Health Legislation - House Bill vs Senate Bill

Now that both the House and Senate versions have been passed, the next step in the process will be to meld the legislation into a single statute. On November 7, 2009, the U.S. House of Representatives passed the Affordable Health Care for America Act and the U.S. senate passed the Patient Protection and Affordable Care Act on December 24, 2009.

The comparison of the House and Senate versions of the health care legislation pending is not intended to be all encompassing of these massive legislative proposals, but is a reasonable comparison of some of the highlights of each. As this grid goes to press there is public discussion that rather than rectifying the legislation in the House and Senate version through the usual use of a conference committee, the Democrats will bypass that process and reach consensus within their party. This process would effectively lock out any public disclosure of the compromises being made prior to the release of the agreement and of course the Republicans would not be part of the process. This document is not intended to be political and is only a recitation of some of the points without taking any position as to whether they are good or bad. The reader should draw his/her own conclusions on the process and the legislation itself.

A few things should be noted about the prospects of health reform as proposed. The Congressional Budget Office has issued a few reports within the limitations of that office on the cost of these plans. The time horizon basically used is 10 years. The conclusion from the Congressional Budget Office is that within the 10 year period the legislation will either be neutral or have a positive impact on the budget. Others score the budget differently. One of the concerns expressed in even pro reform media is that the costs of this plan?whether House or Senate?will have a very significant negative budgetary impact after the 10 year period. Further, the shortfall in Medicare has not been addressed which is already in the billions of dollars and the long term systemic budget deficits are not addressed. Many state Attorneys General are raising concerns regarding the Constitutionality of the legislation and a number of Governors have raised objections regarding the cost to their state budgets of funding the Medicaid portion with already strained state budgets. Lastly, it seems apparent and Congressional representatives are openly acknowledging that not all Americans will be covered by this legislation making universal coverage an unachieved goal.

The American people will have to decide whether this legislation accomplishes health reform. Chances are they will not really know until 10-20 years from now. What we do know is the cost of either of these plans is going to be trillions of dollars.

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