Meet the New Health Care Bill, (Mostly) Same as the Old Health Care Bill.


With a few slight adjustments, of course! That is, the White House’s recently released health care proposal is virtually identical to the Senate’s health care bill, with a few notable changes (if you’d rather not go to the White House site, you can read the full proposal here):

  • The White House’s proposal eliminates the Nebraska Medicaid exemption and provides “significant federal financing to all states for the expansion of Medicaid.”
  • The threshold for the excise tax on the most expensive health plans has been increased from $23,000 for a family plan to $27,500, with a start date of 2018 for all plans. What’s more, the point at which the tax would kick in is indexed to rise each year at the rate of inflation plus one percent. On the whole, this is a big victory for labor, as the trigger point in the earlier compromise was $24,000.
  • The maximum amount of income the average family can pay in premiums is set firmly between the Senate and House ranges, but the percent of costs paid for by the plan (read: the subsidies) has increased significantly. Here’s the relevant chart if you’re curious.

There are a few other differences that I won’t go into detail here, but they’re worth mentioning: the plan closes the “donut hole” in Medicare Part D, includes stronger anti-fraud provisions, and allows the federal government to review insurance rate increases. There is no public option (though that might change) and most of the provisions take effect in 2014. That said, the White House plan is notable in that it doesn’t include address a single Republican objection. At its core, this is the bill passed by the Senate in December and amended by conference in January. The frustrating bipartisan kabuki of the past few weeks has given way to a bill that’s fundamentally liberal, which signals (to me at least) that the administration is under no illusions about the GOP’s (un)willingness to compromise and deal.

For what it’s worth, I think this bill will pass. The stakes for Democrats — and House Democrats especially — are simply too high for it not too make it through Congress (and that’s to say nothing of the profoundly positive implications this legislation will have for Americans). I am certain that sometime soon, liberals will watch with relief as President Obama sits in the Rose Garden — with Democratic leaders at his side — and signs the historic legislation that finally puts America on the path to finishing what Franklin Roosevelt and Lyndon Johnson started.

Photo credit: Associated Press/Politico


Jamelle Bouie is a writer for Slate. He has also written for The Daily Beast, The American Prospect and The Nation. His work centers on politics, race, and the intersection of the two.

You can find him on Twitter, Flickr, and Instagram as jbouie.
  • Seth in LA

    Is it fundamentally liberal, or is it just a bit more liberal than the very compromised plan the Senate approved. Can a bill with no public option really be called liberal?

    The President has called for a summit with Republicans and has invited them to post their own plan. They can do the homework or not, but if they don’t, there is no need for him to make concessions for them. The Republicans have two choices. They can show up at the summit in good faith, put forth a reasonable number of revisions along with the promise that if the compromises are made, they will stand down from the filibuster, recognize that they are the minority party and pass the bill. Or, if they insist on being beligerent and continue to act as if 41 constitutes a majority, the Democrats will pass this by reconciliation.

    You can only let spoiled children ruin everything for so long before you put down your foot and say “playtime is over.”