Senate vs. House bills

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Sunday, November 22, 2009

Government-run insurance

Each bill creates a public option. The Senate bill allows states to opt out.

Individual mandate

Each bill requires people to buy insurance or pay a penalty -- $750 by 2016 in the Senate bill and 2.5 percent of income in the House bill.

Subsidies/exchanges

Each bill sets up insurance marketplaces, called exchanges, in which people without access to affordable coverage through an employer can buy plans. Subsidies are available to households earning up to 400 percent of the poverty level, or $88,200 for a family of four.

Employer mandate

The Senate bill does not require employers to offer health insurance, but it fines employers with more than 50 employees if even one receives a subsidy through the new exchanges. The fine is equal to $750 for every person on the payroll.

The House bill requires employers to pay 65 percent of family premiums or pay a penalty based on payroll; businesses with less than $500,000 in payroll are exempt.

Abortion provision

The Senate bill bars the use of federal funds for abortion but doesn't go as far as the House bill. It requires at least one plan in the exchange to offer abortion and one that doesn't.

The House bill bans abortion from being covered in the public option or in the exchange's private plans that take subsidized costumers. There is an exemption if a woman's life is in danger or in cases of rape or incest.

Medicaid expansion

The Senate bill expands Medicaid to cover everyone earning less than 133 percent of the federal poverty level, or $29,327 for a family of four.

The House bill expands Medicaid to cover households earning less than 150 percent of the federal poverty level, or $33,075 for a family of four.

Insurance reforms

Each bill includes bans on lifetime limits, premium disparity based on health status and sex, and coverage denials based on preexisting conditions.


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