Health Care Bill Passes Senate – What Are The Differences Between House and Senate Versions

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Nevada Senator Harry Reid today flanked by supporters
source: Reid

(Best Syndication News) The United States Senate passed an overhaul of the health care system this morning as votes fell along party lines. Like any controversial legislation, it was hailed as a great breakthrough by supporters but denounced by opponents (see details of the bill below).

Vice President Joe Biden sat in as President of the Senate for this historic vote. “The Yays are 60 and the Nays are 39”, HR 3590 as amended passes the Senate with more votes than required over the simple majority. The “Patient Protection and Affordable Care Act” will require all Americans to purchase private health insurance.

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Section 2718 of the bill says it will bring “down the cost of health care coverage.” Opponents say that it will in fact raise the cost and limit choices citing changes in requirements to insurance companies like: No lifetime limits, coverage of preventative health services, extension of dependent coverage and prohibition against rescission.

Proponents of the legislation say that these requirements are needed to insure that Americans do no lose their benefits. The bill will also provide an appeals process through a health insurance consumer assistance or ombudsman. Read the bill here

The bill needs to go to a joint Senate House resolution committee to hash-out the differences.


Both the House and Senate bills will cover 94 percent of all legal residents under 65. The Senate bill will kick-in in 2014 while the house will start in 2013.

Cost and Who Pays?

The cost of the House bill is expected to be $1.055 trillion, but when you factor in the penalties to individuals and employers, the net cost may be $894 billion. But that doesn’t include the increase in drug coverage for seniors under Medicare which could bring it back up to 1.2 trillion.

The Senate would pay for this by charging a 40 percent tax on plans costing over $8,500. Fees from insurance companies, drugmakers, medical device manufacturers will help offset the cost. They would also increase the income tax by 2.35 percent on individuals making more than $200,000 a year and couples making $250,000. The House bill would add a surtax of 5.4 percent on people making more than $500,000 per year.

Public Option

The House bill has a public option while the Senate Bill does not.



The Senate will require nearly everyone to get coverage through their or through a plan through a “health benefit exchange”. Employers with more than 50 employees will pay a fine of $750 if the government ends up subsidized the coverage. If a person does not get insurance, they will be fined $95 in 2014 going up to $750.


The House bill will penalize individuals 2.5 percent on their income. People will be able to apply for hardship waivers. Employers must provide insurance to their employees or be subject to an 8 percent penalty on their payroll. Companies with payrolls under $500,000 will be exempt. That number may go up to $750,000.


The House plan does not provide for abortion while the Senate bill will allow individuals to add the coverage to their plans.

More Changes

Expect patent laws for high-tech cancer drugs to by changed from 14 years to 12 years. In 1984 President Reagan signed the Drug Price Competition and Patent Term Restoration Act which said the patent life for a drug cannot exceed 14 years from the product's approval date (marketing time).

The House bill will remove the anti-trust exemptions that the health insurance industry enjoys. The Senate bill will allow the industry to continue an exemption from antitrust laws covering market allocation, price-fixing and bid rigging.

By: Tom Madison



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