Details are leaking out about the content of the final house bill. We will clearly have a longer analysis in the days and weeks to come....but here are a few highlights.
First, specific to the physician community -- The permanent SGR fix was carved out of the bill and will be introduced today as a stand alone bill. We all saw this coming with the failure of S1776 in the Senate. We shall see if a one or two year patch gets added to the bill in the amendment process.
As for the public option, the House bill does include one -- but one that is not tied to Medicare rates. Rather payment would be negotiated directly with hospitals and physicians similar to private insurance.
Overall, the bill provides coverage to 35 million or 36 million people. The bill expands Medicaid to cover childless adults, parents and others with incomes less than 150 percent of the poverty level, or $33,075 for a family of four. Additionally, there are subsidies up to 400% of poverty.
PhRMA will pay to close the donut hole completely by 2019, dual-eligible and low-income seniors will get drug rebates under Medicare and HHS will gain authority to negotiate Medicare drug prices.
The new bill, like an earlier version, retains a surtax on high-income people, but increases the thresholds. The tax would hit married couples with adjusted gross incomes exceeding $1 million a year and individuals over $500,000. This "millionaire's tax" would affect three-tenths of 1 percent of all households.
The 10-year cost of expanding coverage would be less than the $900 billion ceiling. The CBO analysis will show that the bill runs surpluses in the first five years and deficits in the second, making it deficit neutral during the first decade.
More details to come...