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Health Care Reform: An Online GuideLinks to everything you might conceivably want to know about the health care reform bill.

By Timothy NoahUpdated Friday, Nov. 13, 2009, at 12:30 PM ET

The legislative effort to reform America's health care system is a story that is unfolding online. Newspapers are playing catch-up, sometimes with their own Web sites. What follows is Slate's guide to the best online information sources for anyone who wants to follow this story as it happens. Because valuable new links are appearing on an almost-daily basis, I add to and update this portal with some frequency.

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House of Representatives:

House Speaker Nancy Pelosi. Click here for the text of the health care reform bill as passed Nov. 7 on the floor of the House of Representatives, 220-215 (roll call).

This "blended" health care bill was assembled from versions that cleared three committees (see below). Click here for the bill text as released by Speaker Pelosi on Oct. 29., here for a Nov. 3 "manager's amendment" from Rep. John Dingell (the bill's lead sponsor) that made a few minor changes, here for last-minute modifications to the manager's amendment, and here for an amendment sponsored by Rep. Bart Stupak, D.-Mich., and adopted on the House floor, 240-194 (roll call), barring virtually any insurer participating in the exchange from offering coverage for abortions. Click here for a log of all actions taken on the blended House bill.

Click here for a summary of amendments submitted to the House rules committee, listed alphabetically by sponsor. Click here for the rule on the House vote, which passed, 242-192 (roll call). The rule set the terms for the floor debate and, most significantly, allowed for a vote on the Stupak anti-abortion amendment, on whose passage the U.S. Conference of Bishops conditioned support for the House bill. Click here for why the Stupak amendment was a crummy deal.

Click here for a nifty New York Times chart listing the 39 House Democrats who voted against the bill, with additional information about their background and their districts. One of the 39 nays came from Ohio Rep. Dennis Kucinich, a stalwart single-payer advocate. He opposed the bill because he thinks it's too kind to private insurers. The rest came from mostly conservative members. Thirty-one of them represent districts that went for McCain; 22 are from southern states; 14 are freshmen; and 12 of them represent districts where 20 percent of the nonelderly or more lack health insurance. (Special shout-out to Oklahoma Rep. Dan Boren, who voted nay even though 29 percent of his nonelderly constituents lack health insurance. Boren opposed the bill because "the worst thing we could do during a recession is raise taxes" and because "the public option would ultimately lead to a single-payer health care system.")

Click here for a statement from the sole Republican who voted in favor, Louisiana Rep. Anh "Joseph" Cao. This was achieved partly by an apparent promise from President Obama to consider boosting Louisiana's Medicaid payments and forgiving its community disaster loans. Passage of the Stupak anti-abortion amendment (see above) also helped win Cao's vote.

Click here for major changes in the blended bill compared to the bill as introduced. Click here for a short summary, here for a more detailed summary, here for a section-by-section summary, and here for an implementation timeline. Click here for some details on the public option, here for some details on the tax provisions, and here for some details on how, contrary to PhRMA's White House deal, the House bill allows the government to negotiate drug prices. The Congressional Budget Office estimates its cost here (updated here to include the manager's amendment, which lowered the bill's ten-year cost by $25 billion, and updated a second time here, to incorporate modifications to the manager's amendment, which bumped the cost back up by $20 billion). Changes to the tax provisions are scored here by the Joint Committee on Taxation. More summary details available here, here, and here.

House Ways and Means Committee. Here is the text of the bill as passed by the Ways and Means committee on July 17, 23-18, and here is a summary of Ways and Means' specific changes to the original bill (text, summary) as introduced by Ways and Means, Education and Labor, and Energy and Commerce prior to markup. For an early "discussion draft" of the tri-committee bill prior to the House bill's introduction, click here. For an even earlier outline, click here.

House Education and Labor Committee. The bill cleared the Education and Labor committee on July 17, 26-22. Here (scroll to bottom) are the 42 amendments that Education and Labor committee voted on, of which 23 were accepted.

House Energy and Commerce Committee On July 31, after extended negotiations between chairman Henry Waxman and conservative Blue Dog Democrats, the bill was passed by the Energy and Commerce committee, 31-28. The committee posted an admirably detailed, day-by-day record of its six-day markup.

