Committee for a Responsible Federal Budget

Comparison: Cost of the House Health Care Bill

Today, House Speaker Nancy Pelosi intoduced the latest House health care reform bill, fresh with estimates from the Congressional Budget Office and the Joint Committee on Taxation. We have also updated our comparisons chart of the House Tri-Committee bill, the Senate HELP bill, the Senate Finance Committee bill, and the President's Reserve Fund.

Below, we have broken down the major costs and savings in this version of the bill, compared to the original House Tri-Committee bill:


ProvisionsHouse Tri-Committee Bill
Amended House Health Bill
Individual Penalties $29$33
Employer Payments $208$135
Mandate Provisions $237$168
Exchange Subsidies ($773) ($605)
Medicaid Expansion ($438) ($425)
Small Business Credits ($53) ($25)
Coverage Expansion ($1264)($1055)
Physician Payment Updates ($229) n/a
Long-Term Care Insurance n/a $73*
Reinsurance ($10) ($10)
Other Spending Changes ($53) ($185)
Other Spending ($292) ($123)
Changes in Prescription Drug Payments $47 $83
Medicare Advantage Cuts $162 $170
Reductions in Provider Payment Updates $196 $173
Medicare Premium Increase n/a n/a
Medicare Payment Commission n/a n/a
Measures to Slow Overall Health Care Cost Growth# $5 $7
Measures to Reduce Federal Health Care Spending $81 $106
Spending Offsets $491 $539
Surtax on High Earners $544 $461
Limit Itemized Deductions n/a n/a
Excise Tax on High Cost Insurance n/a n/a
Tax Gap and Loopholes Closing $37 $56
Limits to Health Care Tax Benefits $8 $23
Impose Fees on Health Care Companies n/a $20
Tax Increases $589 $560
Interactions and Other Spending and Taxes
 $0 $15
Ten Year Deficit Impact
Tenth Year Deficit ($65) $9
Reduction in Uninsured 37 million36 million
Numbers in billions, with positive numbers representing a reduction in the deficit
Sources: Congressional Budget Office, Joint Committee on Taxation, and Authors' Calculations
*Provision raises revenue through premiums; however, due to vesting rules, the program's costs occur mostly beyond the ten year window
#Net effect of spending for and savings from efforts to slow economy-wide health care cost growth