To garner much-needed support from anti-abortion Democrats, House Speaker Nancy Pelosi (D-CA) allowed them to attach the infamous Stupak-Pitts amendment to her chamber's version of the bill. The provision would bar women who are receiving federal subsidies for their insurance from purchasing plans that cover elective abortions. It would also bar the public plan from offering abortion coverage. The Senate version takes a more moderate approach: Those receiving federal subsidies could buy insurance that covers abortion -- but insurers would have to place federal money in separate accounts and could only use private dollars to cover the procedure. The public plan could also offer abortion coverage, as long as it segregated federal subsidies in the same way.

Cost: The difference a year makes

According to the Congressional Budget Office, the House bill would cost about $1.052 trillion and reduce the deficit by $138 billion. The CBO predicts that the Senate bill would cost $849 billion, while cutting $130 billion from the deficit. This difference is largely due to the fact that many major provisions in the Senate proposal would not go into effect until 2014 -- a year later than in the House bill.

Coverage: Universal? Not quite

For decades, the Democrats talked of providing universal healthcare. These bills come closer, but neither quite reaches that goal. Both, however, will significantly reduce the number of uninsured. Today, 83 percent of non-elderly legal residents have health insurance. (The elderly are covered by Medicare.) Under the House bill, 96 percent of that population would be covered by 2016. The Senate's legislation would expand coverage to 94 percent. Still, about 18 million people would remain uninsured under the House's proposal, as would about 23 million in the Senate's.

 

Paying the bills: What gets taxed

Under the House bill, much of the money to pay for the reforms would be raised through a 5.4 percent surtax on high-income people -- that is, individuals making more than $500,000 a year or couples with annual incomes in excess of $1 million. The Senate version, on the other hand, would impose a different series of new taxes including: A 40 percent tax on “Cadillac health plans” (employer-sponsored group plans with premiums of over $8,500 for individuals or over $23,000 for families); the introduction of annual fees for health care companies; an increase in Medicare payroll taxes from 1.45 percent to 1.95 percent for those earning more than $250,000 a year and the implementation of the so-called "Botox tax," which is a five percent tax on elective cosmetic medical procedures.

Employer mandates: Do companies need to offer health insurance?

The House bill stipulates that employers with payrolls of more than $500,000 must offer health coverage or pay a federal tax. The Senate version does not explicitly require employers to provide coverage; however, companies with 50 or more full-time employees would have to pay a penalty of $750 per employee if they fail to offer coverage and if any of their employees obtain federally subsidized care via the new health insurance exchanges.

Friday, Senate Democratic leaders agreed to include the Wyden amendment in their healthcare proposal. Under this provision, employers would have one of two options. Companies could offer their employees a single plan and give all eligible workers the option of accepting a voucher to independently purchase their own insurance. Alternatively, an employer could offer two or more health care plans, provided that at least one has a premium that costs no more than the average premium of the two least expensive health plans in the local exchange. The House bill includes no comparable language.

Individual mandates: Penalties for remaining uninsured

Both bills require most Americans to maintain a minimum level of health insurance. However, the penalties for not doing so are much stiffer in the House bill: Those who failed to acquire insurance would pay a tax equal to 2.5 percent of their gross income of over $9,350 for individuals or $18,700 for couples. Under Reid’s legislation, the penalties would start at $95 per person in 2014 and gradually go up to $750 a head in 2016.

Insurance Exchanges: State-based or national

Both bills would create some sort of health insurance exchange, a marketplace where individuals and small companies can shop for insurance and compare benefits and prices. The exchanges would put individuals into large risk pools, which are intended to provide them with leverage to purchase insurance at a lower cost. The House bill would create a national exchange, although states could petition to run their own exchanges as well. Under the Senate proposal, states would form their own exchanges. This, however, could prove problematic, as it is unclear whether state exchanges would be able to attract a sufficient number of enrollees to push for lower premiums.

Illegal Immigrants

The House bill would allow illegal immigrants to buy insurance from the exchanges, but would not allow them to obtain federal subsidies. The Senate version prohibits illegal immigrants from purchasing insurance from these exchanges, even if they could pay for their own coverage in full. This could have the effect of preventing illegal immigrants from buying individual insurance altogether.

Some skepticism on women's part about these relaxed standards makes sense after years of repeatedly being pinned with pink ribbons, lectured about the importance of yearly paps and hit over the head with pamphlets about the lifesaving HPV vaccine. That's especially true for those of us who know women -- some in their 20s and 30s -- with breast or cervical cancer. As my friend wrote, it feels a bit like the overarching message is: "Chill out, chicks! It's just cancer!" Yeah, and it'll just kill you!

