After months of debate, Senate Democrats unveiled a comprehensive health reform bill that the president dubbed a “critical milestone,” but Senate Republicans warned is far from perfect.

Harry Reid

Majority Leader Harry Reid (D-Nev.) officially introduced The Patient Protection and Affordable Care Act  on Nov. 18. The proposed legislation is expected to cost the nation $848 billion over the next decade while reducing budget deficits by $130 billion, according to the non-partisan Congressional Budget Office.

Reid remains cautiously optimistic that he can secure 60 votes from his colleagues to begin debate on the measure, possibly as early as Nov. 21, according to press reports.

The actions outlined in the 2,074-page bill would reduce the number of America’s uninsured by about 31 million by 2019, according to the CBO, leaving about 24 million non-elderly U.S. residents without coverage.

Similar to The Affordable Health Care for America Act (HR 3962), passed Nov. 7 in the House, the Senate plan also establishes a government-run health insurance program that it says will compete with private insurers, but allows states to opt out of the public option through through own legislation.

The public option was unanimously rejected by Senate Republicans during debate of two committee bills earlier this year, including being completely omitted from a bill passed by the Senate Finance Committee last month authored by Sen. Max Baucus (D-Mont.).

New fees, taxes

Other areas where the Senate bill differs from the one in the House is through a series of new fees and tax increases. The Medicare payroll tax for those earning $200,000 or more a year and couples earning $250,000 a year would increase from 1.45% to 1.95% and a 40% tax on policies worth more than $4,500 for individuals and $23,000 for families – the so-called “Cadillac” health plans – would be created under the bill.

Other sources of revenue for the bill are a 5% tax on the cost of elective cosmetic surgery as well as annual fees on health insurers and pharmaceutical companies.

The individual mandate to obtain health insurance is also included in the bill, with a $95 fine for failure to do so in the first year that gradually escalates to $750 by 2016, according to the bill.

President Barack Obama called the release of the bill “another critical milestone in the health reform effort,” adding his approval to the proposed legislation’s spending guidelines and deficit reduction.

“From day one, our goal has been to enact legislation that offers stability and security to those who have insurance and affordable coverage to those who don’t, and that lowers costs for families, businesses and governments across the country,” the president said in a statement. “Majority Leader Reid, Chairmen [Max] Baucus and [Christopher] Dodd, and countless Senators have worked tirelessly to craft legislation that meets those principles.”

Once passed by both houses of Congress, one comprehensive bill will be delivered to Obama for his signature, which the White House expects by the end of this year.

Bipartisan wrangling

In his own statement, Sen. Dodd (D-Conn.), who oversaw legislation passed by the Senate’s Health, Education, Labor and Pensions (HELP) Committee, called the legislation “a comprehensive and thorough approach that comes in under budget and finally makes stable, affordable, quality care available to every American.

“It is my commitment that those who wish to contribute to this effort will be welcomed, and their ideas carefully considered, in that debate,” Dodd said. “However, those who simply wish to stand in the way of change and protect a system that puts the powerful ahead of the people will be outnumbered and defeated. For too long, the status quo has found a way to endure. Not this time. This time, the Senate will deliver.”

Sen. Mitch McConnel (R-Ky.), however, warned his colleagues in the Senate that “this will not be a short debate,” according to press reports.

“Higher premiums, tax increases and Medicare cuts to pay for more government,” he said. “The American people know that is not reform.”