President Obama, who has been personally lobbying fence-sitters, postponed his trip to Australia and Indonesia for a down-to-the wire vote, set for Sunday, on sweeping legislation that has been more than a year in the making and has drained his political capital.

Despite the complicated parliamentary maneuvering that will be required to get the Senate to accept the “fixes” the House wants on the underlying Senate bill, House passage of that bill will make it the law of the land with Obama’s signature.

The budget office found that the House changes to the Senate legislation will shave $138 billion from the federal deficit over the next decade and save as much $1.2 trillion over the following decade after the more than $900 billion is spent on expanding coverage and other benefits.

Conservative critics called those figures implausible, and Republicans said Pelosi got them by raising taxes and cutting Medicare. But the budget office’s word is gold on Capitol Hill, where the agency is considered by both parties to be a neutral, professional arbiter.

Its bottom line meets Obama’s key objective that health care reform curbs deficits.
House changes

The House unveiled its changes, which would expand the Senate bill’s benefits and reduce a “Cadillac tax” on high-cost insurance plans. To make up the revenue, it would impose a 3.8 percent Medicare tax on unearned income for people who earn more than $200,000 a year and further reduce payments to GOP-backed Medicare Advantage plans, which offer a wider array of benefits than standard Medicare.

Dropped from the changes was a provision by Sen. Dianne Feinstein, D-Calif., crafted in response to Anthem Blue Cross’ planned rate increases as high as 39 percent in California, that would have created an insurance regulator. The provision, backed by Obama, was ruled out of order under the special rules required to get the package of House changes through the Senate.

Several members of the Hispanic caucus swung behind the bill, abandoning objections to Senate provisions to ban illegal immigrants from buying health insurance, for what they called the larger effort to broaden health care coverage.

Anti-abortion Democratic Rep. Bart Gordon of Tennessee also moved into the “yes” column. Wednesday’s endorsement of the bill by groups representing 59,000 Catholic nuns gave political cover for abortion foes who have been a major block to reaching the 216 votes required for House passage.

The nuns, who broke with Catholic bishops who contend the Senate bill does not go far enough to ban taxpayer funding of abortion, told lawmakers that the health care overhaul is “the real pro-life stance” because it will help provide health care for pregnant women.

The AFL-CIO also endorsed the legislation, despite the nation’s largest labor federation’s opposition to the Cadillac tax. The House changes would greatly reduce the tax over the next decade, but after 2018 it would be tied to the general inflation rate, which is much lower than the rise in health care costs.

The tax would help reduce the enormous federal tax subsidy to health insurance. Many liberal House members opposed the tax but the White House considered it key to controlling health care cost inflation.
Pelosi led the effort

More than any other leader in Washington, Pelosi is responsible for bringing Democrats to the brink of a victory that eluded her predecessors in 1994, when congressional Democrats abandoned an equally controversial reform effort by President Bill Clinton.

She remained relentless even when members of her own party declared the bill dead after Democrats lost a Massachusetts Senate seat in January.

“I’ve never seen anything like her,” said Rep. Lynn Woolsey, D-Petaluma, who led the liberal fight for a government-run insurance option, which was defeated by the Senate. “I’ve never seen anybody work harder, know more about every single word that’s in this legislation as it changes, and where every single one of her members is standing at the moment, and why, and what they’re going to do. She’s an amazing speaker.”

Senate Democratic leaders have promised to quickly take up the House changes under “reconciliation” rules that skirt a Republican filibuster and allow the bill to pass on a simple majority of 51 votes.

Democrats have 59 votes in the Senate. Republicans promised to raise parliamentary objections.

Sen. Judd Gregg, R-N.H., said a Senate reconciliation rule could bring down the House fixes if they are found to affect Social Security, even indirectly. Under the legislation, employers are expected to pay out more wages as cash rather than health care benefits, which would increase revenue from the Social Security payroll tax.

To be clear, there are some things that none of these policies cover: if you simply decide not to travel, if your business meeting gets canceled, if you have a child-care emergency. On the plus side, most of the policies cover acts of terrorism (which, sadly, is becoming more of a realistic possibility these days).

Here, then, is a rundown on the five most popular annual travel-insurance policies on the market. Keep in mind that coverage varies from policy to policy and state by state (insurance laws differ by state). It’s also important to note that with any insurance policy, understanding the fine print can be challenging, which is why we recommend calling for more details.

In a list of top tips, the UK Foreign & Commonwealth Office (FCO) explains that medical bills and an air ambulance can reach more than £25,000 in costs in South Africa.

Without travel insurance in place, the individual concerned would be expected to pay these costs back.

Travel insurance cover that includes belongings may also be a wise investment in light of the risks of theft.

“With the high levels of crime it is also important to insure any possessions you take with you,” the FCO urges of travellers.

The news comes as the FCO launches Be on the Ball, a campaign encouraging football fans to make sure they are well prepared for the sporting spectacular.

Other recommendations include the suggestion that passports should have two blank pages before leaving the UK.

According to tour operator Rhino Africa, the most popular spots include flagship city Cape Town and the world-famous Kruger National Park.

Anton De Wit, reservations manager at Rhino Africa, said: “You can find Cape Town which is a bit like Barcelona. You can do a normal safari without malaria issues and next year we are hosting the World Cup. You have the whole world in one country.”

More than 40 hotels have recently opened across South Africa, which could be convenient for travel insurance customers thinking of visiting.

Other activities on offer include whale watching and swimming with dolphins – both of which are on offer around South Africa’s picturesque coastline.

Figures released by South African Tourism earlier this month reveal that the number of Britons visiting the country increased by 6.8 per cent between August 2008 and August 2009.

Taking out expat health insurance should be a top priority for people making a move overseas, particularly if their destination has a weak healthcare infrastructure, Shelter Offshore has advised.

According to the expat advice site, international health insurance is also a sensible idea for workers travelling regularly on business, as this will provide cover in any country they fall ill or have an accident in.

“You have to make sure that your insurance is broad enough in terms of its geographical cover to make sure that you’re not uninsured if you leave your own home country,” the site declared.

The site advises that although in some circumstances expats may have access to public healthcare services by making contributions to the national system, procedures to do so must be followed carefully.

In a separate guide, the site urged expats to take protecting their health overseas as seriously as protecting their money.