Final Senate health bill includes many last-minute changes

New outlets detailed Majority Leader Harry Reid's final changes to the Senate health care bill.

The Associated Press reports that the changes were "designed to solidify support. Among them was an increase in the Medicare payroll tax of 0.9 percent on income over $200,000 a year for individuals and $250,000 for couples. The bill earlier raised those taxes by 0.5 percent."

"The estimated 30 million Americans purchasing coverage through new insurance exchanges would have the option of signing up for national plans overseen by the same office that manages health coverage for federal employees and members of Congress. Those plans would be privately owned, but operated on a nonprofit basis, as many Blue Cross Blue Shield plans are now. The option amounts to a consolation prize for liberals, who failed to include a government-run alternative" (Espo and Alonso-Zaldivar, 12/19).

Related earlier KHN story: 10 Experts Weigh In On Plan To Replace Public Option In Health Bill (12/14).

Bloomberg: "As soon as the legislation is enacted, children couldn't be denied insurance coverage because of a pre-existing medical condition, the summary said. Patients could also appeal decisions to deny a coverage claim to an independent board" (Litvan and Jensen, 12/19).

Reuters notes that some of the revisions would target health "industry profits and taxes ... health insurance plans for large groups would have to spend at least 85 cents out of every dollar on medical costs. That means just 15 cents could go toward overhead and executive salaries, among other things. Small groups or individual plans would have to spend at least 80 cents on the dollar for care. That proportion of spending, known as a 'medical loss ratio,' has a major impact on how much profit companies can make and is closely eyed by Wall Street. Consumer groups and other critics have long argued that insurers aim to trim medical spending and raise customer costs to boost profits and please shareholders, a charge the industry has denied, saying premium increases mirror rising healthcare costs overall. (Heavey, 12/19).

The Hill reports that the bill now includes "a 10 percent tax on 'indoor tanning services.' The tax is replaces a handful of cosmetic-related taxes the original Senate health bill had included," referred to as the "Bo-tax" (O'Brien, 12/19).

The New York Times: "The term 'Christmas tree' has its own special meaning on Capitol Hill. It usually refers to a bill that has been decorated with 'ornaments,' loaded up with special goodies for the folks back home. But the term is particularly apt this week, as Senator Harry Reid, the majority leader, works to have a vote on a heavily festooned health care bill by Christmas Eve." 

Some of the "decorations" listed by The Times include: "The Hawaii exemption, a measure that allows the state to keep its own health care system." and "A break on the excise tax on so-called Cadillac health insurance plans for people in the 17 states where premiums are the highest.  ... But these ornaments are mere baubles compared with some of the neon measures that some lawmakers and lobbyists have fought to keep out of the bill. Most prominent was the demand by Senator Joseph I. Lieberman, independent of Connecticut, that leaders drop two provisions that the insurance industry and big business had been lobbying vociferously against" (Seelye, 12/19).