On July 2, 2009, the Senate Health, Education, Labor, and Pensions (HELP) Committee released title I of its health reform package, the “Affordable Health Choices Act.” The new title includes insurance market reforms, a health insurance exchange (called the “American Health Benefit Gateway”), and requirements that employers contribute to workers’ insurance costs and most individuals obtain insurance. The plan also includes a new public health insurance plan, called a “Community Health Insurance Option,” under which the Secretary would negotiates with providers for covered benefits and aggregate rates would be capped at the average reimbursement rates paid by health insurance issuers offering qualified health plans through the Gateway. According to a Congressional Budget Office (CBO) estimate of these new provisions, the bill would increase the deficit by $597 billion over the 2010-2019 period— but that does not reflect the costs of the Medicaid expansion, certain low-income subsidies, and other health policy provisions. CBO expects the bill to reduce the uninsured population by about 20 million when fully implemented, but 34 million people would still be uninsured. The HELP Committee began debating amendments to the legislation in June (called “markup”), and markup continues this week.