Day One (July 16): transcript; chairman's mark (i.e, the working draft as altered by Waxman in various minor ways): text, summary).

Day Two (July 17): transcript; amendments: summary, texts. Six offered, four passed.

Day Three (July 20): transcript; amendment texts. Nineteen offered, 10 passed.

Day Four (July 30): amendment texts. Thirty-two offered, 18 passed.

Day Five (July 31): amendment texts. Forty-one offered, 22 passed.

Day Six (supplementary markup, Sept. 23): amendment texts. Fifteen offered, three passed. Click here to watch the morning session, here to watch the afternoon session.

House Republican Conference. Click here for its Web site skunking health reform, and here for its "reading guide" to the blended House bill. House Republican leader John Boehner introduced a GOP version alternative to Obamacare (text, summary). On Nov. 7 the House voted it down, 258-176 (roll call). Click here for the Congressional Budget Office estimate of the bill's cost. Click here for an earlier iteration.

Names of the Dead. The slightly-unhinged Rep. Alan Grayson, D.-Fla., set up this Web page to collect testimony from friends and family of people whose deaths can be attributed to a lack of health insurance. Grayson identified which of these people lived in Republican districts and recited their names on the House floor, along with the names of their representatives.

Senate:

Senate Finance Committee. Chaired by Max Baucus, finance completed markup on the bill in the wee hours of Oct. 2 and passed it on Oct. 13, 14-9. It is currently being blended with the Senate health committee bill (see below) by Senate majority leader Harry Reid, D.-Nev. Click here for a plain-English text of the finance bill as amended. Click here for the text in legislative language. The Congressional Budget Office estimates the bill's cost here.

Click here for a summary of amendments adopted by the committee during markup, and here for more detailed descriptions of each one.

The unamended "chairman's mark" is also online, along with a version incorporating certain proposed amendments that was made public on Sept. 22 (text, summary). Proposed committee amendments to the bill are posted here. Slate's Chris Wilson assembled them into this sortable spreadsheet.

Click here for Sen. Jay Rockefeller's Sept. 16 letter to Baucus making a highly persuasive case against health cooperatives as an alternative to a public option.

One week before Baucus introduced the chairman's mark he released a "Framework For Comprehensive Health Reform." For an earlier "draft proposal" (presented to members as a slide show) click here. Click here for Baucus' initial 98-page white paper on health reform, here for the financing options initially under consideration, and here for the coverage options initially under consideration. Click here to watch hearings.

Click here for a summary of provisions in the unamended chairman's mark that would take effect right away. Click here for a finance committee staff memo explaining the discrepancy between the Congressional Budget Office's cost estimate for the unamended bill ($774 billion over ten years; scroll down for link) and the finance committee's ($856 billion over ten years). Click here for a finance committee staff memo explaining (sketchily) how the unamended bill's expansion of the state-federal Medicaid program to enroll 11 to 12 million more people would affect the states. Click here for an analysis of the unamended bill by the Joint Committee on Taxation.

Senate Health, Education, Labor, and Pension Committee. This is the committee that was chaired by the late Ted Kennedy. Sen. Chris Dodd led it during Kennedy's illness (click here to watch markup sessions), and with Kennedy's death the chairmanship passes to Sen. Tom Harkin. The bill (text, summary) cleared the committee July 15 in a party-line vote, 13-10. For some reason, the health committee took two months to make public the bill as amended during the July markup. Here is a partial list of committee amendments (mostly Republican) and whether they passed or failed. Here is an earlier iteration of the Senate HELP committee bill prior to committee markup.

The Senate health committee bill, unlike the Senate finance committee bill, contains a public option, and Senate majority leader Reid has said that the blended bill he sends to the Senate floor will contain a public option with a provision allowing states to opt out. At the moment, though, there's some doubt as to whether he can assemble a filibuster-proof majority to support that, barring a decision to pass the bill through the budget "reconciliation" process, which requires only a majority. Reid is not expected to choose that option.

Senate Republican Leadership. The Senate GOP skunks health reform in a Senate Doctors Show starring Sens. Tom Coburn, M.D., and John Barrasso, M.D. The first episode had a Wayne's World-style charm, but subsequent episodes boasted distressingly slick production values.

