Policy-ish

Glimpses Of Compromise Emerge On Health Overhaul

House Speaker Nancy Pelosi reviews health overhaul costs in a Capitol Hill briefing Thursday. i i

hide captionHouse Speaker Nancy Pelosi reviews health overhaul costs in a Capitol Hill briefing Thursday.

Harry Hamburg/AP
House Speaker Nancy Pelosi reviews health overhaul costs in a Capitol Hill briefing Thursday.

House Speaker Nancy Pelosi reviews health overhaul costs in a Capitol Hill briefing Thursday.

Harry Hamburg/AP

Now we've got plenty of health numbers to chew on, and a heightened sense of importance on health overhaul.

President Obama has put off until June a planned trip to Indonesia, so he can focus on getting health overhaul over the legislative hump.

The Congressional Budget Office finally put out its estimate of what the Democrats' health overhaul package would set us back. As expected, the numbers are in line with the tidbits doled out this morning—$940 billion in costs over the first decade and a reduction in the deficit of $138 billion over the same period. Thirty-two million more people would be insured by 2019.

Digging a little deeper, though, yields a few insights into the change made to the bill to make the costs and how the politics work.

Check out the second paragraph on page 4 of the letter from CBO Director Douglas Elmendorf's letter to House Speaker Nancy Pelosi for a few of the key changes.

The revised bill would raise the subsidies for people who need help buying insurance and soften the bite of the Cadillac on high-end health plans.

In a media briefing, Pelosi explained that House Democrats didn't care much for Cadillac tax, so the revised bill rejiggers the threshold for taxation to spare all but the "Platinum-Rolls Royce" plans. The taxes collected on these plans would be cut by 80 percent in the first decade, as compared with the Senate bill.

She also said the Senate bill didn't do "enough on affordability," so that's why the subsidies for buying coverage were increased.

But, going back to the CBO letter, there is a but to some of these changes. The subsidies for buying insurance would grow more slowly starting in 2019 because a stingier formula would be used.

In the press briefing, Pelosi emphasized that a big chunk of the money to fund overhaul was going to come from the elimination of waste, fraud and abuse in Medicare.

But the biggest changes we can find in the Medicare parts of the CBO analysis all have to do with Medicare Advantage, plans offered by private insurers that have been subsidized pretty richly by the feds. The revised bill, for instance, would whack another $13.7 billion from Medicare Advantage over the next 10 years.

Maybe the speaker has a broad definition of waste.

Update: Now the text of the revised bill is here. For an overview, check out this summary from Pelosi's office.

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