Even the most seasoned policy watcher may be confused by today’s healthcare reform bill debate. With multiple legislative options being debated in Washington, we wanted to provide a guide that highlights the key differences and principles of each plan. As Congress moves closer to passing a reconciled health reform bill for the President’s signature, there are several competing principles related to taxation, coverage and the role of the public option that are worth evaluating. While President Obama revealed his own set of principles for the debate earlier in the year, the mechanics of the legislation are largely a product of Congressional committee compromises, debates and ideas.

Senate Finance Committee

The single most prominent plan devised by senior Senator Max Baucus, the committee passed the America’s Health Future Act (http://www.opencongress.org/bill/111-s1796/show) in October and has drawn widespread attention from health professionals as well as the media at large. The plan is based on the idea of creating state health exchanges which encourage more affordable options for individual insurance as well as subsidies for families who earn up to four times the Federal poverty guidelines. The plan generates revenues by taxing medium and large employers who do not offer coverage, medical device manufacturers, private insurers and holders of premium plans above a certain income threshold. Additionally, the plan aims to extend Medicaid elderly coverage for those earning below 133% of the Federal poverty guidelines, further expanding the reach of the program.

Senate HELP Committee

Passed by the Senate Committee this past summer, the Affordable Health Choices Act (http://www.opencongress.org/bill/111-h3200/show) establishes health cooperatives at the state-level to encourage broader coverage. Families earning less than 400% of the Federal Poverty limit would qualify for subsidized health care on a sliding scale and would have increased access to public health options. The plan mandates health coverage for businesses, and taxes those who do not offer coverage to their employees. Under the HELP plan, Medicaid would cover elderly citizens up to 150% of the poverty limit and would also closely regulate private insurance plans to ensure more equitable treatment of the unemployed, as well as those with pre-existing conditions.

House Tri-Committee

Although the plan never passed by a full committee vote, the America’s Affordable Choices Act  is viewed as a pivotal statement with respect to the Congressional approach to healthcare reform.  The plan creates an Exchange where small businesses and individuals could purchase reduced-rate coverage, with options ranging from subsidized private care, with regulations by State and Federal agencies, as well as a low cost public plan.