House Democrats have introduced a 1,018-page bill that would make scores of Medicare and Medicaid provider payment changes, create a public health insurance option, expand Medicaid eligibility, require individuals to hold some level of health coverage and levy fees against employers that don't offer insurance.
House Energy and Commerce Committee Chairman Henry Waxman (D-Calif.), one of the lead authors of the bill, called it “landmark legislation.”
“This is a defining moment for our country,” he said.
At the outset, the legislation includes a public health plan that would compete with private payers in an open “exchange,” and accounts for federal subsidies to help transition individuals into it. The legislation would also prevent health plans from denying coverage to people with pre-existing conditions. On the Medicare front, the bill would change the way hospitals and doctors are paid, and would create several pilot programs to further reshape the payment process.
The bill would use a surtax on the highest earners to help cover cost. Households with incomes of $350,000, $500,000 and $1 million would see taxes of 1%, 2% and 3% respectively. Those rates could increase if more funds are needed in the future.
Congressional budgeteers have said that the new tax could generate roughly $540 billion over the next decade, or about half the cost of the bill. The balance would be made up in savings reaped from Medicare and Medicaid.
Along with Energy and Commerce, the bill was also shaped by the Ways and Means and Education and Labor committees. The legislation is expected to go through deeper negotiations later this week.
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