While I decided to watch the All-Star Game, the House moved

So last night I had a party for the All-Star Game that sadly did not draw people. I can understand. However, as a result, I did not blog. Hence, I missed a lot of action.

Yesterday, the House Tri-Committee released their bill. The group is called such, because of the Committees shepparding the bill. They are the House Committee on Energy and Commerce, the Committee on Education and Labor, and the Committee on Ways and Means. Ways and Means is there, because there are revenue measures, and Medicare is part of their jurisdiction as well. Education and Labor also gets involved because of the Employment Income Retirement Security Act (ERISA) changes. Energy and Commerce is the main point committee on health care matters.

The amazing thing is the coordination of what is involved. These are three committees that in the past have jealously guarded their jurisdiction. Perhaps Chairman Waxman has been helpful. One of the things actually about the Clinton reform is the fractuousness of the committees. If these committees can hold on their markups, then we will be very well off.

Here, is what the House Bill does (from the New America Foundation's Blog):

• A National Health Insurance exchange that would allow individuals and small businesses to shop around for quality, affordable coverage in a transparent, convenient way.
• A public health insurance plan that would be available to all Americans. The plan's payments to medical providers would be based on Medicare rates, but the bill also promises to expand Medicaid and "modernize and improve" Medicare. (Sidebar, Ezra Klein mentions the Medicaid movement as a step in the right direction)
• Insurance companies could no longer deny coverage because of pre-existing conditions. Everyone would be required to have health insurance, but those who could not afford it would be able to access a sliding scale of "affordability credits" to help cover the cost.
• Financing would come from a federal surtax on the upper income -- up to 5.4 percent on the income of taxpayers making more than $1 million a year -- as well as hundreds of billions of dollars in cuts in projected Medicare and Medicaid spending.
• A focus on prevention and wellness, including the expansion of community health centers and the implementation of community-based wellness programs.
• Employers who do not offer coverage would be required to pay 8 percent of each uninsured worker's salary, with exemptions for smaller firms built into the legislation.

It seems quite good, and has most of what I want. I really like the exchange provisions. The credits and rationalization of Medicaid is great.

On the tax side, I am incredibly wary. It's politically the right move. However, it may not work out as well as people think. Howard Gleckman at the Urban-Brookings Tax Policy Center has blogged about some of the problems. There are two major problems that he points to, both of which are valid from an administrability stand point.

• Pushing marginal rates back up to the 50% level, really does weird things and encourages bad behavior. We return to the late 1970s and early 1980s mess.
• This is a very small slice of the population with a special tax added onto it. Instead of it being broader based, which is much better, and instead of closing loopholes, it adds them.

You can read the two Gleckman pieces here and here.

For more on the House bill, I would recommend the following posts. Ezra Klein discusses the bill well, as does Jon Cohn.

I am spending the next few days enjoying myself with these pieces of information.

The full bill text (do not try to read in one sitting)

A summary by the Tri-Committees.

What often does get read by people, the Section-by-Section analysis.

And finally a link to all the materials. I have chosen Ways and Means, because of my love affair with that committee.