Document Dump: Patient Protection and Affordable Care Act
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In the hub-bub of the phantom congressional district story, Senate Majority Leader Harry Reid, D-Nev., released this week the Patient Protection and Affordable Care Act, the Senate version of health insurance reform.
Normally we here at West Virginia Watchdog use a website called Scribd to pose the full text of the bill in a format that makes it easier for readers to check out. Sadly, Reid placed restrictions on the pdf version of the Patient Protection and Affordable Care Act that prevent how this public document is used. Reid has already been criticized for not releasing details of this bill to fellow senators, and now he won’t release the whole bill so the public can view it how they want to.
Of course, you are allowed to print the bill. Got enough paper and ink to print off 2,074 pages?
Since we can’t imbed the entire bill on this post, we did take a screen grab of the bill (shown on your right). If you have time, read the full text of the bill here.
The Committee for a Responsible Federal Budget created a side-by-side comparison chart showing both the new Patient Protection and Affordable Care Act and the House Affordable Health Care for America Act. The numbers shown are in the billions:
| Provisions | 10-Year Costs | |
| House Bill |
Senate Bill |
|
| Individual Penalties | $33 | $8 |
| Employer Payments | $135 | $28 |
| Mandate Provisions | $168 | $36 |
| Exchange Subsidies | ($602) | ($447) |
| Medicaid Expansion | ($425) | ($374) |
| Small Business Credits | ($25) | ($27) |
| Coverage Expansion | ($1052) | ($848) |
| Physician Payment Updates | n/a | ($11) |
| Medicare Prescription Drug Coverage | n/a# | ($23) |
| Measures to Slow Health Care Cost Growth | ($31) | ($17) |
| Other Spending Changes | ($195) | ($42) |
| Other Spending | ($226) | ($93) |
| Prescription Drug Cost Reductions | $83# | $51 |
| Medicare Advantage Cuts | $170 | $119 |
| Reductions in Provider Payment Updates | $173 | $160 |
| Medicare Premium Increase | n/a | $36 |
| Medicare Payment Commission | n/a | $23 |
| Measures to Slow Overall Health Care Cost Growth | $37 | $26 |
| Measures to Reduce Federal Health Care Spending | $106 | $129 |
| Spending Offsets | $569 | $544 |
| Excise Tax on High Cost Insurance | n/a | $149 |
| Tax Gap and Loopholes Closing | $60 | $17 |
| Surtax on High Earners | $461 | n/a |
| Limits to Health Care Tax Benefits | $22 | $43 |
| Fees on Health Care Companies | $20 | $108 |
| Medicare Payroll Tax Increase for High Earners | n/a | $54 |
| Tax Increases | $563 | $370 |
| Interactions and Other Spending and Taxes |
$15 | $48 |
| Budgetary Impact Subtotal | $37 | $57 |
| CLASS Act+ | $72 | $72 |
| Total Budgetary Impact | $109 | $130 |
| Tenth Year Deficit | $9 | $8 |
| Deficit Reduction in Second Decade | 0% to 0.25% of GDP | 0.25% of GDP |
| Reduction in Uninsured | 36 Million | 31 Million |
Congressional Budget Office Director Douglas W. Elmendorf said their recent spending and revenue estimates for the Reid Bill are not set in stone.
CBO and JCT estimate that the direct spending and revenue effects of enacting the Patient Protection and Affordable Care Act would yield a net reduction in federal deficits of $130 billion over the 2010-2019 period. That estimate is subject to substantial uncertainty.
The estimate includes a projected net cost of $599 billion over 10 years for the proposed expansions in insurance coverage. That net cost itself reflects a gross total of $848 billion in subsidies provided through the exchanges, increased net outlays for Medicaid and the Children’s Health Insurance Program (CHIP), and tax credits for small employers; those costs are partly offset by $149 billion in revenues from the excise tax on high-premium insurance plans and $100 billion in net savings from other sources. Over the 2010–2019 period, the net cost of the coverage expansions would be more than offset by the combination of other spending changes that CBO estimates would save $491 billion and other provisions that JCT and CBO estimate would increase federal revenues by $238 billion.
In total, CBO and JCT estimate that the legislation would increase outlays by $356 billion and increase revenues by $486 billion between 2010 and 2019.
The Senate has decided to follow the House’s example and hold the vote for the Patient Protection and Affordable Care Act tomorrow, Saturday, Nov. 21, 2009. Those who wish to express support for the bill or vice versa need to call Sens. Robert Byrd and and Jay Rockefeller at 202-224-3954 and 202-224-6472 respectively.
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Posted under Document Dump, Federal Government, Finances, Health care, Legislation, News, Politics, Regulatory Reform, Tax Reform, Transparency, U.S. Senate, spending.
Tags: Affordable Care Act, Congressional Budget Office, Harry Reid, Health insurance, Insurance, Jay Rockefeller, Medicaid, Patient Protection and Affordable Care Act, Senate
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