As the House moved toward climactic votes on legislation to remake the health care system, the Congressional Budget Office said Monday that middle-income families might be required to pay 15 percent to 18 percent of their income on insurance premiums and co-payments under the proposal.
Democrats cited the figures as evidence that the legislation would reduce premiums for many low- and middle-income families who currently lack affordable coverage.
Democratic leaders were drawing up ground rules for House floor debate on their bill, expected to begin late this week. The bill would cover 36 million people at a cost of $1.05 trillion over 10 years, according to the CBO.
House Republicans were drafting an alternative, which they said would be much less costly. They acknowledged that it would cover fewer people.
Rep. John Boehner of Ohio, the House minority leader, said the Republican alternative would allow people to buy health insurance across state lines, encourage small businesses to band together to buy insurance at lower prices, and rein in medical malpractice lawsuits.
Boehner said the Republican proposal had none of the taxes or mandates of the Democrats’ bill and would not prohibit insurers from denying anyone coverage because of pre-existing medical conditions. But, he said, the Republicans would provide more money to states to form high-risk pools, which offer coverage to people who cannot obtain private insurance.
Republicans will have only a limited opportunity to influence the Democrats’ bill on the House floor. Under the rules for debate, Republicans will probably not be able to propose amendments other than a complete substitute for the bill, Democrats said.
Those rules are sure to anger Republicans, who have been clamoring for a chance to propose changes. But they may also stymie some Democrats who had wanted to propose amendments dealing, for example, with restrictions on abortion.
The House Democrats’ bill would offer $600 billion in subsidies to help low- and middle-income people buy insurance, most of it from private insurance companies, according to the CBO.
The subsidies would be available to people who obtain coverage through a new regulated market known as a health insurance exchange, scheduled to start operation in 2013. Subsidies are based on the amounts charged for low-cost basic plans.