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Doing quite well, thank you

Totaling up the winners and losers.

WASHINGTON - Little Libby, Mont., is not mentioned by name in the Senate's mammoth health-care bill, but its 2,900 citizens are big winners in the legislation, thanks to the influence of Finance Committee chairman Max Baucus (D., Mont.).

Many of them suffer from asbestos-related illnesses from a defunct mineral-mining operation, and Baucus inserted last-minute language giving them access to Medicare.

Some other winners - and losers:


Cosmetic surgeons, who fended off a 5 percent tax.

Nebraska, Louisiana, Vermont, and Massachusetts. They get more federal help with Medicaid than other states. In the case of Nebraska - represented by Sen. Ben Nelson, who is providing the critical 60th vote to pass the legislation - the federal government will pick up 100 percent of the tab of a planned expansion of the program, forever.

Beneficiaries of Medicare Advantage plans, the private managed-care plans within Medicare, in Florida. Hundreds of thousands of them will have their benefits grandfathered in thanks to a provision tailored by Sen. Bill Nelson (D., Fla.).

Longshoremen. They were added to the list of high-risk professionals shielded from the full effect of a new tax on high-value insurance plans.

AARP, the lobby for elderly people. The new bill has $1 billion in extra Medicaid payments to states that provide visiting nurses and other in-home or community services to prevent low-income people from needing to be admitted to hospitals.

Doctors and hospitals in Montana, North Dakota, South Dakota, Utah, and Wyoming, who will get paid more than providers elsewhere under formulas in the bill.


Tanning salons, which are getting hit with a 10 percent tax on indoor-tanning services, replacing the cosmetic-surgery tax.

Liberals. They had to give up on a long-held dream of a new government-run insurance plan.

People making more than $200,000 a year. A proposed 0.5 percent increase in the Medicare payroll tax was bumped up to 0.9 percent in the latest version, putting the tax at 2.35 percent on income over $200,000 a year for individuals, $250,000 for couples.

Makers of generic drugs. They failed to block giving 12 years of protection to makers of brand-name biotech drugs against generic competitors.