10 Issues that Congress will Need to Resolve in Final Reform Bill

6. Paying for healthcare. The Senate bill includes a Medicare payroll tax increase of 0.9% (to 2.35%) for individuals earning more than $200,000 or families making more than $250,000. A tax also is included on high-cost or "Cadillac" plans: a 40% tax is proposed for employer sponsored health coverage that exceeds $8,500 a year for individuals and $23,000 for families. The Senate also raises the threshold for deducting medical expenses from 7.5% to 10%.

In the House bill, the tax rate for high income families would be increased, with a 5.4% income tax surcharge on individuals with incomes over $500,000 and families with incomes over $1 million.

7. Mandated coverage. Under both bills, most Americans will be required to have coverage or face paying penalties. But some differences still exist. Under the House bill, individuals would have to have coverage by 2013 or pay up to 2.5% of their income; the penalty, however, could not surpass the average cost of a plan found in the exchanges.

In the Senate version, which would take effect by 2014, the penalty for not having coverage is $95 in 2014 or 0.5% of an individual's income—whichever is higher. This penalty would climb in 2016 to $750, or 2% of income—up to the cost of the cheapest health plan.

8. Employers. In the House bill, large employers would be required to offer coverage to their employees and contribute at least 72.5% of the premium cost for single coverage and 65% of the premium cost for family coverage of the lowest cost plan; or pay 8% of payroll into a health insurance exchange trust fund.

The Senate bill requires companies with 50 or more full time employees who do not offer coverage to pay $750 per employee to a trust fund if at least one employee obtains subsidized coverage through the exchange.

The House bill exempts small businesses with payrolls of less than $500,000. The Senate bill exempts firms with less than 50 employees from providing or contributing to coverage.

9. Health and wellness. Both bills call for establishing a fund to provide resources for community based prevention programs, childhood obesity programs, and other similar public health programs. The Senate bill, though, creates a new annual wellness visit, including a health risk assessment and personalized prevention plan, for Medicare beneficiaries.

10. Abortion language. The House bill has strict language: plans in the insurance exchanges that accept federal subsidies could not provide abortion services at all. The Senate bill would permit insurers operating in the new exchanges to offer abortion services, but enrollees would have to write separate checks for the abortion coverage.