WASHINGTON—Democrats in the U.S. House of Representatives unveiled a broad healthcare overhaul on Thursday that would transform the insurance market, create a government-run insurance plan and levy new taxes on the rich.
Weeks of tough, closed-door negotiations to merge three pending House healthcare bills produced a 1,990-page measure that would cost an estimated $894 billion over 10 years—below President Barack Obama's target of $900 billion—and reduce the deficit by $30 billion over the same period.
"Today we are about to deliver on the promise of making affordable, quality health care available for all Americans," House Speaker Nancy Pelosi said in a ceremony on the steps of the U.S. Capitol.
But the measure faced unanimous opposition from Republicans and grumbling from Democratic liberals who wanted a stronger public insurance option and party moderates seeking assurances that federal funds would not pay for abortions under the bill.
The measure could be on the House floor for debate as early as next week.
The unveiling of the House legislation was another step forward in Obama's drive for a healthcare bill that would rein in costs, reform the insurance industry and expand coverage to uninsured people.
Obama praised House Democratic leaders for including insurance industry reforms and said he was pleased the bill featured a public insurance option and was fiscally responsible.
"The House bill clearly meets two of the fundamental criteria I have set out: it is fully paid for and will reduce the deficit in the long term," Obama said in a statement.
House Democrats said their bill would meet Obama's criteria for his top domestic priority. Republicans, who have battled Obama and Democrats at every juncture in the debate, were critical of the size, cost and scope of the House legislation.
'Behind Closed Doors'
"Americans' health care is too important and too complex to risk on one gigantic bill that has been written behind closed doors," said Representative Dave Camp, the senior Republican on the Ways and Means Committee.
The Senate is also putting together its own version of healthcare reform, and the House and Senate measures eventually must be combined before being sent to Obama for his signature.
The House bill would expand coverage to 36 million uninsured people living in the United States, Democrats said. It would offer subsidies to help the uninsured purchase insurance through newly created exchanges.
The House bill would require individuals to buy insurance and all but the smallest employers to offer health coverage to workers. It also would bar insurers from refusing to cover people with pre-existing medical conditions and eliminate the industry's exemption from federal antitrust laws.
The House proposal includes a 5.4 percent surtax on individuals making more than $500,000 and couples earning more than $1 million, which would bring in an estimated $460 billion over 10 years to help pay for covering the uninsured.
It also would expand eligibility for the government's Medicaid health insurance program for the poor to people with incomes up to 150 percent of the official poverty level.
The proposed new government-run insurance program, often called the "public option," has been a flashpoint in the debate over Obama's top domestic priority. In the House bill, it would use reimbursement rates negotiated with doctors and hospitals, a setback for House liberals led by Pelosi who wanted a stronger version to compete with insurers.
Pelosi failed to gain the 218 votes needed to pass a version of the government-run plan using lower rates pegged to Medicare, the government's health insurance program for the elderly and disabled, and could face resistance from liberals who preferred this plan.
The healthcare measure being prepared for debate in the Senate also includes a public insurance option based on negotiated reimbursement rates, but unlike the House bill it would allow states to decline to participate.
The lobbying group for the insurance industry, America's Health Insurance Plans, criticized the proposed new government-run insurance program, arguing it would cause people to lose their existing coverage.
"A new government-run plan would bankrupt hospitals, dismantle employer coverage ... and ultimately increase the federal deficit," Karen Ignagni, the group's president, said in a statement.
