Details of Democratic tweaks to health bill

News reports scour the latest health overhaul bill for specific provisions and adjustments.

The New York Times: "The reconciliation package unveiled by Democrats would impose $28 billion in fees on the drug industry over 10 years ... That is $5 billion higher than the $23 billion the brand-name pharmaceutical industry had agreed to in the Senate package." But, drug makers are glad the government will spend $38 billion filling the Medicare "doughnut hole" - a gap in drug coverage - over that period (Wilson, 3/18).

The New York Times, in a separate story: The bill "would broadly expand Medicaid, the federal-state insurance program for low-income Americans." Since many doctors already do not see Medicaid patients because fees are so low, the legislation would also up payments for primary care doctors to higher, Medicare, levels. The Medicaid program is run by states, but the federal government would fund these increases (Herszenhorn, 3/18).

Main Justice: Two antitrust proposals are not in the latest version of the bill. "One proposal would have banned brand-name drug manufacturers from making payments to keep competing drugs off the market; the other would have repealed a 1940s law that exempts health insurers from some federal antitrust scrutiny. Both proposals have been offered as stand-alone bills, and have made it part-way through the legislative process" (Viswanatha, 3/18).

Kaiser Health News: The legislation "contains a scaled-back tax on high-cost insurance policies." The latest version of the so-called 'Cadillac' tax would impose a 40 percent levy on insurance plans that cost "more than $10,200 for an individual or $27,500 for a family." The tax would not begin until 2018 (Gold, 3/18).

The Associated Press: Also under the current version of the bill, "[f]or the first time, the Medicare payroll tax would be applied to investment income, beginning in 2013. A new 3.8 percent tax would be imposed on interest, dividends, capital gains and other investment income for individuals making more than $200,000 a year and couples making more than $250,000" (Ohlemacher, 3/19). 

BusinessWeek/Bloomberg: "The nonpartisan staff of the congressional Joint Committee on Taxation estimated the Medicare tax on investments would generate more than $30 billion annually, or $210.2 billion from 2013 through 2019. It would be the biggest tax increase in the bill and account for half of the $409 billion in total revenue" (Donmoyer and Rowley, 3/18).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.