On the eve of the U.S. House vote on health care reform, both of New Hampshire's representatives have come out as enthusiastic supporters of the bill.

Democrat Carol Shea-Porter played a prominent role in the bill's unveiling, standing near House Speaker Nancy Pelosi and touting the benefits the bill will give to seniors. Democrat Paul Hodes held a conference call with the news media yesterday and said he too plans to vote yes.

"I've finished reviewing and reading the text of the health care reform bill, and I believe the health care reform plan is the right step toward providing portable, affordable, high-quality health care to New Hampshire's working and middle-class families," Hodes said.

The House plans to vote tomorrow on the 1,990-page bill. The bill, which was proposed by House leadership, is the final version of a bill that was worked on by three House committees.

The bill includes a government-run insurance plan, or public option, which would compete with private insurance companies. That plan would be part of a health insurance exchange, a newly created marketplace where individuals and small businesses could compare private and public insurance plans.

The bill would require all Americans to have health insurance and would require most employers to provide health care coverage or face a penalty, with some exceptions for small businesses. It would ban insurance companies from denying coverage because of pre-existing conditions. The bill would expand eligibility for Medicaid and offer subsidies to help moderate-income people buy insurance. The bill is expected to insure 36 million more Americans.

The estimated cost is $894 billion over 10 years. Savings from changes to Medicare and Medicaid are projected to be $426 billion over 10 years. An additional $461 billion would be raised by a 5.4 percent tax on individuals with incomes over $500,000 and families with incomes over $1 million, according to a summary by the Kaiser Family Foundation.

Senior benefits

Both Hodes and Shea-Porter have praised the public option as a way to increase competition among insurance companies. They both support the bill's focus on preventive measures, its ban on insurance companies denying coverage for pre-existing conditions, and its general goals of increasing coverage and lowering health care costs. Hodes said the bill would end lifetime caps, in which insurance companies cap the amount of money they are willing to pay for a person's health care.

The public option and exchange system, Hodes said, "is an important step forward to introduce more choice, real competition and putting the American people in control of their health care instead of insurance company bureaucrats."

Gov. John Lynch has expressed concerns that the plan would expand eligibility for Medicaid, then shift the burden of paying for that expansion to the states.

Hodes said the federal government would pay all costs for Medicaid expansion until 2015. After that, the state would pay 9 percent. "The benefits of the bill outweigh the challenges we may face for shared sacrifice of additional payments for Medicaid and benefits," Hodes said.

Hodes spoke at Pleasant View Retirement Home in Concord this week and faced several questions regarding whether the bill would take away money from seniors on Medicaid and Medicare. At that event, Hodes said, "I will not support legislation that cuts Medicare in a way that would hurt our seniors." Hodes said benefits would not be cut, but rather, "Medicare will be strengthened and preserved."

The bill, for example, would close the "doughnut hole," a gap that exists in Medicare prescription drug benefits at a price range where standard benefits run out and catastrophic coverage does not kick in. Hodes said the bill would also ensure that doctors serving Medicare patients do not see pay cuts.

At the House unveiling of the bill, Shea-Porter talked about the importance of closing the doughnut hole, which the bill would do by 2019. She mentioned another provision that would give seniors who fall into that gap a 50 percent discount on name-brand drugs.

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