White House:

White House Office of Management and Budget. OMB chief Peter Orszag's blog is frequently about health care reform. Click here for Orszag's entry touting the Independent Medicare Advisory Council, a proposed Fed-like body that could impose cost reductions on Medicare with minimal interference from Congress. Click here for Orszag's subsequent defense of the IMAC after the Congressional Budget Office concluded that Orszag's "game-changer" would save only $2 billion over 10 years (see CBO's July 2009 letter to Rep. Steny Hoyer, below). The IMAC idea is fleshed out in this July 17 letter to House Speaker Nancy Pelosi, and in this draft bill submitted by OMB.

White House Web Page on Health Reform. Bizarrely unhelpful, even in disseminating the latest White House line. Updated infrequently, it appears to exist mainly to increase goodwill among those not really following the legislation. You're better off just going straight to the main White House Web site. Click here for the president's Sept. 9 speech to Congress. Click here for the text of the White House plan (really just a sketchy outline) unveiled that same night. Click here for Obama's July 22 press conference on health care. Click here for Obama's June 15 speech to the American Medical Association. Click here for "The Economic Case For Health Reform," a report by the White House Council of Economic Advisers. Click here for candidate Obama's health plan during the 2008 campaign. (This last is not on the White House Web site.) Click here for a handy compendium of all Obama White House statements relating to health care.

The text of President Obama's St. Crispen's Day-style remarks to the House Democratic caucus prior to the Nov. 7 floor vote on health care reform ("We'll look back and say that was our finest moment") has not been released, but Politico has a reasonably detailed account.

Congressional Budget Office:

November letter to Rep. John Dingell scoring Speaker Pelosi's "blended" House bill as altered by Rep. Dingell's manager's amendment. The revised estimate puts ten-year savings at $129 billion (compared to the earlier $104 billion) and says the bill would, as before, exend coverage to 36 million of the 45 million people who are currently uninsured. A second November letter to Dingell scoring a revised version of his manager's amendment bumps the bill's savings down to $109 billion.

November letter to Rep. John Boehner scoring the GOP's proposed substitute for the Pelosi bill as saving $68 billion over the next ten years and extending coverage to three million of the 45 million people who are current uninsured. "Three million" is not a typo. The GOP bill would save significantly less money than the Pelosi bill and would leave "the share of legal nonelderly residents with insurance coverage" essentially unchanged. This analysis is "preliminary," apparently the only kind CBO is making these days.

October letter to Rep. Charlie Rangel scoring Speaker Pelosi's "blended" House bill as saving $104 billion over the next ten years and extending coverage to 36 million of the 45 million people who are currently uninsured. The bad news for Pelosi's compromise "level playing field" public option (see page six) is that its premiums would be higher than those for private insurers, not lower, as anticipated. This analysis, like CBO's analysis of the Baucus bill (see below) bills itself as "preliminary."

October letter to Sen. Max Baucus forecasting that the finance committee bill as amended during markup will save $81 billion over ten years and extend health coverage to 29 of the 45 million people who are currently uninsured. The analysis, produced in collaboration with the Joint Committee on taxation, is "preliminary."

September letter to Sen. Max Baucus forecasting that his chairman's mark will save $49 billion after ten years and extend health coverage to 29 million of the 45 million people who are currently uninsured.

September letter to Sen. Mike Enzi forecasting that a "public option" government health insurance program would exert competetive pressure on private insurers "to a small degree," and that public-option premiums would end up being "roughly comparable" to premiums in the private market. That's because the public option would likely "attract enrollees who, overall, are less healthy than average," a problem arising in part from restrictions in the various House and Senate bills on how aggressively the public option could negotiate prices with doctors and hospitals. Although the public option would be risk-adjusted (i.e., the sicker its enrollees, the larger a share it would receive of government funds), the CBO predicts that such risk-adjustment wouldn't likely be sufficiently precise to keep premiums low. (The Princeton sociologist Paul Starr, a veteran of the Hillarycare wars, has been predicting this scenario for some time.)

August letter to Rep. Dave Camp about the House health reform bill's impact on drug spending by Medicare beneficiaries. The CBO calculates that while average premiums would increase 5 percent in 2011 and 20 percent by 2019, out-of-pocket costs for drug purchases would decline due to the bill's creation of a rebate program for Medicare beneficiaries who are also enrolled in Medicaid (about one-quarter of the total) and to a phasing-out of the "donut hole," a gap in coverage for seniors who spend more than $2,700 annually on drugs but less than $6,154. (These amounts change from year to year.)

