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Published at www.nejm.org November 4, 2009 (10.1056/NEJMp0910493)

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Accelerating progress toward the Democrats' goal of enacting health care reform legislation, House Speaker Nancy Pelosi (D-CA) unveiled a bill on October 29 that would establish a mandate for most legal U.S. residents to obtain health insurance. The bill would extend coverage to some 36 million people, and according to the Congressional Budget Office (CBO),¹ its net costs ($894 billion over 10 years) would be fully paid for — largely through an income-tax surcharge on high-income persons and a reduction in the growth of Medicare's payment rates for most services, except those provided by physicians. Meanwhile, Senate Majority Leader Harry . . . [Full Text of this Article]

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Mr. Iglehart is a national correspondent for the Journal.

This article (10.1056/NEJMp0910493) was published on November 4, 2009, at NEJM.org.

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