House Democrats Unveil $1.06 Trillion Health Care Bill

Cost may exceed threshold set by Obama, would cover 96 percent of Americans.

October 29, 2009, 11:09 AM

Oct. 29, 2009— -- Speaker of the House Nancy Pelosi, D-Calif., today unveiled the House Democrats' broad new $1.055 trillion health care bill, saying it would provide "universal quality affordable health care for all Americans."

President Obama praised the bill, saying it would benefit small businesses and that those participating in a government-run health care plan could save a quarter of their premiums by 2016.

"As I've said throughout this process, a public option that competes with private insurers is the best way to ensure choice and competition that are so badly needed in today's market. And the House bill clearly meets two of the fundamental criteria I have set out: It is fully paid for and will reduce the deficit in the long term," the president said in a written statement.

When Pelosi unveiled the "Affordable Health Care for America Act" today, House Democrats circulated a bill summary saying it would cost $894 billion, allowing Pelosi to say the bill, "meets President Obama's call to keep the cost under $900 billion over 10 years."

But the total cost of the bill actually is $1.055 trillion.

How did they get the lower number?

They took the $1.055 trillion total cost and subtracted the amount of money that was estimated to come in from people and companies that pay fines for not having or not providing health insurance (more than $160 billion), giving a new "net" cost of $894 billion.

By using that method of accounting, the "net" cost of a bill that passed the Senate Finance Committee is $518 billion over 10 years. The actual cost of the Finance bill, as widely reported and cited by Senate Finance Committee Chairman Max Baucus, D-Mont., was $829 billion.

Pelosi has said she wants to see debate begin on the bill by next week, with a vote before Veterans Day. Some congressional aides say Democrats may not move on a full vote until they have assured there will be ample votes to pass the legislation on the House floor. The bill still has a long way to go before it makes its way to Obama's desk. The House legislation would have to merge with Senate legislation and key differences remain, especially on the type of public option plan that should be included.

This is a "historic moment for our nation and our families," said Pelosi, speaking on the steps at the West Front of the Capitol building. "The drive for health care reform is moving forward."

Congress is "on the cusp of delivering on the promise of making affordable, quality health insurance available to every American -- and laying the foundation for a brighter future for generations to come," she added.

The legislation would insure 36 million more Americans in the next 10 years, covering 96 percent of all Americans, Pelosi said. That is more than the Senate bill currently being negotiated, which would cover an estimated 29 million additional people.

The speaker also said the bill would not add a dime to the deficit, an important factor considering Obama has said he will not sign any legislation which does so.

According to the Congressional Budget Office (CBO), the bill would cut the deficit by about $30 million in the first 10 years.

"What a day for Americans and what a day for our people," House Majority Leader Steny Hoyer, D-Md., said. "Today, we are one step further on one long, hard road."

The proposed legislation would also expand Medicaid coverage and provide more support to low-income citizens.

Republicans, as expected, assailed the Pelosi bill, saying its 1,990 pages don't reflect any change.

House Minority Leader John Boehner, R-Ohio, billed it as a "government takeover of the health care system."

"It's not just the so-called government option, it's the over 50 mandates, bureaucracies, tax hikes -- All of this is going to require tens of thousands of new federal employees, which is clearly designed for a government takeover of our health care system," Boehner, with a printout of the entire bill in front of him, told reporters. "How are we going to fix our health care system with 1,990 pages of bureaucracy?"

Rep. Roy Blunt, R-Mo., said that while the House bill is already huge, it is highly likely to get even bigger with the addition of what he expects will be an 800-page amendment by the time it gets to the floor. "Nobody will know what's in this piece of legislation," he said. "It's possible this will now collapse, literally, on its own weight, and for everybody here whose lifted this bill, it has some weight."

Inching Closer to Health Care Legislation

As House Democratic leaders unveiled the bill, their Senate counterparts await estimates from CBO on the finalized bill.

Senate Majority Leader Harry Reid, D-Nev., said earlier this week the Senate legislation will include a public option plan, but he did not divulge any more details.

The House Democrats' bill does include a public option, but it is not the Medicare-like public option that Pelosi wanted. The government-run insurance company created by the proposed bill would negotiate payment rates with health care providers just like private insurance companies. Pelosi simply could not get the votes to pass the "robust" version she preferred.

White House officials said today they have yet to evaluate the legislation, and defended the public option as a plan that would drive down costs, not increase them.

"You've seen people say that this is going to drive policies up in price. I don't think that -- I think whenever you're adding more choices through greater competition into the health care system, you're driving down costs," White House spokesman Robert Gibbs told reporters. "That's what the president wants to see. That's a big aim in health care reform, and I think that's what we're working toward."

The House Democrats' bill also creates a health insurance exchange whereby those who do not get insured through their employers can shop for coverage.

The House bill would require nearly all Americans to sign up for health coverage by 2013, either through their employer, a government program or the new exchange.

There is also an individual mandate requiring all Americans to have health insurance, although the penalties for non-compliance are lower than penalties in the Senate bill, which imposes a maximum fine of $1,500 for families who forgo insurance.

The House bill also includes an employer mandate. Companies who don't offer health insurance will be slapped with a fine, but small businesses are exempt.

The bill will be paid for, in part, with a 5.4 percent surtax imposed on those with incomes over $500,000 for individuals, $1 million for families. This tax increase is likely to be a key point of contention between Democrats, as the Senate version doesn't include this tax.

The House bill contains a long list of insurance reforms, including banning denial of coverage for pre-existing conditions, mandating wellness and prevention coverage, capping out of pocket expenses and prohibiting caps on benefits.

As Pelosi spoke, demonstrators tried to interrupt her remarks, but they were moved quickly by police.

ABC News' Dean Norland contributed to this report.

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