Health-Care Reform: A Tale of Two Chambers

Health-care reform is halfway to becoming a reality, with the passage of the House bill on Saturday. But the battle is just starting to heat up.

Without the procedural wrangling available to their colleagues in the Senate, House Republicans didn't have much bargaining power. The House Democrats didn't even need their entire party to get on board; 39 of them voted against the bill.

The difference in the need for compromise between the two chambers will make for one interesting show when lawmakers attempt to rectify the two bills in their current forms. Here's a look at the contentious topics, and how they might affect your pocketbook or portfolio.

Government-sponsored public option
House: The House bill provides for a public option that would compete with private health insurers.
Senate: The public plan is back as a possibility in the Senate, with the caveat that states would have the option to bow out of it.
Pocketbook or portfolio: It depends on whom you talk to. Health insurers like UnitedHealth Group (NYSE:UNH) and WellPoint (NYSE:WLP) think a public option would cut into their profits. The Congressional Budget Office estimates that the public plan would have premiums slightly higher than those of private insurers. So there may not be a huge benefit to your own finances, while owners of stock in health insurers may not see much pressure on margins.

Covering everyone
House: Employers with payrolls greater than $500,000 would be required to provide their workers with health insurance.
Senate: The Senate's version is a little more lenient; companies with more than 50 full-time employees would be required to pay a fee for workers who enter into a government-subsidized plan.
Pocketbook or portfolio: It might be about time to start looking into whether the companies you invest in offer health care to their employees. The requirement shouldn't affect larger companies like General Electric (NYSE:GE), Procter & Gamble (NYSE:PG), or AT&T (NYSE:T), but it potentially could cut into profits of some small-cap stocks.

And I do mean everyone
House: The House bill requires everyone to have coverage, or face fines up to 2.5% of their income.
Senate: The Senate's version is considerably more lenient.
Pocketbook or portfolio: Companies like Pfizer (NYSE:PFE) and Johnson & Johnson (NYSE:JNJ) could get a boost from the increased number of insured patients. Your insurance rates could also get a boost -- and not the good kind -- if the penalty to require coverage isn't strict enough. Since the bills require insurance companies to cover everyone regardless of preexisting conditions, there's incentive for individuals not to have coverage until they actually need it, which would ultimately drive up costs for those who have year-round coverage.

Paying for it all
House: A tax on those making $1 million a year, and another $20 billion over 10 years from medical device makers, covers some of the $1 trillion cost.
Senate: High-cost Cadillac plans will get taxed, as will some health-related services.
Pocketbook or portfolio: The high-wealth tax obviously depends on what your paycheck looks like these days. Unfortunately, this Fool is safe for now. The added taxes on health-care companies could cut into profits, but I predict most will be able to pass the added costs along in the form of increased prices. We'll be paying for the whole thing one way or another.

A long way to go
Keep in mind that the Senate hasn't introduced final legislation, and it's still waiting to hear back from the Congressional Budget Office on the final cost of its version of the bill. Even then, the proposed law could -- most likely will -- change during the debate, and a final bill may not be voted on until next year.

Then the real fun begins, as the two chambers try to meet each other halfway. Unfortunately, that means we're a long way from knowing how this will ultimately affect our own bottom lines.

What's the one thing you're most interested in seeing in the final bill? Let us know in the comments section, below.