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The House- and Senate-passed health reform bills are based on the plan set out by President Obama in his campaign and shapedduring the legislative process.

 As a result, they have substantial similarities that will greatly facilitate the final step of developing an

agreement on a bill for the President’s signature. Both bills:

Provide a comprehensive set of “early deliverables,” starting in 2010, which include (1) initial insurance reforms and consumerprotections, (2) a new insurance pool to make coverage available to individuals with pre-existing conditions or chronic illnesseswho can’t get coverage today, and (3) disclosure, review and justification of insurance rate increases. Both bills also containadditional early investments in community health centers and the workforce, which are essential both to ensure access when thecoverage reforms are implemented go into place and to begin to improve both personal and community health and wellnessimmediately. Additional Medicare improvements, including beginning to close the donut hole, also begin in 2010.

Improve insurance coverage by implementing major coverage reforms (2013 in House bill, 2014 in Senate) and providingfinancial assistance to lower- and middle-income families and small businesses. Those provisions include:


Insurance reforms, minimum benefit standards, and creation of a new health insurance marketplace called an “exchange”where health plans compete based on price and quality for individual and small employer business.


Increases in Medicaid eligibility levels for those with the lowest income, and new funding for critical safety net servicesthrough community health centers.


Sliding scale financial credits to ensure affordable premiums and cost-sharing assistance for households with income abovenew Medicaid income levels but below 400 percent of the federal poverty level.

 Individual responsibility to purchase insurance within this new framework.


Employer responsibility to offer coverage or provide financial contributions to help pay for coverage.

Improve Medicare coverage for prescription drugs and preventive services, and implement major Medicare delivery system andpayment reforms to make Medicare more efficient and restrain future spending growth. Both bills institute numerous long-termreforms that experts have called for to enhance quality and value for Medicare beneficiaries and the entire health care system.

Provide revenues that, coupled with the program savings above, meet the commitment of the President, the Speaker and theleaders of the House and Senate that the bill be fully paid for. In fact, both bills actually reduce the deficit by more than $100billion over the first 10 years, and are projected to yield savings in the second 10 years.These similarities provide a strong platform for discussions to lead to a final agreement. However, especially on a topic as historic andsweeping as health reform, there are differences between the chambers that will need to be resolved. A brief look at some of the topline differences follows. Additional and more detailed information will be available as it is developed.

Prepared by Tri-Committee House staff; budget and coverage data from the Congressional Budget Office or the Joint Committee on Taxation.

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