It's big and it's complicated, and it's hardly single-payer, or perfect. But it is extensive, historic, and probably the best incremental approach we can hope for, given the sheer power that US business interests and their organizations have to obstruct and intimidate the political process.
You can find extensive details on the web, but most people care about the high points. So let me list them for you here, so you can repeat them to friends and family, before Fox news trains upon them their inevitable fire hose of cynical and manipulative propaganda and lies.
According to the Washington Post, the measure includes:
- An individual mandate that would require people to buy health insurance.
- An employer mandate that would require companies to cover their employees, though small businesses would be exempted.
- Funding to create insurance exchanges to serve people who don't have employer coverage.
- A government insurance option to compete with private plans on the exchange.
- Subsidies to help households earning up to $88,000 in annual income for a family of four purchase coverage.
- A historic Medicaid expansion that would provide free health care to all Americans with incomes below 150 percent of the federal poverty level.
- Up to $400 billion in Medicare and Medicaid cuts, including to a Medicare Advantage managed-care program that serves nearly 11 million seniors.
- A surcharge on taxpayers who earn more than $500,000 a year, or $1 million a year for families.
- A crackdown on the insurance industry, including bans on lifetime limits, premium disparity based on health status and sex, and coverage denials based on preexisting conditions. The bill also would end a federal antitrust exemption that has for decades protected firms from federal investigations.