House Democrats unveil healthcare-reform legislation

House Democrats have unveiled comprehensive healthcare legislation that aims to cover 96% of all Americans and “keeps costs under $900 billion,” according to House Speaker Nancy Pelosi (D-Calif.).

The legislation, estimated to cost $894 billion over ten years and cover an additional 36 million Americans, will “expand coverage and implement key insurance reforms,” establishing a new health insurance exchange that will include a public option and provide other benefits, such as ending discrimination for people with pre-existing conditions, said Pelosi, flanked by members of the Democratic Caucus on the steps of the Capitol Building.

Steep cuts to Medicare, along with a surtax on individuals with incomes of $500,000 and couples with incomes of $1 million, are expected to foot much of the bill's cost.

New measures to accelerate benefits for those with pre-existing conditions and other populations as early as 2010, in addition to a provision to close up Medicare's coverage gap or “doughnut hole” over 10 years, have “made the bill more expensive,” Rep. Gerald Connolly (D-Va.) told reporters.

An expansion to Medicaid, covering individuals with incomes of up to 150% of the federal poverty level is planned. To ease the burden on states that would be called upon to cover more people, the bill would reduce the state Medicaid match rate to 7% from 10%.

Some Democratic lawmakers appeared confident the bill would easily achieve a simple majority—218 votes—to clear the House floor. Others didn't seem entirely happy with the bill's last-minute changes, such as the decision to base a public option on negotiated rates instead of Medicare reimbursement rates, claiming the new approach wouldn't save as much money and do less to promote competition in the insurance industry.

The bill still has a few procedural hurdles to clear, allowing time for congressional Republicans to review it before it is considered on the floor possibly late next week.

In the meantime, a separate bill addressing a fix to Medicare's troubled physician payment formula was released in tandem with the House health reform bill, a measure that was immediately criticized by the GOP. All members of the House are intent on fixing physician payments to Medicare, but to do so, “it ought to be paid for,” said House Republican Leader John Boehner (R-Ohio), referring to the bill's apparent lack of offsets.