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Comparing the Three Main Health Reform Bills

John Commins and Janice Simmons, August 4, 2009

Nobody knows what the final healthcare reform package that emerges from Congress will include. In fact, at this point, nobody knows if anything resembling comprehensive healthcare reform will pass Congress this year.

As Congress goes into August recess, many lawmakers in both parties are saying they intend to hold public meetings with constituents to gauge their support–or disapproval–of the health plans on the table.

Here's a quick look at the three plans now getting the most attention. Keep in mind that there are a lot of moving parts in these plans, and the details can fluctuate dramatically from day to day.

HR 3200, the America's Affordable Health Choices Act, aka The Tri-Conference Bill. This bill is the joint creation of three separate House committees: Education and Labor; Ways and Means; and Energy and Commerce. The bill has passed all three committees, mostly along party lines–with some conservative "Blue Dog" Democrats joining Republicans in opposition because of cost concerns. The bill is expected to be heard by the full House when lawmakers return in September. The most controversial component in the 1,018-page HR 3200 is the creation of a public insurance option and healthcare exchange that would allow consumers the option of choosing either private coverage or a new government-run public plan.

The bill also calls for:

  • Expanding access to health insurance
  • Standardized benefits packages
  • Provisions to end premium increases or coverage denials for "pre-existing" conditions
  • Eliminating copays for preventive care
  • "Affordability credits" to make premiums affordable
  • Caps on out-of-pocket expenses
  • Employer mandate, which is being called pay or play
  • Guaranteed catastrophic coverage

The Affordable Health Choices Act, aka the Senate HELP Committee bill. The Senate Health, Education, Labor and Pensions Committee passed this package in mid-July, but it's still in mark-up and has yet to receive a bill number. Supporters of this bill boast that it is truly bipartisan, and includes 160 Republican amendments. However, the bill cleared the committee on a 13-10 party-line vote.

The bill is expected to be merged with whatever bill emerges from the Senate Finance Committee. Like the House bill, the HELP bill has a health insurance exchange, referred to in the bill as an "Affordable Health Benefit Gateway," which states would be responsible for establishing. It also features a government-run, public health insurance option that would compete with private insurers to drive costs down.

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