Health Care Bill Passes Senate, Faces New Hurdles in 2010

"Taxing Cadillac plans that don't make people healthier, but just take money out of their pockets because they're paying more for insurance than they need to -- that's actually a good idea and that helps bend the cost curve," Obama said in an interview with NPR.

The Senate bill targets the wealthy also, but by increasing the Medicare payroll tax on individuals who make $200,000 a year and couples who make more than $250,000.

The House, on the other hand, does not include a tax on "Cadillac plans" but it does impose an income tax on the wealthy. Under the House plan, there would be a tax surcharge of 5.4 percent on income over $500,000 in the case of individuals and $1 million for families.


Abortion is likely to be the key point of contention between Democrats in the Senate and the House when they try to reconcile the different bills.

Democrats in both chambers have been deeply divided over abortion language in the health care legislation. The House bill includes Stupak's amendment, which takes federal funding restrictions for abortion further with new language that cuts access to abortions for people who receive federal subsidies and those who purchase insurance through the health insurance exchange, a marketplace where people would be able to shop for and compare insurance plans. It also bans insurance companies participating in the exchange from offering abortion services.

The Senate includes slightly less restrictive language on abortion. In that version of the health care bill, states have the option of banning coverage in insurance plans brought in insurance marketplaces.

Democratic leaders in the House would be happy to concede to the Senate version -- liberal members of the party were unhappy with the abortion language inserted in the bill -- but Stupak told ABC News last week he will not vote for a bill that does not include his language. There are several anti-abortion Democrats in the House who insist on this as a condition to pass the bill.

"We plan on keeping the amendment we had and we've had good conversations with White House officials," Stupak said. "We haven't reached a common ground."

Public Option

The Senate plan does not include the option of a government-run insurance plan, a thorny issue among Democrats. The plan initially had a public option in which states would have the choice of whether they wanted to participate. But Democratic leaders did away with that provision to appease lawmakers such as Nelson and Lieberman.

The House health care bill, however, includes a public option in what becomes one of the biggest health care policy differences between the two bills. Under the House's public option plan, the government would negotiate rates with insurance companies instead of setting fees, as it does in Medicare.

At least 50 Democrats in the House are on the record as saying they will not vote for a bill without this option while Nelson and Lieberman have refused to support a bill that does include a public option.

In her column, Rep. Slaughter said by scrapping the public option, "the Senate has ended up with a bill that isn't worthy of its support."

"Although the art of legislating involves compromise, I believe the Senate went off the rails when it agreed with the Obama Administration to water down the reform bill and no longer include the public option," she wrote.

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