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Early word on the House health-care bill

The House health-care reform bill is out, or at least the text (pdf) of it is. I don't want to say too much that's definitive until I see the CBO score, but all early reports are that it covers more people with more comprehensive insurance than the Senate bill does, and at comparable cost. The big question comes in the so-called "out" years -- that is to say, years 10 through 20 -- where the Senate bill begins really cutting the deficit, but the original House bill began increasing it. The House has been working to bring those numbers under control, and we'll find out later today whether they did.

Originally, I would've said that the big difference between the House and Senate bills would've been the public plan. But in the last few weeks, the House has retreated from a public plan attached to Medicare and the Senate has advanced to a national public plan that states can opt-out of. In other words, the difference will be that individual states can reject the public option in the Senate version, which is much less difference than I was expecting.

Other big difference in the House bill will be the employer mandate, which will be considerably stronger and better designed than the "free rider" provision in the Senate plan; the Medicaid expansion, which goes to 150 percent of poverty rather than 133 percent; and the revenues, which take the form of a surtax on the rich rather than a tax on health-care benefits. More on all that to come.

By Ezra Klein  |  October 29, 2009; 10:50 AM ET
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