By Maggie Astor

Health care reform should not be a partisan issue. While there are legitimate differences of opinion on the means by which the American health care system should be fixed, and how sweeping an overhaul should be, there is no real argument to be made that the current system is adequate. Why, then, has the yearlong debate over health care reform deteriorated into a vitriolic free-for-all, with Congress divided so sharply along party lines that only one Republican in the entire 535-member body voted “yea” in a roll call?

The answer is simple: a dearth of actual, usable information. Politicians and pundits appear more interested in maintaining partisan enmity and attacking proposals on emotional bases than in doing what is best for the country. This, in turn, has crippled the ability of Americans to evaluate the bills passed by the House and Senate on their actual merits. In other words, what is missing from the conversation is a clear, comprehensive set of facts on what the bills passed by the House and Senate would actually do.

Beyond the meaningless, catch-all accusation of “socialized medicine” and the blatantly ridiculous specter of “death panels,” how would these bills, if reconciled and signed into law, affect you?

General Provisions

The House bill would establish a “public option,” or an affordable government-sponsored insurance plan that would compete with private insurers on the exchanges. The bill doesn’t give a specific number for “affordable,” but it says the rates for the public option would be comparable to current Medicare rates.

The Senate bill would not establish a public option, but the U.S. Office of Personnel Management, which currently provides health insurance to federal workers, would contract with private insurers to offer cheaper plans. No insurance company could deny coverage based on pre-existing conditions, terminate coverage arbitrarily, or—under the House bill—set a limit on the total amount of coverage you could receive. The House bill would also limit your annual out-of-pocket costs to $5,000.

Under both plans, individuals could keep their current insurance if they were satisfied with it. Both plans would establish open-market “exchanges” in which private insurers—which would have to meet federal requirements—would compete for customers.

Uninsured people would be required to purchase plans on these exchanges. There would be government subsidies to allow low-income people to afford exchange plans, and waivers from the requirement to buy insurance would be available for people with “financial hardship” (which is not numerically defined in the bill). So it would not insure everybody.

Under the House bill, all employers with payrolls $500,000 or higher would be required to provide health insurance or face substantial fines. Under the Senate bill, employers with more than 50 workers would be fined $750 per year for each worker that obtained federally subsidized coverage through state exchanges, or $3,000 per such worker if the insurance the employer provided cost more than 9.8 percent of a worker’s salary. Some low-income workers would receive vouchers from their employers to buy private insurance on the exchanges.

Both bills would require everyone to have insurance, with waivers available for financial hardship or religious objections; subsidies would be available for low-income individuals. If you did not buy insurance, the House bill would tax you 2.5 percent of your gross income, but no more than the national average health insurance premium. The Senate bill would tax you $750 per year, but no more than $2,250 per family, and no more than 2 percent of your taxable income, with an exception if insurance would cost more than 8 percent of your total income. In exchange, you would be guaranteed treatment at hospitals.

Income-based Provisions

Currently, only individuals below the Federal Poverty Level ($10,830 for a family of one; $22,050 for a family of four) can qualify for Medicaid, which is the federal health insurance program for low-income people. Under the House bill, the eligibility level would be raised to 150 percent of the poverty level; under the Senate bill, to 133 percent of the poverty level. Under both bills, those ineligible for Medicaid but earning less than 400 percent of the poverty level would receive tax subsidies to purchase private insurance.

The House bill would impose a 5.4 percent tax on individuals with annual salaries over $500,000 and couples with combined salaries over $1 million. The Senate bill would impose a 40 percent tax on individual insurance plans costing more than $8,500 per year and family plans costing more than $23,000, with higher limits for retirees and “high-risk” employees such as police officers; individuals with salaries over $200,000 and couples with salaries over $250,000 would pay 2.35 percent of their income in Medicare payroll taxes, as opposed to the current 1.45 percent. Individuals below these income thresholds would be unaffected.

Age-based Provisions

The House bill would allow individuals to stay on their parents’ health insurance plans up to age 27, and the Senate bill up to age 26. Currently, cutoff ages vary by insurance company, and many only allow full-time students to stay on parental plans past age 18. At the other end of the age spectrum, insurance companies could charge older people no more than two times as much as younger people under the House plan, and no more than three times under the Senate plan.

For the elderly, both plans would eliminate the Medicare “doughnut hole”—the gap between the upper limit of regular prescription drug coverage ($2,700 per year) and the lower threshold for catastrophic coverage ($6,154 per year)—by 2019.

The Abortion Question

Both plans would restrict abortion coverage significantly. Under the House bill, the public option would not cover abortion; you couldn’t choose a plan that covered abortion if you received federal subsidies to buy insurance; and insurance companies participating in the exchanges could not cover abortion, even for individuals who bought a plan with their own money. If you wanted abortion coverage, you would have to purchase a “rider” in addition to your basic insurance plan.

Under the Senate bill, federal subsidies could not be used to fund abortion, and individual states could choose not to allow insurers that covered abortion to participate in state exchanges. Anyone with abortion coverage would have to pay for it separately from the rest of their plan—so if your plan cost $1,000 a month and $50 of that was for abortion, you would have to write one check for $950 and a second check for $50.

Maggie Astor is a journalist/student at Barnard College.