Every day, there's more news from Capitol Hill on health care reform. Different lawmakers propose changes to three different bills, with updates as key players refine their positions. Last week, some of the "Blue Dog Democrats" succeeded in pushing the vote on healthcare reform until after the Senate's August recess.

Having trouble understanding this complicated process? The Takeaway has a guide for you. (And if you have more questions, get in touch!) Here are the key points to the major health care plans proposed, the stage of the process they're in, and even a bit about how bills become laws. Here's what we know about the House's H.R. 3200, and the Senate's H.E.L.P. (Health, Education, Labor & Pensions) Committee bill. ...(continue reading)

House Bill H.R. 3200 proposes Plan #1

Who Introduced It?

• House Democrats

What Does the Bill Say?
• Requires individuals to have health insurance through a "health insurance exchange" that individuals and employers can purchase;
• Expands Medicaid to 133 percent of the poverty level;
• Requires employers to contribute at least 72.5 percent of premium cost for insurance;
• Requires employers not providing insurance to pay a penalty of 8 percent;
• Eliminates or reduces the worker health care contribution employers have to pay if their business makes less than $500,000.

How Is It Funded?
• Through reductions in some Medicare programs, Medicare payment reforms, and the surtax, which would tax the wealthiest 1.2 percent of Americans.

Where Is the Bill?
• Passed by both the Ways and Means Committee and the Education and Labor Committee;
• Passed by the Energy and Commerce Committee;
• The Blue Dog Democrats have lobbied the House to delay voting on H.R. 3200 until September, saying it's too expensive for small businesses and that it costs the government too much;
• The House Education and Labor Committee Progressives are not sold on the plan, as they're pushing for a bill with a strong publicly-funded option.



The Senate's H.E.L.P. (Health, Education, Labor & Pensions) Committee proposes Plan #2

Who Introduced It?

• The Senate Health, Education, Labor and Pensions (H.E.L.P.) Committee

What Does the Bill Say?
• Requires individuals to have health insurance. Individuals would have a state-based American Health Benefit Gateways plan, and small businesses would be required to purchase health coverage;
• Expands Medicaid to 150 percent of the poverty level;
• Requires employers to contribute at least 60 percent of the premium cost for insurance;
• Requires employers not providing insurance to pay a penalty of $750 per employee;
• Exempts employers with less than 25 workers from providing health care.

How Is It Funded?
• No clear funding proposal yet.

Where Is the Bill?
• It has been reported out of the Senate H.E.L.P. Committee, and awaits action on the Senate floor.

A group within the Senate Finance Committee is also creating a set of proposals that will ultimately be joined with the H.E.L.P. bill. The Finance Committee's proposals are in early stages, but they will likely include a tax on high-cost insurance policies of up to 35 percent, and the creation of a commission charged with slowing the growth of Medicare. The Finance Committee will likely not include a new taxpayer-supported insurance option, but instead co-operative (individual and employer-owned) insurance plans.

Bills To Laws

We here at The Takeaway were also a little rusty on how bills become law, despite many viewings of the relevant video from Schoolhouse Rock as children. So, here's a primer:
• Most bills and resolutions start with ideas, and ideas for bills can come from anyone. Only Congresspeople can introduce those ideas into the House or Senate when Congress is in session. When a Member of Congress introduces a bill, that Member becomes the bill's sponsor. Two or more sponsors on the same bill are co-sponsors.
• Once introduced, bills are assigned to committees. Committee members debate the bill in Committee, make changes to it, and can vote to accept the bill as is, accept the bill with changes, "table" the bill (or stop action on it), or send the bill to a Subcommittee for further study.
• When Committee and Subcommittee Members agree on the text of the bill, it leaves Committee, and is "reported" or sent to the House or Senate floor for consideration. There, Members debate the bill, add amendments or introduce a "clean bill" before voting. At the conclusion of debate on the floor, the bill is read by title and Members vote "Yea" (to pass the bill), "Nay" (not to pass the bill) or "Present" (to show they are in attendance but not votting). Senators may also choose to ignore a bill.
• If a bill passes in the House, it is "engrossed," but it still must pass in the Senate. Vice versa is also true, ie, the House most also vote on a bill passed in the Senate. If the bill passes with different language in the Senate than it passed in the House, a conference committee of House and Senate members reviews the language.
• If the bill passes in both Houses, the bill is sent to the President for signature. The President has a couple of options: he can take no action on the bill, at which point it automatically becomes law after ten days. If he takes no action on the bill while the Congress is not in session, the bill dies (that's called a "pocket veto.") The President may also veto the bill outright, or sign it and it becomes law.
• If the President vetoes the bill, it returns to its House of origin. Congress can also override a presidential veto if there are enough objections. If the veto is overruled by Congress, it becomes law.

Source: Office of the Clerk in the House of Representatives.

Links to more information


• The House's plan
• The House's plan's implementation timeline
• The Senate HELP Committee plan
• The Senate Finance Committee Health Reform
• Kaiser Foundation's Health policy research
• THOMAS, a public website where the Library of Congress posts bills with their status