House Speaker Nancy Pelosi on Thursday unveiled details of a health care bill that Democrats say would extend insurance coverage to 36 million more Americans and outlaw exclusions for pre-existing conditions and that includes a public option.
The measure calls for the creation of a new government-regulated insurance exchange, so private companies could sell policies in competition with the government.
Under the bill, most Americans would be required to have insurance by 2013 through their employer, a government program or the new exchange. Federal subsidies would be available to lower-income individuals and families to help them pay for the policies.
As changes are phased in, a temporary government program would help people turned down by private insurers because of poor health or a pre-existing condition. The plan would also expand Medicaid, the health program for the poor.
The bill "reduces the deficit, meets President Obama's call to keep the cost under $900 billion over 10 years, and it insures 36 million more Americans," Pelosi, surrounded by Democratic lawmakers, said at a news conference on the west steps of the Capitol.
Obama said the plan meets his goals of being fully paid for and reducing the deficit.
"They forged a strong consensus that represents a historic step forward," Obama said Thursday during a meeting with small-business leaders.
He said the House bill and one being drafted in the Senate would benefit small-business owners and their employees by making coverage more affordable and offering a tax credit to small businesses that are trying to provide coverage.
"Under the House and Senate bills, millions of small businesses would be eligible for a tax credit of up to 50 percent of their premiums," the president said.
The Congressional Budget Office has estimated the plan will cost $894 billion over the next 10 years, according to House Democrats.
It would be paid for by cuts in planned Medicare spending and an income tax surcharge of 5.4 percent on individuals making at least $500,000 annually and couples making at least $1 million.
The bill comes after months of negotiations to combine separate plans proposed by three committees. Pelosi wanted a government-run public option where the government would set the rates to be paid to doctors, hospitals and other health care providers, but she couldn't persuade enough Democrats to support it.
Instead, the House plan includes a government-run insurance plan in which the rates would be negotiated between the government and providers.
Republican lawmakers were quick to attack the bill.
"This really is a government takeover of health care," said Rep. Mike Pence of Indiana, the chairman of the House Republican Conference. House Republicans are expected to oppose the bill unanimously.
Not all Democrats are onboard. Rep. Lynn Woolsey of California, co-chair of the Congressional Progressive Caucus, hasn't committed. "This is not walk-away time, and it is not acceptance time," she said.
Pelosi promised the plan will lower costs for patients, but it still leaves 4 percent of the population — about 12 million people — without coverage.
House Democrats have not worked out disputes over abortion services and health care for immigrants, issues that must be settled before the bill can come to a vote.
Meanwhile, Democrats in the Senate are also working on a bill. Earlier this week, Majority Leader Harry Reid said the Senate plan would include an option for a government-run plan, but states would have the option of dropping out of it, if they wanted.
According to The Associated Press, the bill would strip the health insurance industry of a long-standing exemption from antitrust laws covering market allocation, price fixing and bid rigging. Democratic officials said the bill also would give the Federal Trade Commission authority to look into the health insurance industry on its own initiative.
From NPR and wire service reports
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