A procedural vote to move forward to debate the Senate healthcare bill unveiled last night is most likely to occur on Saturday November 21. Senators would have the Thanksgiving Congressional Recess to review the bill.

Senate Majority Leader Harry Reid (D-Nevada) needs all 60 of his members to vote for cloture Saturday and, if that passes, to vote Sunday on a motion to proceed to the bill.

The Congressional Budget Office (CBO) has estimated the bill would cost $849 billion over ten years and would be offset by a mix of reductions in federal spending and new taxes. The bill would extend medical coverage to 94 percent of Americans and reduce the uninsured by 31 million. The bill would be paid for in part by increasing the Medicare payroll tax for couples earning more than $250,000. The tax would increase from 1.45 percent to 1.95 percent. The bill also taxes high cost insurance plans valued at more than $8,500 for individuals and $23,000 for families. The bill also includes a new 5 percent excise tax on elective cosmetic surgeries that would raise $5.8 billion.

The measure creates an insurance exchange where people can compare and purchase coverage, allows insurance co-ops to be formed, expands Medicaid to those earning 133 percent of the federal poverty level, and offers federal subsidies to help those without employer-sponsored coverage purchase insurance.

The Senate plan includes an individual mandate with penalties reaching $750 per person for noncompliance by 2016. Employers that do not offer coverage will pay a fine for each of their employees who received federal subsidies to purchase insurance in the exchange of as much as $750 per employee at the company. A large company appears to be defined in the legislation as a company with more than 50 employees. If a company has more than 50 employees for 120 days or less because of seasonal workers, they would not be considered a large employer. Triggers for penalties appear to be tied to whether a company has waiting periods for health insurance coverage for new employees.

Senator Reid has pledged that he would be open to significant floor amendments to change or remove the public option as some Democratic Senators remain opposed to creating a government-run plan or “private option” to compete against private insurers. The bill would allow states to choose not to participate.

The Senate healthcare bill as proposed by Senator Reid reflects an attempt to mollify the party’s influential centrists, who have been withholding their support over a range of issues, including abortion restrictions and the scope of the public option. Senators on both sides of the issue of federal funding for abortion appear to tentatively support the compromise language restricting federal funding for abortion.

Republicans are united in opposition to the bill. There are a handful of moderate Democrats who come from more conservative states who are not on board either. Several wary swing-vote Democrats have signaled they may side with Republicans in opposing the measure on procedural votes.

Republicans have said the bill will grow the size of government exponentially, explode federal spending, and provide lower quality, government-run healthcare for all Americans. The bill also assumes unrealistic tax increases and Medicare cuts that Members of Congress will not be filling to follow through on, according to statements released this morning by Senator Judd Gregg (R-New Hampshire), the Ranking Member of the Senate Budget Committee.

The Senate healthcare legislation released last night is over 2,000 pages, and HAI legislative affairs staff will continue to review the bill and will provide further analysis in the coming days.