But instead of an income tax surcharge on the wealthy, it would impose a 40 percent tax on insurance companies that provide what are called "Cadillac" health plans valued at more than $8,500 for individuals and $23,000 for families.
Proponents of the tax on high-end plans argue it's one of the most effective ways to curb medical inflation. However, House Democrats oppose taxing such policies because it would hurt union members who traded higher salaries for more generous health benefits.
Asked in an NPR interview Wednesday if he prefers the income tax surcharge or the tax on high-end plans, Obama predicted the final bill will probably end up with "a little bit of both."
"Cadillac plans ... don't make people healthier, but just take more money out of their pockets," he said.
The Senate bill also would hike Medicare payroll taxes on families making over $250,000; the House bill does not.
Another key sticking point is the dispute over a public option. The House plan includes a public option; the more conservative Senate plan would instead create nonprofit private plans overseen by the federal government.
Given the reality of the 60-vote threshold in the Senate, however, there hasn't been much serious discussion among House leaders about pushing hard to keep the public option.
The Senate "tried to see if they had support for it. There isn't. That's the reality," a top House Democratic leadership aide told CNN. "I think a lot of people are coming to terms with that, and I don't know how productive it would be to bring it out again."
Individuals under both plans would be required to purchase coverage, but the House bill includes more stringent penalties for most of those who fail to comply. The House bill would impose a fine of up to 2.5 percent of an individual's income. The Senate plan would require individuals to purchase health insurance coverage or face a fine of up to $750 or 2 percent of his or her income, whichever is greater. Both versions include a hardship exemption for poorer Americans.
Employers face a much stricter mandate under the House legislation, which would require companies with a payroll of more than $500,000 to provide insurance or pay a penalty of up to 8 percent of their payroll.
The Senate bill would require companies with more than 50 employees to pay a fee of up to $750 per worker if any of its employees rely on government subsidies to purchase coverage.
Abortion also has been a sticking point for both chambers. A late compromise with Catholic and other conservatives in the House led to the adoption of an amendment banning most abortion coverage from the public option. It would also prohibit abortion coverage in private policies available in the exchange to people receiving federal subsidies.
Senate provisions, made more conservative than initially drafted in order to satisfy Nebraska Sen. Ben Nelson, would allow states to choose whether to ban abortion coverage in plans offered in the exchanges. Individuals purchasing plans through the exchanges would have to pay for abortion coverage out of their own funds.
Nelson said on CNN's "State of the Union" Sunday that he would withdraw his support if the final bill gets changed too much from the Senate version

Still reading through a bit, though it seems nice to get this over with.

TL;dr

-Party line vote, 60-39
-No public option, but replaced by federally overseen private plans.
-40% tax on "Cadillac" health plans
-Abortion coverage issues are to be handled by the states.
-$750 or 2% of your income as a fine if you don't have insurance.

[Odesseiron]

it's the beginning of the end!

[kuronosan]

DAT OBAMA WANTZ 2 TAKE AWAI MAH GUNZ! ASSASINATE DAT NERF-HERDER!

[Kryssan]

In before... oh to hell with it. We all know where this is going to lead.

[Jodwahh]

Well that's one less thing to rip the piss out of americans about.

[Rockstaru]

Quick, if 60% of BG votes to lock the thread at 10 pages, it means Egon, Leif, and Swampdonkey won't be able to troll indefinitely, right?

[kuronosan]

No, pretty sure that's inevitable whether the thread is locked or not.

[Demosthenes11]

gutted bill is gutted

some good things, but by and large it's spending a fuckton of money to do very little.
also, charging people for not having insurance is wut

[Rhinox]

What this bill accomplishes:


-Royally fuck labor unions
-Force people to buy Insurance without a public option
-Increase profits for insurance companies
-Royally fuck poor people in 'red states' out of abortion coverage that they are forced to buy.

The funny thing about all this is watching the Democrats who were big supporters of single payer such as Anthony Wiener shining this turd like its a victory for him. Fuck even Bernie Sanders caved in to this abomination and his exuse? "It was gonna pass anyway"


The only good in this bill could've been added on a appropriations bill sorta like that hate crimes sham was added to defense spending bill. Instead you have the only 2 things(ban on preexisting conditions and banning Lifetime caps) mixed in with this handjob to the insurance companies.


