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New Health Reform Features Public Option, Individual Mandate, Payment Changes

Janice Simmons, for HealthLeaders Media, July 14, 2009

House Democrats Tuesday unveiled their new 1,018-page Tri-Committee healthcare reform bill that includes a health insurance exchange, public policy option, individual and employer "pay or play" provisions, and a surtax on upper incomes.

How much the bill will cost, though, is still not known: While the Congressional Budget Office released a preliminary analysis on Tuesday, it noted that more time was needed to review updated language included in the just-released bill. Mark-up will begin on the measure in the three committees—Energy and Commerce, Ways and Means, and Education and Labor—on Thursday; Wednesday will be reserved for opening statements from committee members.

In introducing the bill, House Speaker Nancy Pelosi (D-CA) called the measure "a starting point" that addresses costs, individual choice, and quality issues. "Inaction is not an option for us. That is why we are still on schedule to do what we have planned, to vote on this legislation before we leave for the August recess."

"We are trying to achieve a number of different objectives, but holding down the costs in healthcare is certainly, by far, our number one objective," said House Energy and Commerce Chairman Henry Waxman (D-CA). "The system is unsustainable. We cannot continue to put more and more money into healthcare—especially when you recognize that this country spends more money on healthcare than any other Western industrialized nation."

Not surprisingly, GOP members—who just saw copies of the new bill themselves on Tuesday—were vocal in their opposition. Rep. Roy Blunt (R-MO), chairman of the Republican Health Care Solutions Group, said the bill would eliminate jobs, raise taxes, limit access to healthcare, "and lead to a government takeover of healthcare." He proposed offering an amendment that would require all federal officials to enroll in the public insurance plan "if it was such a good deal for the American people."

Rep. Joe Barton (D-TX), the ranking minority member on Energy and Commerce, argued that hurrying to approve a bill before the July 31 recess was a mistake because "healthcare is too big an issue to rush." He predicted that the votes would not be there in the end to approve the bill because of its various taxes, mandates, and the push to "eliminate physician owned hospitals, which in those states that allow them have been chosen as an efficient way to get healthcare."

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