Overview

This report provides an overview of key provisions of the two comprehensive health reform bills passed by the five committees of jurisdiction in the U.S. Congress: the Finance Committee and the Health, Education, Labor, and Pensions (HELP) Committee of the Senate, and the Ways and Means, Education and Labor, and Energy and Commerce committees of the House of Representatives. While the general frameworks of the bills are very similar—all bills include provisions intended to improve and expand coverage and all would create a comprehensive and coherent strategy for improving health care quality—they differ in a few key respects. Most important, the Senate Finance Committee bill does not include a public plan option or a requirement that employers offer coverage; the House bill and the Senate HELP bill both include all of these features.

Introduction

This year, policymakers in Washington have risen to the challenge posed by the faltering U.S. health care system and placed major reform at the top of the nation’s agenda. The five committees with jurisdiction over health care in the U.S. Senate and House of Representatives have now voted to pass major reform bills. In the Senate, the Health, Education, Labor, and Pensions (HELP) Committee passed its bill in July and the Finance Committee passed its bill on October 13. In the House, jurisdiction is shared among three committees—Ways and Means, Education and Labor, and Energy and Commerce. All three committees worked in concert to pass similar bills by July 31, 2009, and on October 29, 2009, Speaker Pelosi introduced the the blended House bill, H.R. 3962, for floor consideration.

This report provides an overview of the key provisions of the Senate and House bills that are critical to achieving a high performance health system, as well more detailed descriptions of these provisions in Appendices A, B, and C. It also discusses estimates prepared by the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) of the number of people potentially covered under the bills and the projected effect on the federal budget. Forthcoming Commonwealth Fund reports will analyze the coverage, system reform, and financing implications of these proposals in more detail.