August letter to Rep. Nathan Deal arguing that preventive care typically "leads to higher, not lower, medical spending overall."

July 2009 letter to Rep. Dave Camp estimating that six million people would purchase health insurance through the House bill's proposed health insurance exchanges, and that two million of these would select the public option. The CBO disputes an estimate by the Lewin Group (see "The Cost and Coverage Impacts Of A Public Plan," above) that more than 100 million people would enroll in the public option if all employers were given access to the exchanges. (Under the existing bills, only small employers are) The CBO does not give a figure of its own, but says its estimate would be "substantially smaller."

July 2009 letter to Rep. Steny Hoyer scoring savings from the White House's proposed Independent Medicare Advisory Council, a Federal Reserve-type agency that could impost cost reductions on Medicare with minimal interference from Congress, at a measly $2 billion over 10 years, thereby dashing White House budget director Peter Orszag's hopes that the IMAC would be a political "game-changer." The CBO believes "the probability is high that no savings would be realized ... but there is also a chance that substantial savings might be realized," and that after 10 years the IMAC "would generate larger but still modest savings on the same probabilistic basis."

July 2009 letter to Rep. Charles Rangel scoring the House bill as costing a whisker over $1 trillion over ten years. This doesn't take into account the bill's proposed measures to raise money, which include a surtax on high incomes.

July 2009 letter to Sen. Ted Kennedy scoring his bill as costing $597 billion over 10 years and halving the number of uninsured Americans. Jonathan Cohn of the New Republic writes that this does not take into account a planned expansion of Medicaid that does not fall under the Kennedy committee's jurisdiction. That would increase the bill's cost to at least $1 trillion, Cohn estimates, but would very nearly eliminate the ranks of the uninsured.

June 2009 letter to Sen. Ted Kennedy scoring his bill as costing $1 trillion over 10 years and extending coverage to only 16 million of the 45 million uninsured. The cost is high and the coverage is meager because the estimate assumes no "pay or play" provision for employers, no public option, and no "individual mandate" requiring all Americans to purchase health insurance. Kennedy's HELP committee is still trying to hammer these out.

June 2009 letter to Sen. Kent Conrad on budgetary impacts of health reform. Reviews various policy options.

"Key Issues in Analyzing Major Health Insurance Proposals," December 2008.

Bloggers:

The Treatment. (New Republic health blog). For analysis of the health care debate, this is the best single source available online, largely because of its principal author, New Republic Senior Editor Jonathan Cohn. Cohn is the author of Sick: The Untold Story of America's Health Care Crisis—and the People Who Pay the Price, which is the smartest and most readable survey I've seen of America's centurylong failed experiment with market-driven health care. Cohn is thoughtful and judicious (occasionally to a fault), and he stays on top of important developments.

Ezra Klein. (Washington Post blog; for posts prior to May 13, see his American Prospect blog). Klein writes on a variety of economic topics, but he's developed a particular expertise on health care. Like a lot of younger bloggers, Klein can write in a tone that's irritatingly narcissistic and self-aggrandizing. But Klein is extremely knowledgeable and well-sourced. He frequently scoops the Post's newspaper staff on important health care stories, and his arguments are usually sound.

The New Health Dialogue Blog. The New America Foundation's health reform blog is much more interesting than its deadly name would have you believe.

Matthew Yglesias. Yglesias majors in foreign policy but minors in health reform, and is worth reading on both.

Gooznews. Smart analysis from the left by Merrill Goozner, a former economics reporter for the Chicago Tribune, with an emphasis on Big Pharma.

Kausfiles. Slate's Mickey Kaus focuses mainly on the politics of health care reform.

Robert Reich. The policy entrepreneur and former labor secretary has emerged as a leading critic from the left. Occasionally a little sloppy with the facts, Reich nevertheless stays on top of developments and offers characteristically sharp analysis.

Megan McArdle. The Atlantic's libertarian economics blogger, imported from the Economist, opposes health reform.

