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House Democrats roll out legislation to extend health care to millions

The House bill is similar to its Senate counterpart, although a handful of key differences could make for protracted negotiations.

Last update: October 29, 2009 - 7:45 PM

WASHINGTON - After six months of deal-making, Democratic leaders on Thursday introduced a health care bill that would expand coverage to almost all Americans and overhaul the insurance industry while asking the wealthiest taxpayers to pay much of the tab.

House Speaker Nancy Pelosi of California announced the 10-year, $894 billion package on the Capitol steps, surrounded by Democrats from all factions of her diverse caucus. "Leaders of all political parties, starting over a century ago with President Theodore Roosevelt, have called and fought for health care reform and health insurance reform," Pelosi said. "Today we are about to deliver on the promise."

The House bill is similar to its Senate counterpart, although a handful of key differences could make for protracted negotiations. For example, the House's surtax on those earning more than $500,000 per year is a nonstarter in the Senate. Yet House Democrats oppose the Senate's main revenue measure, an excise tax on high-value, or "Cadillac," health insurance plans. And while both bills include a government insurance plan, the Senate version would allow states to opt out.

Under the House bill, 36 million uninsured Americans without access to affordable health benefits at work would become eligible for coverage. About 15 million of the poorest children and adults would enroll in Medicaid. Another 21 million would purchase coverage on a new national insurance exchange, where private plans would compete with a "public option" backed by the federal government.

An analysis of the House bill by the nonpartisan Congressional Budget Office estimated that just 6 million people would choose a public plan, making it a relatively small player despite the issue's outsize role in the debate.

The House bill would require most individuals to purchase insurance and would require employers to provide health coverage to their workers or face a penalty, although firms with payrolls below $500,000 annually would be exempt.

House Minority Leader John Boehner, R-Ohio, mocked the bill's 1,990 pages as 620 pages longer than President Bill Clinton's failed plan 15 years ago. The conservative Republican Study Committee warned of "higher taxes, job-killing employer mandates, choice-restricting individual mandates, government-run insurance, budget-busting entitlement expansions and countless provisions that set Washington bureaucrats firmly between you and your doctor."

House Democratic leaders have huddled for weeks behind closed doors, seeking to stitch together a 218-vote majority from disparate Democratic blocs. Up to 40 conservative Democrats remain unhappy with abortion-related provisions and are still threatening to vote no. But with a debate on the House floor expected to begin late next week, most major differences appear to have been bridged.

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