Chart: Comparing Health Reform Bills: Democrats and Republicans 2009, Republicans 1993


By Maggie Mertens
KHN Staff Writer
Feb. 24, 2010

The proposal President Barack Obama unveiled on Monday is based largely on the bill passed by the Democratic Senate on Dec. 24, 2009, the Patient Protection and Affordable Care Act.  It has some similarities to a GOP proposal sponsored by Sen. John Chafee, R-R.I., during the Clinton presidency, the Health Equity and Access Reform Today Act of 1993. 

This chart compares those two bills with the Nov. 3, 2009 proposal from House Minority Leader John Boehner, R-Ohio, the Common Sense Health Care Reform and Affordability Act.

Related KHN story: The Democrats’ 2010 Health Reform Plan Evokes 1993 Republican Bill

Major Provisions Senate Bill 2009  Sen. Chafee (R) Bill 1993  Rep. Boehner (R) Bill 2009 
Require Individuals To Purchase Health Insurance
(Includes Religious and/or Hardship Exemption)
 Yes

 Yes

 No (individuals without
coverage would be taxed)

Requires Employers To Offer Health Insurance To Employees

 Yes (above 50 employees, must help pay for insurance costs to workers receiving tax credits
for insurance)

 Yes (but no requirement to contribute to premium cost)

 No

Standard Benefits Package 

 Yes

 Yes

 No

Bans Denying Medical Coverage For Pre-existing Conditions 

 Yes

 Yes

 No (establishes high risk pools)

Establish State-based Exchanges/Purchasing Groups

 Yes

 Yes

 No

Offers Subsidies For Low-Income People To Buy Insurance 

 Yes

 Yes

 No

Long Term Care Insurance

 Yes (sets up a voluntary insurance plan)

 Yes (sets standards for insurance)

 No

Makes Efforts To Create More Efficient Health Care System 

 Yes

 Yes

 Yes

Medicaid Expansion 

 Yes

 No

 No

Reduces Growth In Medicare Spending

 Yes

 Yes

 No

Medical Malpractice Reform 

 No

 Yes

 Yes

Controls High Cost Health Plans

 Yes (taxes on plans over $8,500 for single coverage to $23,000 for family plan)

 Yes (caps tax exemption for employer-sponsored plans) 

 No

Prohibits Insurance Company From Cancelling Coverage 

 Yes

 Yes

 Yes

Prohibits Insurers From Setting Lifetime Spending Caps

 Yes

 No

 Yes

Equalize Tax Treatment For Insurance Of Self-Employed 

 No

 Yes

 No

Extends Coverage To Dependents

 Yes (up to age 26)

 No

 Yes (up to age 25)

Cost 

 $871 billion over 10 years

 No CBO estimate

 $8 billion over 10 years

Impact On Deficit

 Reduces by $132 billion over 10 years

 No CBO estimate

 Reduces by $68 billion over 10 years

Percentage Of Americans Covered 

 94% by 2019

 92-94% by 2005

 82% by 2019