Senate Health Care Bill Released (And a Comparison Chart)

UPDATE: CBO mistakenly overestimated the deficit-reducing effect of the Medicare Commission in their score. As a result, they now estimate deficit reduction of between 0.25 and 0.5 percent of GDP, as opposed to 0.5 percent in the second decade.

ALSO: Click here for charts and interactive graphs comparing the House and Senate bills.

Today, Senator Reid released his Manager's Amendment of the Patient Protection and Affordable Care, which will likely be passed by the Senate before Christmas. The CBO also released its corrected score of the bill which showed that it would reduce $132 billion over the next decade ($60 billion excluding the CLASS Act). More importantly, the CBO estimates the bill could reduce the deficit in the second ten years by somewhere in the broad range of 0.25 percent and 0.5 percent of GDP. This is somewhat more significant than the previous most recent bills from both the House and Senate, and is largely the result of new rules enhancing the power of the Independent Medicare Advisory Board (The "Medicare Commission").

We will provide more information soon, but for now here is our newest chart comparing the new bill to previous versions:

Provisions Finance Committee Senate Leadership
 Manager's Amendment
Individual Penalties  $4 $8 $15
Employer Payments  $23 $28 $28
Mandate Provisions  $27 $36 $43
       
Exchange Subsidies  ($461)  ($447) ($436)
Medicaid Expansion  ($345)  ($374) ($395)
Small Business Credits  ($23)  ($27) ($40)
Coverage Expansion  ($829) ($848) ($871)
       
Physician Payment Updates  ($11)  ($11) $0
Medicare Prescription Drug Coverage  ($21)  ($23) ($23)
Measures to Slow Health Care Cost Growth  ($14)  ($17) ($12)
Other Spending Changes  ($26)  ($42) ($57)
Other Spending  ($72)  ($93) ($92)
       
Prescription Drug Cost Reductions  $28  $51 $51
Medicare Advantage Cuts  $114  $119 $119
Reductions in Provider Payment Updates  $163  $160 $157*
Medicare Premium Increase  $33  $36 $36
Medicare Payment Commission  $22  $23 $28
Measures to Slow Overall Health Care Cost Growth  $29  $26 $19
Measures to Reduce Federal Health Care Spending  $135  $129 $126
Spending Offsets  $524  $544 $536
       
Excise Tax on High Cost Insurance  $201  $149 $149
Tax Gap and Loopholes Closing  $17  $17 $17
Limits to Health Care Tax Benefits  $42  $43 $41
Fees on Health Care Companies and Taxes on Certain Heath Procedures  $121
  $108 $103
Medicare Payroll Tax Increase for High Earners  n/a  $54 $87
Tax Increases  $382  $370 $398
       
Interactions and Other Spending and Taxes
  $49  $48 $46
Budgetary Impact Subtotal  $81  $57 $60
CLASS Act+  n/a  $72 $72
Total Budgetary Impact  $81  $130 $132
       
Tenth Year Budgetary Impact
 $12 $8 $16
Deficit Reduction in Second Decade  0.25% to 0.5% of GDP 0.25% of GDP 0.25% to 0.5% of GDP
Reduction in Uninsured 29 million
 31 million 31 million

Numbers in billions, with positive numbers representing a reduction in the deficit
Sources: Congressional Budget Office, Joint Committee on Taxation, and Authors' Calculations
*Assumes $10 billion in home health cuts are the result of market-based payment updates
+The CLASS Act makes available government-sponsored long-term care insurance. Because this insurance would have a "vesting period," the provision appears to raise considerable amounts of revenue over the next decade. However, these revenues must ultimately be used to cover the program's costs, and therefore do not belong in the bill as an offset.

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