Comparing Costs of the Health Care Reform Bills
UPDATE: CRFB has posted updated charts comparing the cost estimates of the most recent Senate leadership bill, HELP Committee bill, and Senate Finance Bill. To view the most recent comparison of the Senate leadership bill and the House bill, click here.
To see a comparison of the Chairman's Mark and the amended version, click here. For a comparison of of the House Tri-Committee bill and the recent House legislation click here.
Today, the Finance Committee released the "Chairman's Mark" of its proposed health care reform bill, America's Healthy Future Act of 2009. Additionally, the Congressional Budget Office (CBO) and the Joint Committee on Taxation released their budget estimates (seen here and here) associated with the Finance Committee bill.
The bill is now the third major health care reform proposal being considered, along with the House Tri-Committee bill and the Senate HELP bill.
Below, we have broken down the costs and savings from these proposals
(as well as from President Obama's proposed cost-cutting measures) for comparison. In the coming days and weeks, we plan to follow up with further analysis.
| Provisions | House Democrats | HELP Committee | Finance Committee | President's Reserve Fund |
| Individual Penalties | $33 | $36 | $4 | C |
| Employer Payments | $135 | $52 | $23 | C |
| Mandate Provisions | $168 | $88 |
$27 | |
| Exchange Subsidies | ($605) | ($723) | ($461) | C |
| Medicaid Expansion | ($425) | F / ~($500)* | ($345) | C |
| Small Business Credits | ($25) | ($56) | ($23) | C |
| Coverage Expansion | ($1055) | ($779) / ~($1279)* | ($824) | |
| Physician Payment Updates | n/a | n/a | ($11) | C |
| Long-Term Care Insurance | $73 | $58 | n/a | C |
| Reinsurance | ($10) | ($10) | n/a | C |
| Other Spending Changes | ($85) | ($14) | ($26) | C |
| Other Spending | ($123) | $34 | ($63) | |
| Changes in Prescription Drug Payments | $83 | F | $7 | $105 |
| Medicare Advantage Cuts | $170 | F | $114 | $176 |
| Reductions in Provider Payment Updates | $173 | F | $185 | $110 |
| Medicare Premium Increase | n/a | F | $33 | $8 |
| Medicare Payment Commission | n/a | F | $22 | $2 |
| Measures to Slow Overall Health Care Cost Growth | $7 | F | $15 | $47 |
| Measures to Reduce Federal Health Care Spending | $106 | F | $113 | $197 |
| Spending Offsets | $539 | $510 | $645 | |
| Surtax on High Earners | $461 | F | n/a | n/a |
| Limit Itemized Deductions | n/a | F | n/a | $269 |
| Excise Tax on High Cost Insurance | n/a | F | $202 | n/a |
| Tax Gap and Loopholes Closing | $56 | F | $17 | $27 |
| Limits to Health Care Tax Benefits | $23 | F | $42 | n/a |
| Impose Fees on Health Care Companies | $20 | F | $121 |
n/a |
| Tax Increases | $560 | $382 | $296 | |
| Interactions and Other Spending and Taxes |
$15 | $46 | $49 | ($33) |
| Ten Year Deficit Impact |
$104 | ($611) / ~($1111)* | $81 | $908 |
| Tenth Year Deficit | $9 | ($120) | $12 | $130 |
| Reduction in Uninsured | 36 million | 21 million / ~38 million* | 29 million |
n/a |
Numbers in billions, with positive numbers representing a reduction in the deficit
Sources: Congressional Budget Office, Joint Committee on Taxation, Office of Management & Budget, Authors' Calculations
F = Left to Finance Committee
C = Left to Congress
*The HELP Committee bill includes no Medicaid expansion, due to jurisdictional issues. However, they have expressed their intent to do so, and CBO has provided a very rough estimate as to how much that would cost.
See a PDF of the chart here.
