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Senate leader unveils $849 billion health care bill

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CBO: Health care to cost $849B
  • NEW: 2,074-page bill includes controversial provisions such as public health insurance option
  • NEW: Saturday vote to start debate possible; unclear if Democrats can fend off filibuster
  • Measure estimated to cut deficit by $127 billion, insure additional 30 million Americans
  • Sen. Harry Reid meets with Democrats Wednesday afternoon

Washington (CNN) -- Senate Majority Leader Harry Reid unveiled a sweeping health care bill Wednesday that would expand health insurance coverage to 30 million more Americans at an estimated cost of $849 billion over 10 years.

Reid and other Senate Democrats cited an analysis by the nonpartisan Congressional Budget Office for the coverage and cost figures.

In addition, they said at a news conference, the budget office estimated that the proposal would reduce the federal deficit by $127 billion over the next 10 years and by more than $600 billion in the following decade.

The CBO figures were preliminary, the Senate Democratic leadership said in a media briefing. The CBO was expected to provide its final analysis later Wednesday or on Thursday, according to the briefing.

President Obama hailed what he called a "critical milestone" in the push to meet his top domestic priority for 2009.

Read the health care bill (PDF)

"From day one, our goal has been to enact legislation that offers stability and security to those who have insurance and affordable coverage to those who don't, and that lowers costs for families, businesses and governments across the country," Obama said in a statement, adding that the Senate proposal "meets those principles."

The proposal drafted from two separate bills approved by Senate committees now goes to the full Senate, where Republicans have vowed to try to block it.

Reid, D-Nevada, needs 60 votes in the 100-member Senate to overcome a certain GOP filibuster attempt and open the chamber's debate on the bill. It would take another 60 votes to close debate that could last for weeks, while final approval of the bill would only require a simple majority.

Democratic leadership sources have said a Saturday vote to start debate is possible. It remains unclear, however, whether Democrats will have enough votes to fend off a filibuster. Even if they do, the ensuing debate is expected to last weeks, challenging the goal of Senate Democratic leaders to pass the bill by the end of the year.

Reid met with Senate Democrats late Wednesday afternoon before a news conference with the party's Senate leaders. At the news conference, Reid touted the proposal as providing health care to more Americans "in a fiscally responsible way," while Sen. Christopher Dodd, D-Connecticut, proclaimed the projected deficit reductions "real savings for Americans."

Sen. Tom Harkin, D-Iowa, who succeeded the late Sen. Edward Kennedy as chairman of the Senate Health, Education, Labor and Pensions Committee, expressed sorrow that Kennedy was not present to continue supporting "the cause of his life."

The 2,074-page Senate bill seeks to reduce long-term costs of health care for the government, businesses and individuals while reforming how services are delivered to increase efficiency and effectiveness. It includes controversial provisions such as a government-run public health insurance option unanimously opposed by Republicans.

The bill would prohibit illegal immigrants from participating in a health insurance exchange created for those unable to afford health coverage, and it also would prohibit the use of federal funds for abortion coverage in the exchange, according to the briefing for journalists.

According to information at the briefing, the bill includes a range of tax increases and new fees. The Medicare payroll tax on individuals earning $200,000 a year and couples earning $250,000 a year would increase by half a percentage point, from the current 1.45 percent to 1.95 percent.

In addition, insurers providing costly health coverage -- known as "Cadillac" plans -- would face a 40 percent tax on policies worth more than $8,500 for individuals and $23,000 for families.

The bill also includes a 5 percent tax on the cost of elective cosmetic surgery, as well as new fees on insurers and pharmaceutical manufacturers. The total projected revenue raised by all the taxes and fees exceeds $200 billion.

The bill would require individuals to purchase health insurance, with a fine for noncompliance of $95 in the first year that would escalate to $750 by 2016. Parents would be responsible for providing coverage for their children up to 18 years old.

Unlike the House version, the Senate bill does not mandate that all employers offer health care. Instead senators focus on larger companies. In businesses with 50 or more workers, where at least one employee qualifies for government subsidies, the business would face a penalty of $750 for every fulltime employee if it does not offer health care coverage.

The Senate bill also would expand government-run Medicaid coverage for the poor to everyone making less than 133 percent of the national poverty level.

Earlier Wednesday, Reid met with Sens. Mary Landrieu of Louisiana, Blanche Lincoln of Arkansas and Ben Nelson of Nebraska, moderate Democrats who have expressed concerns about the cost and scope of health care reform proposals.

The trio will play a pivotal role in the success or failure of health care reform in the Senate. If Republicans stay unified in opposition to the health care bill, Reid would need the support of all 58 Senate Democrats as well as independent Sens. Bernie Sanders of Vermont and Joe Lieberman of Connecticut to overcome a filibuster.

Landrieu said she has concerns relating to the bill's costs to small businesses and individuals. She also expressed opposition to a public health insurance option "that will undermine the private insurance market." If that's included in the measure, she said, "it needs to come out at some point."

She stated, however, that Reid gave her multiple "assurances ... that he's working hard toward those goals."

Nelson released a statement Wednesday noting that the likely weekend vote represents an opportunity "to commence debate and an opportunity to make changes" to improve the bill.

A source close to Nelson indicated that the Nebraska senator may be willing to vote to start debate even if he doesn't support everything that's in the bill.

Landrieu, Lincoln and Nelson have all indicated that they want a chance to read the budget office-scored bill before deciding whether to back a vote starting debate.

Reid has spent the past several weeks melding bills passed by two Senate committees. A version passed by the House -- by a 220-215 vote -- was crafted by Democratic leaders who merged legislation from three House committees.

The House measure is projected to cost more than $1 trillion over the next 10 years.

If the Senate manages to pass a bill, a congressional conference committee would need to merge the House and Senate proposals into a consensus version requiring final approval from each chamber before moving to Obama's desk to be signed into law.

Democratic leaders in both chambers have been wrestling with a series of controversial issues tied to health care reform, including abortion and immigration. They're also at odds over how to pay for reform.

They have, however, reached agreement on a broad range of changes that could impact every American's coverage.

Among other things, they've agreed to subsidize insurance for a family of four making up to roughly $88,000 annually, or 400 percent of the federal poverty level.

They've also agreed to expand Medicaid and create health insurance exchanges to make it easier for small businesses, the self-employed and the unemployed to pool resources and purchase less expensive coverage.

They also would limit total out-of-pocket expenses and prevent insurance companies from denying coverage for pre-existing conditions.

Insurers under the Democratic plans would be barred from charging higher premiums based on a person's gender or medical history.

CNN's Ted Barrett, Deirdre Walsh and Dana Bash contributed to this report.