Democrats in the US House of Representatives unveiled a sweeping healthcare overhaul on Thursday that would transform the insurance market, create a government-run insurance plan and levy new taxes on the rich.
Weeks of closed-door talks to merge three House healthcare plans produced a 1,990-page bill that drew cheers from US President Barack Obama but sparked an immediate fight with Republicans over its cost and size.
“Today we are about to deliver on the promise of making affordable, quality health care available for all Americans,” House Speaker Nancy Pelosi said in a ceremony on the steps of the US Capitol.
The bill’s release was another step forward in Obama’s drive for a healthcare overhaul that reins in costs, reforms the insurance industry and expands coverage to many of the 46 million uninsured living in the US.
Obama has made reform of the US$2.5 trillion healthcare industry, which constitutes one-sixth of the economy, his top domestic priority.
The bill was met with unanimous opposition from Republicans and grumbling from some Democrats. Party liberals had sought a stronger public insurance option and party moderates want assurances that federal funds will not be used to pay for abortions under the measure.
The legislation could be debated in the House as soon as next week. The Senate is putting together its own version, and the House and Senate bills eventually must be combined before being sent to Obama for his signature.
The nonpartisan Congressional Budget Office said the measure would cost a net US$894 billion over 10 years — just below Obama’s target of US$900 billion — and reduce the deficit by US$104 billion over the same period.
But Republicans highlighted the budget office’s estimate that the bill’s health coverage would cost a gross US$1.055 trillion, and a public insurance plan would “typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges.”
“Tell me how we’re going to fix our healthcare system with 1,990 pages of bureaucracy,” said House Republican leader John Boehner, who urged Democrats to slow down the process and allow a full floor debate.
Obama praised the bill’s insurance industry reforms and said he was pleased it featured a public insurance option and was fiscally responsible.
“The House bill clearly meets two of the fundamental criteria I have set out: It is fully paid for and will reduce the deficit in the long term,” he said in a statement.
The House bill would expand coverage to 36 million uninsured people living in the US, the budget office said. It would offer subsidies to help the uninsured purchase insurance through newly created exchanges.
It requires individuals to buy insurance and all but the smallest employers to offer health coverage to workers. It also would bar insurers from refusing to cover people with pre-existing medical conditions and eliminate the industry’s exemption from federal antitrust laws.
The House proposal includes a 5.4 percent surtax on individuals making more than US$500,000 and couples earning more than US$1 million to help pay for covering the uninsured.
It would save money by expanding eligibility for the government’s Medicaid health insurance program for the poor to those with incomes up to 150 percent of the official poverty level. Covering people through Medicaid is cheaper for the government than providing subsidies to purchase insurance.
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