That these new guidelines come amid a contentious healthcare debate has also raised paranoia that this is part of an effort to lower healthcare costs -- at the expense of women's health. The impossible-to-avoid Sarah Palin took to Facebook late Thursday to air her worries about this shift in the wisdom about pap smears: "There are many questions unanswered for me, but one which immediately comes to mind is whether costs have anything to do with these recommendations," she wrote. "The current health care debate elicits great concern because of its introduction of socialized medicine in America and the inevitable rationed care." Many other Republicans have jumped on the "rationing" bandwagon as well. (Yeah, now they care about women's healthcare!) Judy Norsigian, executive director of the Boston Women's Health Book Collective (aka Our Bodies Ourselves), told me that "we have a discourse at the moment that is dominated by right-wing rhetoric that the Democrats are all about denying healthcare services."

The truth is that Kathleen Sebelius, secretary of health and human services, insists that the breast cancer screening guidelines will not change "what services are covered by the federal government." (Also, insurance companies claim they won't change mammogram coverage and, as David Dayen points out on FireDogLake, "the procedure is mandated at [age 40] in 49 of the 50 states.") The Obama administration has yet to address the new standards for cervical cancer screening -- but medical opinion on the benefits and risks of pap smears is far less contentious than when it comes to the mammogram debate (which has been going on for decades).

Cindy Pearson, executive director of the National Women's Health Network, an independent consumer-advocacy group, told me that the suggested pap smear routine "is not at all about cost-cutting," but instead "improving women's health." Most women's bodies are able to fight off the virus that causes cervical cancer -- but, when a doctor does detect infection through a test for the virus or the appearance of "disturbed cells" on the surface of the cervix, they typically provide treatment that very well might be unnecessary. This isn't just an issue of experiencing bothersome "cramping, discomfort and missing some work" after having the abnormal cells removed, she says -- "what's actually happening is it's weakening the cervix in some women so that they can't support a pregnancy full-term."

My question for her was why doctors haven't instead adjusted their response to the discovery of the virus' presence -- was it in the interest of avoiding malpractice suits? She explained that the medical community operates under the mantra of "if you see it, you treat it." Essentially, the new cervical cancer screening guidelines reduce the likelihood of a doctor seeing it, so as to avoid their treating something likely to clear up on it's own. "Sometimes there are cases when you say, 'Watch and wait,'" she says, "but almost no one does it."

It just goes to show that you have to be your own advocate when it comes to navigating the healthcare system. As Mary Elizabeth Williams wrote earlier this week about the new mammogram standards, "What’s optional for one woman may be the difference between life and death for another." She also added that "blanket guidelines are just that -- they're fine for covering the many, and they are not laws we have to follow." A woman and her doctor still have to take into account her individual history and particular risk factors. That has always been the case and continues to be so. As Norsigian from Our Bodies Ourselves said: "You give women the scientific evidence and let them make their own choices."

"Throughout my Senate career I have consistently rejected efforts to obstruct," Nelson said in a statement. "That's what the vote on the motion to proceed is all about. It is not for or against the new Senate health care bill released Wednesday .... If you don't like a bill why block your own opportunity to amend it?"

Another key vote, though, remains uncommitted. Majority Whip Dick Durbin had said Friday that Sen. Blanche Lincoln, D-Ark., had told Reid how she'll vote, implying that she, too, was a yes. He's since walked that back, however, and Lincoln remains publicly uncommitted. So does Sen. Mary Landrieu, D-La.

Elsewhere on Salon today, there's a great piece from Joe Conason on Lincoln and her vote. You can read it here.

Among the handful of Democratic senators who have threatened to support a Republican filibuster, Lincoln is alone in facing reelection next year. Her weakness in recent polls, which suggest that well under half of her home state's voters approve of her performance, has clearly frightened her and emboldened nearly a dozen Republican candidates who want to run against her. Despite careful pandering to right-wing opinion, she has inevitably become a prime target of the National Republican Senatorial Committee, which has vowed to punish her for voting with her party on healthcare.

But as that fateful tally approaches, Lincoln is at last feeling serious pressure from Democrats as well. The man who brought the free clinic to Little Rock -- along with "Countdown" host Keith Olbermann -- is Lt. Gov. Bill Halter, who could be encouraged to enter a primary against her should she uphold the Republican filibuster. A former Clinton administration official and Rhodes scholar, Halter raised his profile by establishing a popular statewide lottery, with proceeds dedicated to education.

When Halter was asked on "Countdown" whether he might run for Lincoln's seat, he didn't say no. No doubt he knows that the activists who belong to Moveon.org and Democrats for America have vowed to raise millions of dollars to support a primary opponent for Lincoln unless she votes for cloture.

Lincoln's position is especially perilous at the moment because no matter what she says or does, her ratings seem to decline. Back in July, she wrote an Op-Ed essay on healthcare reform for the Arkansas Democrat-Gazette, the state's largest daily newspaper, indicating that she supported "real" reform, including either "a quality, affordable public plan or non-profit plan that can accomplish the same goals as those of a public plan." In that same essay she went on to berate "the opponents of reform, who have no real plan for improving health care," for reviving the "tired arguments of the past," with their warnings about "a Washington takeover of health care which will raise your taxes, get between you and your doctor, and eliminate private insurance." She warned Arkansans not to be misled by those who would use such "misinformation" to stimulate fear and block change.

