Health Care: Key Differences Between House and Senate Bills

The Senate this morning took another step toward passing a $871 billion health care bill with a vote to cut off debate and pass a 383-page amendment. But the battle is far from over.

After senators pass the health care legislation, it will have to be reconciled with the House bill in the conference committee. Both chambers have to approve the exact same bill, with a simple majority, before sending it to the president.

VIDEO: The next step for health care is to merge the two pieces of legislation.

Democrats say the final health care bill will pass before President Obama's State of the Union address in February. But they could face a tough time resolving differences among members of their own caucus.

Even though both health care bills were crafted by Democrats and are similar in some ways, there are several significant differences between the two.

Some senators, such as Democrat Ben Nelson of Nebraska, have warned that they could yank their support for the health care bill if changes are made. For some members of the Senate, the House version of the health care bill was dead on arrival and many say that members of the House will simply have to cave in.

Meanwhile, some House Democrats, such as Rep. Bart Stupak of Michigan, who wanted strict language prohibiting federal funding for abortion, say they are unhappy with the language in the Senate bill. Stupak has refused to back down from his abortion amendment, saying he won't settle for anything less than outlined in his proposal, which would prohibit insurance firms that participate in a proposed health insurance exchange from covering abortion services.

Here is a look at some of the key similarities and differences between the House and Senate bills:


The Senate bill curbs costs by taxing so-called "Cadillac plans," high-deductible insurance plans that some believe are one of the reasons for high insurance costs. The plan would impose a 40 percent tax on insurance coverage in which premiums are more than $8,500 for an individual and $23,000 for a family. The Senate bill, however, 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.


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.

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