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The Congressional Budget Office's analysis of the Senate health care bill was released late Wednesday. CBO pegged the cost at $849 billion over 10 years but also found that it would have a deficit reducing impact overall. CBO also figured that the legislation would reduce the rolls of uninsured by 31 million. The bill may see initial voting as early as this week.

Senate Majority Leader Harry Reid (D-NV) presented the bill to Democratic senators at a special caucus meeting Wednesday evening. Meanwhile, Reid is promoting the Senate Democrats' readiness to begin debate on the bill. "Our purpose and resolve remain strong. We're energized," said Reid on the Senate Democrats' website. "We stand on the doorstep of delivering historic reform to the American people."

Demographic Impact

As the Senate gears up for a possible vote, many in support of the health care reform legislation are publicizing the positive effects that reform will bring to different demographics. Last week, Reid praised a report from the Business Roundtable. "Today's report...is more proof that health insurance reform will lower skyrocketing health care costs for businesses. Their balanced analysis emphasizes what we've already known to be the case: our economy can't afford for reform to fail. According to their report, passing reform this year could help lower the cost of health care for businesses by as much as $3,000 per employee within a decade. They also conclude that without reform, the skyrocketing health care costs that threaten American families will only continue to explode. In short, the status quo dooms the American people and our business community."

That Business Roundtable report states that reforms likely to have cost-saving effects include: value-based purchasing; financial penalties for failing to avoid preventable hospital re-admissions; increased individual accountability for health care spending decisions, including health reimbursement arrangements and health savings accounts; cost and quality of care data that is easier for patients and providers to access and use; elimination of sharp regional variations in practice patterns; promotion of wellness and prevention programs and expansion of financial incentives to participate in specific programs to reduce lifestyle related illness; and insurance market reforms that promote competition and choice. However, the report is firmly against a public health insurance option.

Middle-class Americans are another group expected to reap benefits from the proposals. Several Senators, including Ben Cardin (MD), Kay Hagan (NC), and Patty Murray (WA), held joint press conferences to discuss the likelihood reform will provide stable, affordable coverage, as well as the current impact that health care costs are having on middle-class families.

"The cost of health care has been eating away the paychecks of middle class Americans at an alarming rate. It's unsustainable. You cannot raise a family or run a small business when an ever increasing share of your income is spent on health coverage," Senator Cardin stated.

"Under the Senate's reform bill, middle class Americans will no longer have to fear that losing a job means losing health insurance too. The Senate bill will slow down the exploding cost of health care, which is growing increasingly unaffordable for middle class families..." Senator Hagan added. "In 1996, the average family premium was $6,000. Today it's $12,000. On our currently trajectory, it's expected to be $24,000 by 2016."

Senator Murray also commented, "Middle class families are already struggling in the toughest economic climate since the Great Depression and they simply can't afford these kinds of cost increases. It is for these families-- middle-class, working families--that we need health insurance reform."

Help for Women and Other Groups

Recently, First Lady Michelle Obama hosted a discussion in the White House on the effect of health care reform for women. Mrs. Obama recalled the stories she had heard from women across the U.S. "...These kinds of stories are being told in city after city, town after town, all across America. They're being told by women who lost their coverage when their husband lost a job, or their husband passed away. They're being told by women who aren't getting regular checkups because it's simply too expensive. They're being told by women living on fixed incomes who can't afford the prescription drugs that they need."

The First Lady stated that women are struggling most under the status quo, and women will be among those who benefit the most from reform because of their "special relationship" with the health care system. Mrs. Obama pointed out: eight in 10 mothers say they're the ones responsible for choosing their children's doctors, taking them to appointments, and managing the follow-up care. In addition, over 10 percent of all women are now caring for a sick or elderly relative.

Women are more likely than men to do part-time work or to work in a small business, she said, in jobs less likely to offer the kind of insurance they need. "In fact, over half of all women in this country don't have the option of getting insurance through the workplace at all." To compound that problem, because women earn less than 80 cents for every dollar their male coworkers earn, "...it's more difficult for them to pay their premiums-especially when studies show that they're paying far more than men for the same coverage."

Mrs. Obama referenced a study that found one-third of all women have used up savings, taken on debt, or given up basic necessities just to pay their medical bills. The problems only grow worse when you get older and need quality, affordable coverage the most, she said. "In the individual market, people in their early 60s are more than twice as likely to be denied coverage than people in their late 30s. Older women are more likely than men to face a chronic illness, but they're less likely to be able to afford the cost of treating that illness. And in recent years, studies have shown that women over the age of 65 spend about 17 percent of their income on health care. And that's just not right."

Mrs. Obama then moved to the changes in health reform that will benefit women, which include caps on how much one can be charged in out-of-pocket expenses in a year or in a lifetime, and a prohibition against insurance companies denying coverage for pre-existing conditions. "And that change alone will help us end the discrimination women face in our health care system. And also, insurance companies will be required to cover, at no extra cost, routine checkups and preventive care."

Finally, the Kaiser Family Foundation has released an issue brief detailing the effects of reform on racial and ethnic health disparities. According to the brief, by 2045, more than half of the population of the U.S. will be persons of color. However, people of color continue to have worse access to health care and worse health outcomes than white persons.

The brief states that people of color would incur significant benefits from the health care reform legislation under consideration. The reasons include:

--Fifty percent of persons of color are uninsured, and are more likely to be of low income status and/or work at low wage jobs unlikely to offer coverage. The options for expanding coverage, affordable coverage, and employer mandates would assist this situation.

--Many people of color would benefit from the proposed Medicaid expansions and the proposed financial aid for some of the individuals purchasing coverage through health exchanges.

--The plans to increase funding for community health centers helps in filling a critical need for communities of color, as they comprise half of the patients who receive care at a community health center.

--The health care system is experiencing or will soon experience a shortage of health professionals. The hardest hit will likely be in medically underserved areas, such as rural areas. Several of the health reform proposals have provisions to increase the number of providers, particularly primary care providers, and increasing the number of providers in medically underserved areas.

--All the bills under consideration have provisions for preventative services. Preventative services help in diagnosis and treatment of chronic conditions, which people of color experience at higher prevalence rates, as well as higher death rates from many of these conditions.

Senator Reid's remarks: http://democrats.senate.gov/multimedia/
And http://democrats.senate.gov/newsroom/record.cfm?id=319925

Information on the Business Roundtable report: http://www.businessroundtable.org/sites/default/files/2009.11.11%20Hewitt%202%20Press%20Release_FINAL.pdf

Democratic Senators remarks: http://democrats.senate.gov/newsroom/record.cfm?id=319832
And http://democrats.senate.gov/newsroom/record.cfm?id=319989&

The First Lady's remarks: http://www.whitehouse.gov/the-press-office/remarks-first-lady-health-insurance-reform-and-older-women

The Kaiser Family Foundation brief: http://www.kff.org/healthreform/8016.cfm