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Senate Passes Health Reform Package

Next step is compromise with House plan, before proposal can become law

THURSDAY, Dec. 24 (HealthDay News) -- Senate Democrats gave President Barack Obama a Christmas Eve gift on Thursday with passage of a landmark health care bill that would extend coverage to 31 million uninsured Americans.

Obama said the Senate bill contains 95 percent of the health reforms that he has sought since his inauguration on Jan. 20. "Every single criteria for reform that I put forward is in this bill," the president told the Washington Post.

The 10-year, $871 billion bill would expand health insurance coverage to more than 94 percent of Americans under age 65, including more than 30 million uninsured people; require nearly all Americans to buy insurance; and provide tax credits to help low-income individuals and families pay for coverage. Exclusions on pre-existing medical conditions -- a longstanding practice of the insurance industry-- would be a thing of the past.

The final Senate vote had 58 Democrats and two independents voting "yes" and Republicans unanimously voting "no," the Associated Press reported.

Democrats hailed the passage of the bill, saying in a prepared statement that the "historic health reform legislation" would "extend affordable, quality coverage to millions of Americans in a fiscally responsible way. Our bill saves lives, saves money and saves Medicare."

Republicans countered that the bill would damage Medicare through projected spending cuts, and add billions of dollars to the federal deficit at a time when the nation can't afford such a massive undertaking.

Still, the health reform package won't make its way to the White House until early next year, because House and Senate negotiators must huddle to iron out differences between their respective bills. Assuming they reach an agreement, each chamber must vote on a compromise version. If the House and Senate pass the compromise measure, then it would go to Obama for his signature, becoming law.

Some of the differences between the two bills could prove contentious, including stricter provisions in the House proposal against using taxpayer money to pay for abortion coverage and the House's income tax increase for high-earning Americans to help pay for the expanded coverage, the AP reported.

If the bill becomes law, it would represent the most significant change to the nation's health system since the introduction of Medicare in the 1960s.

Earlier this week, several prominent health-care experts threw their support behind the Senate version of the health reform package.

"Overall, it is a multi-dimensional attack on the problems of our health-care system," said Karen Davis, president of the Commonwealth Fund, and includes all of the essential elements for achieving the goals of ensuring access to care, making coverage more affordable and slowing the growth of health-care costs.

The American Medical Association on Monday announced its support of the Senate bill.

"All Americans deserve affordable, high-quality health coverage so they can get the medical care they need -- and this bill advances many of our priority issues for achieving the vision of a health system that works for patients and physicians," AMA President-elect Dr. Cecil B. Wilson said in a statement.

While Obama remains steadfast in his drive for health reform, the latest polling data from the Henry J. Kaiser Family Foundation suggests that the American public's outlook soured somewhat in December. Fifty-four percent of Americans now support health reform, while 41 percent say the nation cannot afford to take on health reform now. Those percentages mirror the spread in August, when angry citizens lambasted members of Congress at town hall debates across the country.

Thirty-five percent of Americans in December said they would be better off if Congress passed health reform, down 7 percentage points from November. The percentage who said they'd be worse off rose 3 points to 27 percent.

The Senate bill requires most people, with some limited exceptions, to have health insurance coverage. Those who don't buy coverage that meets federal standards would pay a fine of $95 in 2014. That fine would rise to $750 in 2016.

One policy expert who touts free-market ideas in health care said the Senate bill, with its threat of fines and other penalties, bodes ill for consumers.

"It's all about devolving power and control over health care -- one-sixth of our economy -- to Washington," said Grace-Marie Turner, president of the Alexandria, Va.-based Galen Institute, a non-profit public policy research organization that says it's devoted to advancing free-market ideas in health policy.

The Senate version does not include a so-called public health option. But it does allow the federal Office of Personnel Management to negotiate with private health plans to offer coverage to the uninsured.

AARP, an advocate of the Senate measure, said the bill would strengthen Medicare for beneficiaries.

"The thing that's probably most important over time is it saves them a lot of money," said John Rother, executive vice president of the AARP. Seniors will save money on premiums and out-of-pocket costs, he said, adding, "It also saves them money by making preventive services free."

Still, there's some unfinished business as far as seniors are concerned.

"The most obvious thing for us is it does not finish the job of closing the 'doughnut hole' in the Medicare drug benefit and, of course, we have commitments from the Majority Leader and senior members to do so in the conference with the House," Rother said.

More information

To see how the Senate and House versions of health reform size up, visit The Commonwealth Fund.

SOURCES: Karen Davis, Ph.D., president, The Commonwealth Fund, New York City; John Rother, executive vice president, AARP, Washington, D.C.; Grace-Marie Turner, president, Galen Institute, Alexandria, Va.; Dec. 21, 2009, news release, American Medical Association; December 2009, Kaiser Health Tracking Poll, Henry J. Kaiser Family Foundation, Menlo Park, Calif.; Washington Post; Associated Press

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