Senate Passes Health Care Reform Bill

      After months of acrimonious debate, the Senate passed its version of the Health Care Reform Bill on Thursday, December 24.  In a vote early this morning, the bill passed 60 to 39 with all 58 Democrats and 2 Independents voting in favor of it .  The House passed its version of  health care reform in November.  Senate and House conferees must now meet to negotiate a merged bill to present for final votes in the House and Senate.  Assuming the final bill passes this last hurdle in each chamber, it will then be sent to President Obama for his signature.

      There are some important differences between the House and Senate versions which may pose challenges in negotiating a final bill.  These differences include the following:

• Abortion - The House version is more restrictive than the Senate bill in banning coverage of abortions in plans using federal subsidies of any type.
  
  
• Public Option - The House bill includes a public option, but the Senate bill does not.  Instead, the Senate version provides for health plans offered by private insurers under contracts negotiated with the Federal Office of Personnel Management.
  
  
• Expansion of Medicaid - The House bill would expand Medicaid to 150 percent of the federal poverty level, while the Senate bill expands Medicaid to 133 percent of the federal poverty level.
  
  
• Taxes and Penalties - The House version establishes new income taxes on single people making more than $500,000 a year and couples making more than $1,000,000, a new $20 billion fee on medical device manufacturers, penalties paid by individuals and employers who do not obtain coverage, and other taxes and fees.  The Senate version imposes fees on insurance companies, drug makers and medical device manufacturers.  Additionally, under the Senate bill, the Medicare payroll tax would be increased to 2.35 percent on income over $200,000 a year for individuals and $250,000 for couples, and persons using tanning salons will pay a 10 percent sales tax.  The Senate version also imposes a 40 percent excise tax on insurance companies related to premiums on "Cadillac" plans - premiums greater than $8,500 annually for individuals and $23,000 for families,  and imposes fines on people who do not purchase coverage.