Obama builds on Senate health bill in hopes of broader support

President Barack Obama's health care proposal, an effort to resuscitate the debate, merges the separate legislation passed in the Senate and House "into a final version that could pass muster in both chambers," The Washington Post reports. "Obama's proposal takes the more modest Senate bill as his basic framework. But, in what is perhaps his proposal's most notable feature, he scales back the Senate bill's main revenue source, a tax on high-cost insurance that he has strongly supported. Instead, he would impose a new tax on the unearned income of the wealthy" (MacGillis and Goldstein, 2/23).

The proposal would change the definition of high-cost "Cadillac" health plans from $23,000 for families in the Senate version to $27,500, USA Today reports. It also increases fees to drug manufacturers and adds a 2.9 percent tax on investment income from $200,000-plus earners to help pay for Medicare. It would charge employers (with over 50 workers) $2,000 a year for each employee without coverage who ends up receiving federal subsidies. The plan would take a deeper bite out of Medicare Advantage premiums than the Senate bill and strip out certain special deals, such as a provision that favored Nebraska's Medicaid program (Fritze, 2/23).

The New York Times: "The director of the Congressional Budget Office, Douglas W. Elmendorf, said on Monday that the White House had not provided enough detail about President Obama's health care plan for the C.B.O. to make a full analysis. ... Senior White House officials said that they expected the insurance coverage provisions in the president's plan would cost $950 billion over 10 years and that by 2019 the proposal would extend coverage to 31 million people who are currently uninsured" (Herszenhorn, 2/22).

Los Angeles Times: "The package could also include traditional Republican healthcare priorities, including new efforts to clamp down on waste and fraud in government healthcare programs. The extent to which GOP ideas are incorporated could depend on the outcome of Thursday's summit. Even without GOP support, Democrats believe that the package could be advanced through a process known as budget reconciliation, which requires only 51 votes in the Senate…" (Levey, 2/23). 

The (Mont.) Missoulian has an analysis of the major elements of the proposal, which also include a plan to close a coverage gap in the Medicare drug program, known as the "doughnut hole," and increases Washington's power to control insurers' premium rates (Dennison, 2/22).

The Minneapolis Star Tribune also offers a primer (2/22).

The plan seeks support from state officials, Health News Florida reports. "The President's proposal would pay 100 percent of the cost of Medicaid for newly eligible recipients from 2014 to 2017, 95 percent through 2019 and 90 percent for 2020 and thereafter. In effect, it extends the favorable treatment that had been accorded to Nebraska in return for the vote of Sen. Ben Nelson to all the states" (2/22).

The proposal reaffirms a provision to create a long-term care insurance program, including the disability insurance program known as the CLASS Act," McKnight's reports (2/23).