Huzzah

[Not Kuno]

-Royally fuck poor people in 'red states' out of abortion coverage that they are forced to buy.

Doesn't it say abortion will be covered by each state individually? I have a feeling the red states won't let that one happen.

[Takedown3]

covered as in states still need to decide what to do i believe

and to force a fine on the uninsured without having a public option is fucking pathetic

[Bingbong]

and to force a fine on the uninsured without having a public option is fucking pathetic

When you couple that with the pre-existing conditions clause, it's actually quite the hookup for the folks that don't want insurance.

Don't buy it, pay the fine, and when you need it, then buy it because hey, can't deny me coverage based on a pre-existing condition. If I didn't have kids, I'd be the first one to dump my coverage... 750/year vs 250/month.

[Rhinox]

When you couple that with the pre-existing conditions clause, it's actually quite the hookup for the folks that don't want insurance.

Don't buy it, pay the fine, and when you need it, then buy it because hey, can't deny me coverage based on a pre-existing condition. If I didn't have kids, I'd be the first one to dump my coverage... 750/year vs 250/month.

This argument only worked if there was a Public option. You using the same argument here makes you sound just plain retarded.

[kuronosan]

I really like the idea of a ban against pre-existing conditions, but then again:

No public option, no care.

[Olo401]

There's one major reason that I didn't completely freak out and fight to have this bill tanked. The exchange is still a part of the bill, whether or not a federal-based public option exists or not. This still allows small businesses and individuals who buy their own insurance (private contractors/small business owners) to effectively group together to get larger bulk discounts. And the exchange still allows the government to pool everyone on the private plans, get a bulk discount, and split the savings between everyone's premiums and paying the deficit & Medicare. Having that bullshit anti-reimportation measure in there would have helped too.

Also, nothing in this bill says an individual state can't create their own state government run insurance pool and tie it into the exchange. Existing public plans such as Commonwealth Care would already be in, and if Texas suddenly decided they wanted to keep their poor citizens healthy instead of executing them they'd be allowed to join the pool as well. You'd have to play by that plan's rules though - even with the interstate barriers removed an out-of-state resident would still not be allowed to buy into that particular plan.

The major thing that worries me is that the price controls are still not there, nor is there any incentive for the insurance companies to push the AMA to lower prices either. So even with cost reductions in one place, is it going to be able to offset the hikes elsewhere?

And last of all, when I started flipping out on the capitulation made to LIEberman someone brought me back to ground by reminding me that there will be future votes and future bills. This is a workable framework that fixes lots of problems, and we can tweak down the road after we take out some more trash Senators.

[barber2006]

Somewhere between 871 billion and 1 trillion dollars. That all? I'm sure we have that in a shoebox under the bed somewhere since we have such a booming economy and don't owe anyone any money.

[BerenTebogo]

When you couple that with the pre-existing conditions clause, it's actually quite the hookup for the folks that don't want insurance.

Don't buy it, pay the fine, and when you need it, then buy it because hey, can't deny me coverage based on a pre-existing condition. If I didn't have kids, I'd be the first one to dump my coverage... 750/year vs 250/month.

I was thinking the same thing and since I'm in MA too I'm wondering if this will work <_< My wife and I don't have kids and don't plan to have them so fuck yeah dumping insurance.

[Olo401]

I was thinking the same thing and since I'm in MA too I'm wondering if this will work <_< My wife and I don't have kids and don't plan to have them so fuck yeah dumping insurance.

And then you can pay whatever savings you might see on the regular uninsured price of biannual regular doctor visits, dentist visits, or any scripts you or your wife need, plus that fine.

I bet it'll come out more expensive.. actually I know it will because I was uninsured for ten years.

[Khamsin]

I was thinking the same thing and since I'm in MA too I'm wondering if this will work <_< My wife and I don't have kids and don't plan to have them so fuck yeah dumping insurance.

Doesn't your employer cover you under their group plan?

[Woozie]

I really like the idea of a ban against pre-existing conditions, but then again:

No public option, no care.

.