One of the D's said in an interview regarding the lack of support from the voters, "We don't care what the public thinks." Congratulations. You just committed treason, asshole. That sounds familiar. Who does it remind me of? Oh, yes. Al Gore, when he was on his quest to shred the Constitution so he could be President. When the public opinion was shifting against him, he brushed it off, saying, "This is America!" In other words, we know what's best, the great unwashed should keep their noses out of it. If the politicians are looking to prove to voters that it doesn't matter whether or not they support them, the pols will ignore them anyway despite their promises to listen to them, good going, it's working.
The whole thing is bullshit anyway. The R's were complaining that the only way to stop things was by buying votes. Bullshit. There have been several instances where either the same party held Congress and the White House (Clinton at the start of the first term) or the opposition party held a supermajority that could override any veto (the R's at the start of Clinton's second term). None of them got jack shit done, and that was with things that had public opinion behind them. Now, all of a sudden, the R's either can't or won't cut deals, and the D's are moving faster than any Congress ever. No, there's something else going on.
The R's threw the Presidential election, and now are trying to gear up for the midterms and the Presidency in 2012. They are clearly going to paint themselves as riding to the rescue. Reagan got in office in 1980 with a simple statement to voters -- Are you better off now than you were four years ago? The voters did the rest, and Reagan rolled over Carter. With everyone ready to sweep out the incumbents that pushed the bailouts and health care through, the R's will present themselves as the alternative that will fix the whole thing. This overlooks that voters are pissed, and ANY opposition party is going to win in a walk. The R's will claim they have a mandate from the voters for their philosophy when all they have is the rejection of the other philosophy, they don't actually have the people behind them. Not that reality is going to dissuade them from their fantasy lives. This is about getting themselves in a position to pluck the strings that hold the world, not do right by the public.
For those playing at home, what are the bones of contention? The two separate bills have to be merged into one. Here's where the gaps are:
The Individual Mandate. This requires you to get insurance or else. People get fined $750 a year or 2% of household income, whichever is more. Families get fined $2,250 per year or 2% of household income. Fines go into effect gradually, starting in 2014 (why not right away? Trying to by time for a court challenge to shoot this down?). The only real difference is the House bill makes exemptions for certain low-income people. Not all low-income people, mind you, just certain groups.
Businesses. You got more than 200, you must enroll your people in a health insurance plan, and employees cannot opt out (that'll be great for people with different coverage and providers. At least, until the smaller insurers die off and the biggies are all that is left. Collusion? What's that?) Between 50 and 200, you don't have to offer insurance, but if you don't you have to pay $750 per head each year. 50 or fewer, you're exempt. The House bill has its own way of determining who is required to offer it.
The Public Option. Government-run health insurance in competition with private enterprise is part of the House bill and not part of the Senate bill. This is one of two places where you'll see the sparks fly.
The insurance exchanges. Starting in 2014, if your employer does not provide insurances, you get it from a newly-created protected market -- I mean, exchange. It's really complicated, meaning it's open to abuse and fraud, but who cares, you gotta buy in whether you get screwed or not. The Senate plan would have each one set up by each state working with the feds (they could make more than one if they wanted to). Traditional companies would then compete for customers here, assuming the meet the federal government requirements (RED ALERT! RED ALERT! GOVERNMENT MANIPULATION AT WORK!). The least expensive plans offer catastrophic coverage only, but won't be available to everyone. Like it or not, you're going to pay one way or another. The House bill also creates an exchange on a national level and the public option that would compete with them.
Subsidies. Subsidies would go for people at or below 4X the poverty line ($10,830 for individuals, $22,050 for families). Remember, this is only partial aid, you don't get everything. What the hell are the tax dollars going to? The key difference is what exactly the subsidies will be.
Medicaid expansion. Senate bill: expanded to people or families earning 133% of the poverty level, effective 2014. The House bill is 150% of the poverty level, effective 2013.
High risk applicants. Can't get insurance because of a pre-existing condition? Congratulations, you can get it under a new "national high-risk pool" with comparable rates (thank you for upping my copay, assholes). It will start within 90 days of teh bill becoming law. The House bill has different premiums and deductibles.
Lifetime limits. Insurers can't cap your benefits or cancel coverage unless you commit fraud, effective 2010. 2014 will see tougher limits. The House bill is all that, plus further restrictions on who can be denied coverage due to pre-existing conditions.
New taxes. You knew this was coming. A lot of long-standing tax credits and deductions are going bye-bye, and taxes on some other benefits will go up. There's a tax on gold-plated plans that provide lavish benefits but are expensive (threshold is $8,500 of an individual premium or $23,000 for a family, but there are so many exceptions and loopholes, this is likely to never kick in). The Senate bill also puts a 10% on tanning sessions to pay for this. No shit. The House bill doesn't hit gold-plateds or tanning sessions, but calls for an additional 5.4% income tax on anyone earning more than $500,000 a year, and families getting $1 mil a year.
Abortion. Here's the second area where you'll see fireworks. The Senate plan won't pay for abortion without the usual trifecta (life of the mother at risk, rape, or incest). The House bill won't give any money to any insurer that covers abortions, with public or private funds.
Grab your ankles, America, and squeal like a pig.