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First Read is an analysis of the day's political news, from the NBC News political unit. First Read is updated throughout the day, so check back often.

Chuck Todd, NBC Political Director

Mark Murray, NBC Deputy Political Director

Domenico Montanaro, NBC News Political Reporter



House Dems health bill: $1 trillion

Posted: Tuesday, July 14, 2009 6:43 PM by Domenico Montanaro
Filed Under: ,

From NBC's Mike Viqueira, Domenico Montanaro and Luke Russert
The Congressional Budget office estimates, preliminarily, that the House health care bill will cost $1.04 trillion -- before "offsets" are calculated.

The measure would leave 17 million uninsured in 2020, according to CBO. Half of that number would be illegal immigrants, and much of the remainder would be people who opt to forgo coverage and pay a fine. Without the plan, the CBO says 54 million would be without insurance in 2020.

The bill would leave 97% of Americans with insurance -- 30 million would be choosing the "public option."

Democrats are quick to point out that with the offsets, they expect the measure to be revenue neutral after 10 years. Offsets include a surtax on the wealthiest Americans and reforms in Medicare.

The bill will see committee action in the House this week. Leaders promise a vote before August recess in the House.

So-called Blue Dog Democrats wanted the bill to come in under $1 trillion, so this could reflect a compromise.

Video: Few distractions have been deemed worthy of the Obama Administration's attention as they put the hard sell on health care reform. NBC's Chief White House Correspondent Chuck Todd provides analysis.

But Republicans are already calling this calling an "incomplete number" and a backloaded bill that the CBO will have to update after they read the actual bill.

Don Stewart, an aide to Senate Minority Leader Mitch McConnell, writes that "the average cost of the second five years is about $171 billion annually. Or, put another way, 85 percent of the costs are in the second five years of the bill (2015-2019). So…they’ve backloaded the costs and the consequences until after the next presidential election. They’ve also lowered their per-year cost by not implementing the bill until four years into their budget window."

Michael Steel, an aide to House Minority Leader John Boehner, called the tactic  "the ‘fierce urgency’ of chutzpah."

Steel also called the bill "scored" with an asterisk: "Actually, CBO didn’t score the bill. In the second paragraph of CBO’s letter, it says, 'It is important to note, however, that those estimates are based on specifications provided by the tri-committee group rather than an analysis of the language released today.' So they scored what Democrats asked them to score. Not the actual bill."

And he further points out: "House Democrats have used a gimmick to backload the true cost of their health bill. One consequence they may not have expected? According to CBO, under their bill the number of Americans without health insurance increases for the next three years."  

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Your reporting is wrong. (30 million would be choosing the "public option.") is a incorrect.

30 million will get insurance through the exchange. Only a fraction of them would choose the public option.
...

or about the cost of one Iraq War.....

Somehow, I'd rather have health care for all Americans than a donneybrook to steal Iraqi oil

Maybe we could stop feeding our 'War Machine'
That might save us some money

'My President and Vice President invaded Iraq and all I got was this LOUSY deficit'
The number of people who would use the public plan is
"total enrollment in the
public plan would equal about 11 million or 12 million, counting both individually purchased
policies and employer-sponsored enrollees." straight from the CBO report. Please edit your post to make the correction. It is not 30 million
I'm okay with it.  I'm okay with spending a trillion for health care, a trillion for child education, and a trillion for adult education (colleges and trade schools).  

For decades politicians talk about helping the people and all they ever do is give handout to huge corporations or a blank check for fighting wars that only kill our soldiers.  No nation has ever been a serious threat to the USA since the USSR caved in on itself.  Yes, any army can bloody our nose, but not one is a serious threat to our country.

