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The lost revenue is made up by extending the Senate bill's Medicare surtax on families earning more than $250,000 to cover investment income. I'm a little befuddled as to why Republicans aren't raising holy hell about this—President Obama first proposed it nearly a month ago—but they aren't, and that's great, because in the absence of a straight-up income-tax-rate increase on high earners (which I'd still prefer), it seems just and fair.
Do Medicaid docs get a raise? The House-passed bill brought pay for primary care physicians who treat Medicaid patients in line with pay for primary care physicians who treat Medicare patients, which is higher because our government till now has judged old people more deserving of medical care than poor people. The Senate bill did not bring Medicaid fees up to Medicare levels. The reconciliation bill reinstates the House raise for Medicaid docs. The next necessary reform will be to do the same for specialists who take Medicaid patients.
Does it close the doughnut hole?The 2003 Medicare expansion to cover pharmaceuticals left a gap in drug coverage for seniors who spend more than $2,700 annually and less than $6,154. (These amounts change from year to year.) The House-passed bill closed the gap. The Senate-passed bill didn't. The reconciliation bill does.
There's more, of course, but these strike me as the most important features. Time to stop dithering, Congress, and get this baby to the Rose Garden!
E-mail Timothy Noah at email@example.com.