If a principal goal of health care reform is universal coverage, both the House and Senate bills fall short of this ideal. But each bill gets us most of the way there.
According to the CBO, the House bill would extend coverage to an additional 36 million Americans by the year 2019; the Senate bill would add 31 million persons to health insurance rolls. (October 29 CBO report on House bill; December 19 CBO report on Senate bill). The House bill would leave 18 million residents without health insurance and the Senate bill would leave 23 million persons without coverage, of whom about 8 million are not legal residents. (Page 16, CBO report on House bill; page 22, CBO report on Senate bill) As a result the House bill would cover all but 10 million lawful residents, and the Senate bill all but 15 million lawful residents.
The predominant distinction between the bills explaining their differential impact on total coverage lies in the amount of money that each bill provides in subsidies to low income persons and small employers to purchase health insurance. The House bill allocates $630 billion over ten years for this purpose; the Senate bill only $476 billion (Page 17 of CBO report on House bill; page 23 of CBO report on Senate bill) One of the principal matters to be reconciled between the two bills is how much funding the law will provide for low income Americans to purchase non-group health insurance through the Exchange.
There are, furthermore, substantial differences between the House and Senate bills in the type of health insurance that Americans will have. The House bill includes a stronger employer mandate, and the CBO predicts that under that bill employer-provided health insurance will actually increase by 6 million enrollees to 168 million persons, as opposed to 162 million under current law. Under the House bill another 21 million people would purchase non-group insurance through the Exchange. The Senate bill lacks a strong employer mandate, and the CBO estimates that 4 million fewer people (158 million people) would receive insurance from their employers than would under current law, but that 26 million additional people would purchase insurance through the Exchange. (Page 16, House; page 22 Senate). This accounts for the difference in total insurance coverage – the House bill would result in 10 million more people being covered by employer-sponsored plans than under the Senate bill, and 5 million fewer through the Exchange.
Visit Professor Huhn's website on health care financing reform for links to information about proposed legislation, studies and reports, public agencies, and private organizations concerned with this issue.
{ 4 comments… read them below or add one }
Falling about 20 million short on universal coverage is "most of the way there"?
larry,
As opposed to 54 million uninsured, yes. And there would be close to 20 million uninsured only if you count 8 million undocumented aliens who will not be eligible for coverage under either the House or the Senate bill. Do you favor extending universal coverage to them as well? I do not mean that sarcastically, but realistically. That is a debate we will be having as the new immigration bill comes to the fore. They are human beings, just as inherently precious as any citizen, there is a higher percentage of workers among them than among the "native" population, and they are here because our economy needs them. Or, to look at it selfishly, are we better off if our "illlegal" workforce has health care or if it does not?
It just seems like they count when the 54 million number is needed, but don't count and are in fact deemed "unlawful" when the 20 million number is examined, professor. It also seems like the lefties claim worries that this bill is simply a prelude to more government control, free healthcare for illegals, publicly funded abortions, rationing, etc., etc., are the paranoid rantings lunatics and not in the bill, while at the same time claiming that it's a flawed bill but a good start to bigger and better things. Not too many folks are buying it, anymore.
RE: "They are human beings, just as inherently precious as any citizen,"
That, in my opinion, is the same stretch of moral justification that extreme anti-abortionists use to bolster their position. While true that all humans are human, our laws currently differentiate between 'citizens' and 'illegals'. What is the point of establishing citizenship if similar rights are granted to criminals who knowingly ignore our laws? Equal rights are the reward of equal responsibility.
RE: "and they are here because our economy needs them."
Really? Is our standard of living so fragile that we could not exist without the laborers, crop harvesters, and housekeepers that sneak into our country? Put our non-violent prison population to work in 'the fields' and let them earn credit toward early release. We only 'need' illegal workers because we haven't figured out a way to outsource the less glamorous jobs that our spoiled children are socially conditioned to avoid.
RE: "Or, to look at it selfishly, are we better off if our "illlegal" workforce has health care or if it does not?"
What happened to the idea that we are a nation that respects and follows the rule of law? I'm not trying to pick a fight over this, but there needs to be a line in the sand which separates those who obey the laws and those who don't. Unfortunately but realistically there will frequently be unpleasant consequences for those whose actions fall outside the limits of the law. We are all 'better off' if we understand and accept that fact.