Making Sense of the Debate on Health Care

Three Major Reform Bills Offer Different Blends Of Penalties and Perks

By ANNA WILDE MATHEWS
WSJ

Lawmakers are trying to crunch 2,079 pages of health-insurance overhaul proposals into a sweeping new law. As they do, some key decisions could impact your wallet and your coverage.

The three major bills now being debated have broadly similar outlines that probably won't change. They would expand the number of Americans with health insurance by requiring nearly everyone to have coverage and helping lower-income people purchase plans. All three would force insurers to sell to people even if they have health problems. And they would grandfather existing insurance so people can keep their current plans.

But the bills also have important differences that can affect us as health-care consumers.

Some key areas where consumers might see the impact of different overhaul proposals:

• Taxes: Some options would tax upper-income people or the richest health plans.
• Premiums: Proposals vary on how much insurers can raise rates based on age.
• Exemptions: Bills have different rules about who's required to have insurance.
• Medicare: A big difference is how the bills handle the drug-benefit 'doughnut hole.'

House leaders are trying to pull together a bill for a vote. In the Senate, the health committee passed a bill in July, and the Finance Committee is still working to finish its own. The two are then supposed to be merged into a final version. A bill that gets through the Senate is likely to be seen as the bellwether, at least on the most politically contentious provisions.

Here are five important consumer issues that will have to be resolved:

Taxes. Someone would have to pay new taxes if a bill passes, and the question is who. The House bill's levies are squarely aimed at wealthier Americans, with a surtax on married couples making more than $350,000 and individuals above $280,000. But House leaders have already signaled they're considering changes, including potentially bumping up those income levels.

(More here.)