Health care reform narrowly passed in the U.S. House of Representatives, Sunday night, and is now expected to easily pass the Senate.
Democrats -- particularly leaders Pres. Obama, House Speaker Pelosi and Senate Majority Leader Reid -- have succeeded in narrowly passing a health care reform bill, despite complete Republican opposition.
For the first time, most Americans would be required to purchase insurance, and face penalties if they refused. Much of the money in the bill would be devoted to subsidies to help families at incomes of up to $88,000 a year pay their premiums.
The large and complex legislation involved several benefits and costs, including these:
FEATURES (including benefits and requirements):
Mandatory insurance requirements for most Americans -- partially offset by government subsidies (especially for the poor) The non-partisian Congressional Budget Office predicts 32 million uninsured Americans -- about 1 in 10 Americans -- will now acquire health care insurance as a result.
Insurance companies will have to provide coverage without regard to pre-existing conditions.
Insurance companies will not be allowed to dump someone who becomes sick.
Closes the "donut hole" gap in prescription drug coverage for seniors.
PAYING FOR IT:
Savings in health care expenditures (the non-partisan Congressional Budget Office predicts it will result in a $138 billion reduction in the federal deficit over the next 10 years; some analysts believe it will cut costs by getting more people medical care before their problems become irreversible or catastrophic).
Reductions in future payments to institutions caring for Medicare patients (hospitals, nursing homes, hospices, etc.)
Higher payroll (Medicare/Medicaid) taxes, chiefly on the rich (folks with household incomes over $200,000), and by
New payroll taxes on large health-care benefits. (see CONCESSIONS, below)
Juggling money between existing Medicare, Medicaid and the new health care provisions.
Support from pharmaceutical companies, for covering the "donut hole", in exchange for concessions from the Democrats. (Drug companies were facing hositile regulation, legislation and taxes resulting from rising drug costs and consumer/voter frustrations).
The program will be chiefly paid for by:
Pres. Obama promised anti-abortion Democrats that he will issue an executive order forbidding the use of the program to fund elective abortions.
Unions persuaded Democrats to water down planned taxes on big health insurance benefits (benefits largely won for workers by the unions). Taxes on those comparatively lavish insurance benefits had originally been planned to help pay for the overall health care plan.
Federally-guaranteed college student loans for (another priority for Democrats) will now be directly funded by the government, rather than acquired through private banks and lenders. Until now, all federal-backed student loans had to come through banks, greatly enriching the banking industry.
Several late changes to the bill were made to ensure passage:
This event is considered by most observers, and most politicians on both sides of the debate, to be a "watershed" moment in American politics and government:
The first major "national health care program" since Medicare and Medicaid, and
The first program EVER to essentially guarantee health care for nearly ALL Americans.