Health Affairs Blog. Health Affairs, a peer-reviewed journal about government health policy, devotes much of this Web page to expert commentary from a variety of perspectives. Kind of blah, but I keep hoping it will get better.

The Health Care Blog. Informed insider commentary from Matthew Holt and others. Not for dilettantes.

News Sites:

Politico Health Care Page. Politico has stayed on top of breaking developments, frequently scooping the competition, and takes the trouble to provide readers direct access to documents of interest. The Web site can be a bit lazy about updating its health care page, so if you want to be certain not to miss its latest offerings on the reform bill try the home page.

Kaiser Health News. A news agency recently started by the Kaiser Family Foundation, a nonprofit cousin of Kaiser Permanente, the pioneering health maintenance organization. (The common ancestor is Henry J. Kaiser. There is no current affiliation, financial or otherwise, between the Kaiser Family Foundation and Kaiser Permanente.) It claims and has thus far demonstrated independence from any financial interests; the executive editors, Laurie McGinley and Peggy Girshman, are veteran journalists for the Wall Street Journal, Congressional Quarterly, and National Public Radio, and the scrupulously nonpartisan Len Downie, former executive editor of the Washington Post, chairs the advisory committee. Kaiser Health News has quickly established itself as a comprehensive news source on health care reform. The site is updated throughout the day, but not quite enough, and often only with summaries of other news organization's scoops.

New York Times Prescriptions. Love the name! David Herszenhorn, the principal author, is an excellent reporter, and in a few short months this site has gone from being ho-hum to being clearly superior to the Washington Post's Daily Dose and the Wall Street Journal's Health Blog (see below).

Talking Points Memo/Health. TPM is looking less like a blog these days and more like a news site. Brian Beutler's coverage has been especially scoop-intensive.

The Huffington Post still looks mostly like an aggregation of blogs, but Sam Stein has been delivering health-reform scoops there.

C-span Health Care Hub. Video of congressional hearings, press conferences, etc. related to health reform.

Daily Dose. The Washington Post's health reform blog. Less interesting than Ezra Klein's Post blog, which is a little embarrassing because Klein is only one person, whereas Daily Dose has multiple authors. The Post doesn't seem to be putting much energy into the site. Still, worth a glance.

Health Care Reform 2009. The New England Journal of Medicine privides expert commentary from many different points of view.

Wall Street Journal Health Blog. Less focused on health reform, but what's there is usually very good.

Columnists:

Paul Krugman. The Nobel Prize-winning economist's New York Times column (scroll down) often slices through conservative cant about health reform. So does his blog.

Karen Tumulty. Intelligent reportage from straight down the middle. Tumulty doesn't surprise, but she does inform.

Steven Pearlstein. Washington Post financial columnist increasingly preoccupied with health care; smart liberal-centrist analysis.

David Leonhardt. New York Times columnist who writes frequently and intelligently on health care.

Robert Samuelson. The Newsweek columnist has emerged as a leading critic from the right.

Timothy Noah. Modesty forbids.

Comparison Charts of House, Senate, and White House Bills/Proposals:

The Wall Street Journal's chart, updated Nov. 3, includes the "blended" House bill that Speaker Nancy Pelosi sent to the floor.

The Commonwealth Fund's chart is more interactive and fairly detailed. Dated Oct. 29, it covers the Pelosi bill. A separate chart details the bills' insurance provisions.

The Committee For A Responsible Budget has a chart that focuses on costs, updated Oct. 29 (ignore the Sept. 16 date), which means it, too, covers the Pelosi bill.

The New York Times' chart was updated on Nov. 8, which means it, too, covers the Pelosi bill.

The Kaiser Family Foundation has a superbly detailed chart, updated on Oct. 15, but it doesn't include the Pelosi bill and is therefore out of date. C'mon, Kaiser, get the lead out! On the plus side, Kaiser has a tool for calculating health care subsidies under the various bills, updated Oct. 30, that does include the Pelosi bill. Katharine Seelye of the New York Times explains how to use it here.

The Washington Post's chart is the prettiest and most interactive, updated Oct. 13, but it's out of date because it lacks the Pelosi bill.

Academics:

Uwe Reinhardt. Links to publications by America's leading health care economist. Click here for Reinhardt's recent posts to the New York Times' "Economix" blog.

