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May 26, 2022

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2,074-page health bill includes surgery, payroll tax hike

WASHINGTON -- Ready for a little light reading? The new Senate health care bill, the Patient Protection and Affordable Care Act, is now posted online at

Be sure to check out the highlights -- including a new 5 percent tax on elective cosmetic surgeries (the provider gets taxed, not you, at least not directly).

It has lots of familiar terrain about insurance reform, which has been the centerpiece of the Democrats' bills, including bans on insurance companies being able to deny coverage for preexisting conditions, as well as the much-discussed public option.

In crafting the bill, Senate Majority Leader Harry Reid has altered somewhat the way it is paid for -- hence the cosmetic surgery tax.

To raise revenue, the bill also retains the tax on high-end insurance plans, the so-called Cadillac plans, but ups the limit employees can receive before the tax kicks in.

The biggest tax change is in the new half-percent increase in the Medicare payroll tax on employees who earn more than $200,000 a year ($250,000 for families.) This may generate problems down the road, as the House faced pushback on a similar, higher tax on high-wage earners, and ultimately taxed those at $500,000 (or $1 million for families.)

Nevadans watching the health care debate may be interested to know that Reid has abandoned the deal he initially struck to provide 100 percent federal coverage for Medicaid expansion in high-unemployment states, including Nevada. Now, all states will receive full federal funding to expand their Medicaid programs for the first three years.

The bill also includes stricter language on illegal immigrants, which prohibits those here illegally from using their own money to buy insurance on the new health care exchange.

The legislation does not include the strict anti-abortion language adopted in a divisive House amendment, but rather ensures that no federal funds be used on abortion coverage.

Republicans wasted no time attacking the bill -- noting, in part, the light reading: It's a 2,074-page bill.

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