It's long past time to actually help the CITIZENS of this country instead of only trying to HURT or EXPELL aliens.
What is the big deal with the $1 trillion price tag? Iraq cost a lot more than that. And with health care coming in at $40 trillion over the next twenty years, what's the problem with a trillion dollar fix? That's less than 4% of the total. That's a bargain if the process is correct. Admittedly, that's a big if.
As I see it, creating a system of health care that is beneficial to those in need is paramount in order to bring down the overall costs of health care to this government.  That being said, 100% control of health care by the government is not the answer.  The obvious 2 reasons for this are 1. It would have to be paid for with tax dollars and 2. In order to not overly burden the average American with a large tax increase, they would have to trim services.  This would not be acceptable as, after all this is America where we demand the best of everything, have become accustomed to that lifestyle and would not be willing to sacrifice that privilege.  These are just simple facts of economics and has already been shown to be the pitfalls with respect to Medicare and Medicaid.  Yes, corporate health care is out of control for the simple reason that they are big business with big expenses with respect to executive pay and shareholder responsibilities.  The only way to compete with that is through free enterprise.  But the government cannot undercut private enterprise to the point of running them out of business.  Once that happens, they call all the shots being the only game in town and provide only those services that they feel are necessary (once again giving up the possibility of receiving the best of all care leabving some of the decisions to the consumer).

Here is my proposal.  You create a government sponsored alternative with specific limitations placed on who can make use of that option.  Not make it available to everyone.  These limitations will be based on annual salary for independent users and size of small business with respect to the number of employees in those businesses.  The federal funding would be separated by state as health care costs are not the same in all areas.  Each program would be administered by each state.  This alone would create jobs and provide employment and training for an altogether new job set and a provision could be put in place to fund that training ( let’s decrease unemployment while we are at it).

For example, let’s say anyone who makes less than $40,000 qualifies for the program and any small business with fewer than 10 employees could make use of the system (these numbers are only examples and not written in stone).  If you are an independent individual, your monthly premium would be based on your salary and pro-rated to an affordable monthly premium.  Small business would benefit from the large pool created by other small businesses becoming involved in the plan (large numbers decrease overall costs).  If a large enough group of people make use of the program, the overall costs will diminish due in part to the large pool of participants as well as the decreased operating costs due to no high executive salaries or payouts to shareholders (the object is to cover the cost of health care, not make a profit in a government sponsored set up)  In this way, those who are not as affluent can afford adequate health care leaving the current system in place for those who can afford the services currently provided through the private health care system.  For those of you who think the more affluent are not paying their fare share, this evens the playing field.  If a large enough group of people move to the government sponsored program, thereby cutting into the profit margins of private enterprise, those companies will be forced to either decrease their costs in order to compete or continue to loose business (that’s supply and demand).  Lastly a provision should be put in place that everyone should be required by law to carry health insurance.  No one should have the ability to burden someone else to cover their health care costs just because they would rather drive a nicer car or live in a bigger house rather than plan for their future well being with respect to health care.    As always, there will always be people that are unable to pay anything and will have to continue on Medicare or Medicaid, but we do live in a real world not utopia.  

Unfortunately we live in a governmental society that has shown that when one group is in power, they like to stick it to the other group whenever possible.  And also, our congressional leaders never do what is needed without adding a lot of extras to pad their resume prior to re-election and to push potential future agendas.  It’s time as American citizens that we require our elected officials to provide programs that help us now with a potential to improve those programs as time goes on.  Now is not the time to try and plan for ever future contingency and overspend.
"Insurance" is not the answer. In fact, for many of us, dealing with insurance companies is just as bad as being in the hospital.

I can't believe that we have people still in our great land that think health care is some sort of privilege. It isn't. It should be an absolute right provided by the community for its members.

But then again, we gladly throw out tons of food every day while somebody is starving somewhere.

Why again are we trusting the keepers of the insanity to (allegedly) fix this issue?

And by the way, nothing that costs $1 trillion has the *slightest* chance of ever working efficiently.
Hey wait a darm minute here. Lets just put a stop to the nonsense that we should be covering illegal aliens healthcare under any plan. If we have that much money we can find them all and ship them home where they belong. And throw the bums who hire them in jail, and yes that means you!
This is a Jobs killer. Just give everyone the exact same plan congress has and then tell us the cost.
MSierra, you blathering imbecile...
"Maybe we could stop feeding our 'War Machine'
That might save us some money.  

Better talk to your boy in the Soiled House about HIS WAR IN AFGHANISTAN.


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