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An Update On Health Care Overhaul Plan

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An Update On Health Care Overhaul Plan

Health Care

An Update On Health Care Overhaul Plan

An Update On Health Care Overhaul Plan

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NPR's Julie Rovner brings host Jacki Lyden up to date on the national debate about revamping health care. Potential parts of the plan include a mandate that all Americans have health insurance, new taxes to pay for the new system and a new government-financed health insurance plan for the uninsured.


For a look at that national picture, we turn now to NPR's health policy correspondent Julie Rovner.

Hi, Julie.


LYDEN: Julie, let's pick up where Karen Brown left off. How likely is it that we'll see Congress require that all Americans have health insurance?

ROVNER: Well, certainly it is a goal of President Obama and many Democrats and some Republicans in Congress that everyone have health insurance, that there be universal coverage. So that is certainly a goal. Now whether people will be required to have coverage is another question.

There's another element to this. The insurance industry, the health insurance industry says that it is ready to make what it considers sacrifices: to not charge people more if they have pre-existing conditions, to not charge women more, but only if everyone is covered so that they get the healthy people into the pool in addition to the sick people into the pool. And for that they would need some sort of mandate. So this is a big issue that's being argued about.

Now it's not quite as big as the issue about whether there is going to be a public plan. That's really the biggest issue that Congress is grappling with.

LYDEN: So break it down for me. How would a public plan work?

ROVNER: Well, it depends how you define a public plan. You could have a public plan that would be like Medicare. Medicare is funded by the government and basically run by the government. They decide what the prices are going to be for doctor care and hospital care and pay all the bills, or you could have a public plan like many states have for their state workers, where basically the state pays the premiums but hires a private insurer to run it - you know, parcel it out to a private insurer. So there's a public plan, and there's a public plan.

LYDEN: This all sounds very expensive. And it spurred a lot of discussion about how to pay for it, cutting health care costs, taxes on health insurance benefits, even new taxes on sweetened drinks. What do you think is likely to emerge from all of this?

ROVNER: Well, an awful lot of arguing and ducking and bobbing and weaving. Basically what Congress is talking about tends to cost in the neighborhood of about $1.5 trillion. So it's a lot of money, and they're going to have to find that money.

Congressional rules require them to offset that money, which means that they have to either raise taxes or cut spending somewhere else. And they are indeed looking at all those things that you mentioned: taxes on sugared soft drinks, perhaps raising taxes on alcohol, perhaps cutting some of the spending in Medicare.

I think in the end, Congress is going to try to do a little bit of everything to try perhaps to minimize the pain or at least spread the pain around as much as they possibly can.

LYDEN: And I'm just thinking $1.5 trillion is the size of the U.S. debt to China, Julie. I understand the Senate is farther along in considering this health care overhaul. Tell us what we're likely to see over the summer weeks and months ahead, will you?

ROVNER: Well, we're certainly looking at a very ambitious schedule. The Senate Finance Committee is expecting to start its markup. That's where it actually sits down and members vote on and actually write this bill. Sometime in mid-June, the Senate HELP Committee, the Health, Education, Labor and Pensions Committee, is expected also about that timeframe to start doing that. That's with a goal of getting a bill to the Senate floor in July. I imagine it will take most of the month of July to get a health bill to and through the Senate.

The House also expects to get a bill onto and off the House floor before the August recess. Remember Congress is gone for the month of August. That would give the House and Senate basically the fall to reconcile these two bills, to put them together and come up with a final bill with the hope of getting it to the president's desk before the end of the year.

LYDEN: NPR's Julie Rovner, joining us from our studios at NPR West. Julie, thanks a lot.

ROVNER: You're welcome.

LYDEN: You can find out more about how the health insurance mandate works in Massachusetts on our Web site at

And Karen Brown's story on the health care system in that state was the product of a new collaboration between NPR and Kaiser Health News, a nonprofit news service.

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