But as her poll numbers plummeted and her position shifted sharply to the right, Lincoln herself quickly became a purveyor of misinformation, particularly concerning the public option. In a September speech at the University of Arkansas medical school, the senator described a bill that does not exist. "For some in my caucus, when they talk about a public option they're talking about another entitlement program, and we can't afford that right now as a nation," she said. "I'm not going to vote for a bill that's not deficit-neutral, and I'm not going to vote for a bill that doesn't do something about curbing the cost in the out years, because it would be pointless ... I would not support a solely government-funded public option."

As Lincoln certainly knows by now, because she claims to have read every page of the pending bills, the public option is neither an entitlement nor solely government-funded, but is to be financed with premiums from its beneficiaries. As for the cost of reform, she also knows that the Senate bill saves hundreds of billions of dollars over the next two decades, according to Congressional Budget Office scoring.

Running away from reform, Lincoln looked weak rather than thoughtful, and cowardly rather than centrist. Her numbers have not improved, and the Republicans are mocking her as a flip-flopper. The damage to her standing among Democrats could make the difference on Election Day, because many voters who pulled the lever for her in 2004 will simply fail to show up. A Democratic state senator who has supported Lincoln in the past told me that she recently sent a message to Lincoln's office: Healthcare is a "line in the sand," not just another issue.

It was Bill Clinton who uttered the most pungent criticism of Lincoln in recent days, however, although he didn't mention her by name. Speaking at a luncheon to celebrate the fifth anniversary of the opening of his presidential library in Little Rock on Wednesday afternoon, he berated the opponents of reform for preserving a system that spends far more than other developed countries for worse care -- at least $900 billion annually, according to his back-of-the-envelope calculations.

Clinton asked his audience, which included hundreds of Democratic donors and activists, to imagine a scenario in which he could somehow run for a third term as president (which drew enthusiastic applause). Then he asked them to consider what would happen if he offered the following campaign promise:

"If you elect me again, the first thing I'm going to do is put a $900 billion tax on you ... I'm going to have the government print the money, and put it on elevated flatbeds, and display it along the national mall. And we're going to broadcast this ceremony on national television. And then I'm going to motor myself from one end of that $900 billion to the other, sprinkling Kerosene on it, and then I'm going to set it afire and watch it burn.

"How many people do you think would vote for me?" he demanded. "If you don't want to reform healthcare, that is your position. That is what you are advocating."

Lincoln wasn't there, but she could have heard the roaring laughter all the way back in Washington.

Like other Republicans in the last couple of days, Barrasso tried to pretend that the recent decision by the U.S. Preventive Services Task Force, recommending that women start routine mammograms at 50 and not 40, was related to the Democrats' push for insurance reform. Even Sarah Palin has had to admit there are no "death panels" in the Democrats' bills; so now we have "breast panels," where Republicans claim bureaucrats will deny mammograms to women under 50 thanks to Obama's push for reform.

It's an enormous lie. Various government advisory panels have been trying to ratchet up the age for women to begin routine mammograms (from 40 to 50) going back to the Clinton administration through the George W. Bush administration and now, again, in the Obama administration. I'm not sure which side is right; I know doctors and breast cancer advocates on both sides of the issue. All I know is that the recent recommendations have nothing to do with so-called Obamacare. But I watched Barrasso, who clearly knows better, lie to Schultz about it all on Thursday. Here's what he said:

"You see what happened now with this rationing of care, with this preventive task force, they're preventing services for women, with mammograms. That's really a preview into what may happen with healthcare in America, when you get the government standing in between a patient and their doctor….Washington says it knows best, it says 'No, don't do mammograms to age 50, stop after age 75. 'You know what that's gonna do? That's gonna cost lives."

Thanks to Ed Schultz for giving me the chance to answer Barrasso, and explain how badly he distorted the facts about the panel's origins and power, and how well he represented the Republican position: say absolutely anything to stop healthcare reform. Lie, if you have to. Of course, the preventive services panel has no standing to change policy, and both Health and Human Services Secretary Kathleen Sebelius and the American Cancer Society came out against the panel's recommendations. And Barrasso knows that.

That's what I said on "The Ed Show." One post-show correction: It's not the very same panel issuing these mammogram-restricting guidelines over the years; earlier it was the National Institute of Health's Consensus Development Conference that recommended that mammograms begin at 50. The point is that various federal panels under various presidents have suggested raising the age at which women start mammography, and three presidents in both parties over the last 20 years have had to decide what to do. Clearly it's a medical debate, not a political one, and Republicans are dishonest and fear-mongering to pretend otherwise.