Jacob Hacker. Links to publications by the political scientist who created the "public option." Click here for Hacker's December 2008 report, "The Case For Public Plan Choice in National Health Reform." Click here for Hacker's April 2009 report on how to structure such a plan on a "level playing field" with private insurers. Click here for other Hacker writings on health care.

Jonathan Gruber. Links to the MIT economist's op-eds on health reform. Click here for his Oct. 12 paper arguing that, contrary to a health insurance industry study, the Senate finance comittee bill would lower health premiums. Click here for his Nov. 2 testimony before the Senate health committee arguing that health reform would help small businesses.

Think Tanks and Public-Policy Consultants:

Rapid Response: The Obama Health Plan. Heritage Foundation Web site dedicated to killing the Obama health care plan with all deliberate speed. Here's the right-wing solution Heritage prefers.

Health Care Cost Monitor. The latest research on health care costs, an issue that the White House and Congress have placed at the center of the health care debate, from the Hastings Center, a bioethics think tank.

"Is The Public Plan Option a Necessary Part of Health Reform?" Yes, argue John Holohan and Linda Blumberg of the Urban Institute. They predict the insurance industry "would survive at about the same size but be more efficient and more effective in controlling health care spending."

The Lewin Group. Widely respected in the past, since 2007 Lewin has been owned by the insurer UnitedHealth, which may have undermined its objectivity. Click here for its report forecasting financial catastrophe for health insurers if a robust "public option" is included in health care reform. (Say it with me: Not my problem!) Click here for Lewin's budgetary evaluation of the Senate finance bill (summary findings here), and here for a similar evaluation of the House bill as passed by the Energy and Commerce committee prior to its being blended with two other versions of the bill (summary findings here). These last two studies were commissioned by the fiscally conservative Peter G. Peterson Foundation, whose president, former Comptroller General David Walker, drew on their findings in this somewhat gloomy Nov. 9 speech.

Commonwealth Fund. A frequent source for health journalists of research related to health reform.

Henry Aaron. Links to publications by Brookings' smartest expert on health reform. Brookings also has a Center for Health Care Reform led by Mark McClellan, former Food and Drug Administration commissioner and administrator of the Centers for Medicare and Medicaid Services under President George W. Bush (and older brother to prodigal White House press secretary Scott McClellan).

Other Data and Documents:

"Health Insurance and Mortality in U.S. Adults." This study by six Harvard-affiliated physicians calculated that between 35,000 and 45,000 annual deaths among the nonelderly can be attributed to a lack of health insurance.

Side-by-Side Comparison of Health Care in U.S. vs. Other Industrialized Nations. From NPR. Read it and weep.

"Health Systems: Improving Performance." This is the 2000 report by the World Health Organization made famous by Michael Moore's Sicko. It ranks the world's health care systems. France is no. 1. The U.S. is no. 37. But hey, that's still two notches ahead of the impoverished island nation of Cuba! (For rankings, go to Page 152.)

"The Language of Healthcare 2009." The Republican game plan for killing health reform, as outlined to House members in May by "Dr." Frank Luntz. (No, not that kind. Luntz has a Ph.D. in political science.) Herr Doktor Luntz's prescription owes some debt to William Kristol's 1993 memo about how to kill Hillarycare. Kristol recently updated the latter, advising Weekly Standard readers: "Kill It, and Start Over." (In the intervening years Kristol has learned it's bad form not to pretend to want to start over.) See also Celinda Lake's strategy memo for Democrats on how to sell health reform this year.

Lobby Groups:

Health Care for America Now! A coalition of labor unions and other liberal groups lobbying for universal health care.

Campaign for an American Solution. The insurance lobby. Click here for its Oct. 12 study, released on the eve of the Senate finance committee vote, alleging that over the next decade the bill would raise the cost of the average family health insurance policy by $4000. The study does not take into account "the impact of the new subsidies on the net insurance cost to households. Also, if other provisions in health care reform are successful in lowering costs over the long term, those improvements would offset some of the impacts we have estimated." An underappreciated aspect of the study is the industry's admission that even without health reform health premiums will nearly double. A more succinct case for the public option can scarcely be imagined. Click here for the group's Oct. 20 attempt at damage control on the Washington Post op-ed page.