The Senate finally released its merged health overhaul bill, sending the blogosphere a specific document to pour over.
The action took off when Democratic staffers announced the Congressional Budget Office’s assessment: $849 billion over ten years, a federal deficit reduction of $127 billion, and coverage for an additional 31 million Americans. Director Douglas Elmendorf offers a brief overview on his blog and is careful to note the uncertainties in some of the estimates.
Here’s what various folks are saying:
Hot Air’s Allah Pundit is very unimpressed, and argues that a CBO score matters only “when it’s bad:”
Another week, another “scoring” of a bill that (a) looks nothing like what it’ll look like in its final form and (b) almost certainly has been crafted to hide certain key costs (a la “doctor fix” in the House bill) to improve its “score.” Realistically, the only time a CBO score matters is when it’s bad: Were this to come in at over $900 billion or be judged a deficit-buster over the long term, it would be rejected for failing to meet the White House’s baseline demands. But this one just makes the cut, so look for the obligatory back-pat in this weekend’s presidential message about it being a “fine starting point” or an “encouraging beginning” or whatever. Reid managed to come up with a bill that isn’t too expensive … for Barack Obama. Congratulations.
The New Republic’s Jonathan Cohn compares the Senate’s offering with the House-passed bill. Cohn seems cautiously optimistic, although he admits it’s “worse than the House:”
But, again, the Senate was never going to pass the House bill. Realistically, the question going forward was whether Majority Leader Harry Reid was going to be able to improve what came out of the Senate Finance Committee–and move it closer to what the Senate Health, Educaiton, Labor, and Pensions Committee produced. And there it seems pretty clear that he did, mostly. The early consensus among experts (and, again, this is pending further analysis) is that the new Senate bill boosts financial support for people purchasing health insurance. And, of course, it has a public insurance plan.
It’s not huge progress. But given the political pull to the right from conservative Democrats and independent Joe Lieberman, any progress is an accomplishment. And Reid clearly deserves credit for that.
The Washington Monthly’s Steve Benen thinks some Democratic holdouts should be satisfied: “it’s worth taking a moment to remember that center-right Democrats, who’ve been complaining about this initiative all year, have very little to complain about right now. Indeed, they should be thrilled — Senate Majority Leader Harry Reid (D-Nev.) has put together a reform package custom made to give the so-called “moderates” just about everything they said they wanted.”
Jacob Goldstein of the WSJ’s Health Blog lists the key tax provisions in the Senate bill, which include a tax on high-end health insurance plans and an increase in the payroll tax for high-income earners.
Insure Blog’s Henry Stern is nonplussed with the bill’s estimated savings: “That bears repeating: if (and that’s a big if) it really meets expectations, Sen Reid’s baby will cut, over 10 years, the equivalent of one month’s deficit. Color me underwhelmed.” (Italics/bold Stern’s).
The Washington Post’s Ezra Klein disagrees, looking at the bill’s cost provisions in the three decades following its passage. “In the second decade, however, …savings from Medicare and Medicaid, paired with the excise tax (which CBO says “is effectively a reduction in the existing tax expenditure for health insurance premiums”) and a handful of other changes, leaves the government spending no more on health care than it otherwise planned to. That’s impressive stuff. And it implies, of course, that in the third decade, the federal commitment actually goes down relative to expectation. The curve, as they say, is bent.” Klein goes on to argue that getting these cost controls in the bill was part of a “grand bargain” that would not have passed without coverage expansions.
Critical Condition’s Kathryn Jean Lopez posts a message from the National Right to Life Committee on the bill’s abortion provisions. The anti abortion group says: “Regrettably but predictably, Reid rejected the bipartisan Stupak-Pitts language. Instead, Reid has sought to please the militant minority that demands funding of abortion through federal programs, even though substantial majorities of Americans believe that abortion should be excluded from government-funded and government-sponsored health programs.”
Amy Allina of Raising Women’s Voices takes a look at the abortion provisions from the other side of the issue:
Senator Reid rejected the calls of antichoice activists to add the House-passed ban on abortion coverage in the exchange. For the most part, the Senate bill confirms current law on access to abortion, as the Senate Finance bill did. To respond to the concerns of antichoice Democrats, Reid’s bill spells out more specific accounting guidelines for the segregation of public and private funds to ensure that no federal money would be used to pay for abortion care. It would allow insurers to offer abortion coverage to women in the exchange, including women who choose the public option if the Secretary of HHS ensures that federal money is not being used to pay for the services. It also confirms that states would be allowed to pay for abortion services on their own, if the federal government decided not to include them in the public option.
Wonk Room’s Igor Volsky made a table comparing the House and Senate bills, saying, “The merged Senate legislation has lower affordability standards, covers less people, invests less in prevention, does not require all large employers to provide health insurance, and includes a weaker public option. But the bill goes further in controlling health care spending and reducing the deficit.”
And you can always follow the action on Twitter. A selection of this morning’s many thousands of tweets below.