The Reid bill

THE REID BILL…. As promised, Senate Majority Leader Harry Reid (D-Nev.) unveiled the Senate’s health care reform bill late yesterday afternoon, presenting it first to an impressed Democratic caucus, and then to the media. As far as the politics of the rollout are concerned, Reid has to be thrilled.

Senate Majority Leader Harry M. Reid presented an $848 billion health-care overhaul package on Wednesday that would extend coverage to 31 million Americans and reform insurance practices while adding an array of tax increases, including a rise in payroll taxes for high earners.

Democratic leaders were jubilant…. The legislation received a positive response from across the Democratic spectrum. “This is the bill that we’ve been fighting for,” said Sen. Sherrod Brown (Ohio), a liberal who pressed Reid to revive the public option. Sen. Kent Conrad (N.D.), the budget chairman and a leading Democratic fiscal hawk, said after a briefing on the bill, “I was very impressed by what Senator Reid has done.”

OK, so what’s in it? Let’s briefly review some of the key elements:

Cost and deficit reduction: The Senate bill carries a price tag of $848 billion over 10 years, well below the arbitrary White House limit of $900 billion and less than the House version. The CBO estimates that the legislation will cut the federal budget deficit by $130 billion in the first decade, and a hard-to-believe $650 billion in the second decade.

Timing of implementation: To make the bill more affordable, the effective date of the Senate reform package would be 2014, a year later than the House bill.

Financing: To pay for reform, Reid’s plan would impose an excise tax on the so-called “Cadillac” plans (insurance packages worth more than $23,000). There would now also be a 5% tax on elective cosmetic surgery (which would exclude procedures on those with congenital abnormalities, disfiguring diseases, or traumatic injuries). Reid also proposes a 0.5% increase to the Medicare payroll tax for families earning more than $250,000.

Subsidies: Medicaid would be expanded to 133% of the poverty line, and subsidies would help those making up to 300% of the poverty line — which is short of the 400% threshold that many progressive reform advocates had hoped for. Instead, Reid would impose regulations on insurers to cap expenses for those between 300% and 400% of the poverty line.

Coverage: The bill would extend coverage to 31 million uninsured Americans, bringing insurance to 94% of the population. About a third of those left out would be undocumented immigrants.

Public Option: As expected, Reid went with a national public-option plan, which states could pass laws to opt out of.

Abortion: Reid steered clear of the Stupak amendment language, but would separate abortions paid for through premiums and taxpayer subsidies. The provision is a little complicated, but to make a long story short, Sen. Barbara Boxer (D-Calif.) loves what Reid came up with, and the U.S. Conference of Catholic Bishops is livid.

Mandates: There’s an individual mandate, but the penalties are fairly weak. There is no formal employer mandate, but there are some modest fines imposed on larger employers who fail to cover their workers.

Anti-trust: Buckling to demands from Sen. Ben Nelson (D-Neb.), the Senate bill does not end anti-trust exemptions for the insurance industry.

For a caucus that’s been at odds with itself for quite a while, Senate Dems left their meeting smiling. Sen. John Kerry (D-Mass.) said, “We’re going to pass this legislation.”

On the other side of the aisle, Sen. Orrin Hatch (R-Utah) vowed, “It’s going to be a holy war.”