Reconciling the House and Senate’s healthcare bills
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The Senate is still days away from a final vote on its version of a healthcare overhaul, but the questions have already begun on how the bill will be balanced with a House version.
To make a law, the bills have to be combined in a conference composed of legislators from both chambers, who will issue a report that then must be voted on by both houses. In effect, all of the political problems that existed in passing the bills will be repeated; all of the lobbying for things within and excluded from the bills will be resumed.
Democratic senators have already warned their House colleagues that the final conference report must be close to their version of the bill, else there is no way to pass a final bill. The House bill contains a government-operated insurance plan, but the Senate’s reluctance means that liberal hopes of resurrecting even that limited form of a public option remains dead.
There are other major differences between the bills, especially in the language in the House bill on abortion funding. Liberals in both chambers want to eliminate it in the final product, even though anti-abortion lawmakers made the language a key token in the political bargaining to round up votes.
There is a controversial tax on so-called “Cadillac” plans in the Senate versions that the House wants to stop because it could hit unions who bargained for benefits rather than raises in past years.
But the bills have similarities as well. Each costs about $1 trillion over 10 years and is paid for by a combination of tax and fee increases and cuts in projected Medicare spending.
Each increases the number of people who will be covered by insurance and sets up exchanges where consumers can compare prices. Some insurance practices such as using pre-existing conditions to prevent payments would be eliminated.
-- Michael Muskal
