From what I’m hearing, the specifics will look something like this. The Senate Finance Bill gets to 94 percent coverage. The House bill will hit 96 percent. The Senate Finance bill spends a bit over $450 billion on subsidies to help people afford insurance. The House bill will spend more than $700 billion. The Senate Finance bill doesn’t have an employer mandate. The House bill does. The Senate Finance bill funds itself by taxing family health-care benefits over $21,000. The House bill funds itself by taxing incomes over $500,000. The Senate Finance bill expands Medicaid. The House bill expands Medicaid by more. The Senate Finance bill costs $829 billion. The House bill costs $871 billion.And the rumor is that there are some other goodies in there, but I’ve not been able to confirm that yet.
The House bill, in other words, will cover more people at a more affordable cost to individuals. It can do this for a number of reasons, but the big one is that it saves a lot of money by including a strong public option and a real individual mandate. The combination of those two policies allows the government and individuals to pay a bit less while encouraging employers to pay a bit more. Its funding mechanism is a whole lot more popular than taxing health-care plans, but it will also do less to “bend the curve.”
(emphasis in the original)
Not a whole lot to add; Klein's a thorough guy.
To clarify on the mandates, though: an individual mandate would make it the responsibility of each person to get insurance, like the system we currently have for car insurance. Obviously this is difficult for the less affluent, though, which is why the subsidy rate is so important. The 3x subsidy funding in the House bill would go straight into the pockets of the families that need insurance most but couldn't afford it (or the new penalties for not having it).
The employer mandate would work in conjunction with the individual one by requiring that businesses offer their employees coverage. This also broadens coverage, brings in more competition, and would also be helped by a robust public option. With these mandates to bring in vast numbers of new customers, a non-profit force to drive competition will be that much more important.
Unfortunately this isn't a strictly finance- or health-based debate. I don't really have a lot of ideology invested in this: if it covers more people, with more stability, for less, let's go for it. We're just so behind the ball on this compared with other industrialized democracies... We cover fewer people and pay 150% for no discernible improvement in outcome. I can only hope that more of the stronger House bill ends up in the final product, but this is such a fragile, ideological balancing act that I'm not sure how optimistic to be. Are we close enough to the 2010 elections? Will legislators' votes on health care reform be the ultimate decider when they roll around? And would any Republicans cross over anyway, no matter how watered-down the bill is? Given the complexity of the political situation, I plan to sit tight, encourage the strongest bill, and hope that it makes it through the grandstanding and posturing that will assail it until the very end.
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