All this week, Senate officials are meeting with White House officials to continue their efforts to combine the Senate’s two big health care bills.  While the meetings are being held behind closed doors, we do know what are likely to be the main topics of discussion.  Senate Democrats are likely to discuss four big issues:

The Public Option

The Senate HELP (Health, Education, Labor, and Pensions) committee bill would create a government-run insurance plan to compete with private insurers, a “Public Option.”  However, the Finance Committee bill does not include a public option.  Instead, it would create private, nonprofit health cooperatives.  In its analysis of the Finance committee bill, the Congressional Budget Office (CBO) said that the co-ops “seem unlikely to establish a significant market presence in many areas of the country”. 

Subsidies

Some Senate Democrats have expressed concerns that the subsidies to help lower-income Americans buy health insurance are set too low in the Finance committee’s bill.  The Finance Committee bill creates premium and cost-sharing credits for individuals and families with income between 100% and 400% of the Federal Poverty Level (FPL).  The HELP committee bill simply creates subsidies for individuals and families with incomes up to 400% of the FPL. 

In an analysis of the Finance committee bill, Senator John D. Rockefeller wrote that a provision in the bill specifies that “In the event that the legislation is projected to increase the federal deficit in the coming year, then premium subsidies for families and individuals who cannot otherwise afford coverage would have to be reduced to make up for the anticipated increase in the deficit.  …The failsafe provision would automatically decrease premium subsidies for low- and middle-income families who would be relying on them to purchase insurance.  …The subsidies will fluctuate based on the budget.”

The Tax on High-Cost Plans

The Finance Committee bill includes a tax on “high-cost” health insurance policies.  Some senators have expressed the concern that these so-called “Cadillac” plans may actually be purchased by members of the middleclass, and thus, that this tax will affect more than just the wealthy.  In a document by Senators Kerry, Schumer, Menendez, Stabenow and Rockefeller, the senators write that the threshold for “Cadillac” plans is too low, and that, due to inflation, in the future, more and more plans will be taxed.

The Employer Mandate

The HELP committee bill requires most employers with more than 25 employees to offer coverage and pay a minimum of 60% of the premium costs.  The Finance committee bill penalizes employers with more than 50 employees for each employee receiving government subsidies for health insurance.

Sources & More Information:

The New York Times – Merging the Senate bills

http://prescriptions.blogs.nytimes.com/2009/10/19/merging-the-senate-bills/

Congressional Budget Office scoring of Bacus bill – .pdf file

http://www.cbo.gov/ftpdocs/105xx/doc10572/09-16-Proposal_SFC_Chairman.pdf

Finance Committee Report of theAmerica’s Healthy Future Act of 2009 – Additional Views Submitted by Senator John D. Rockefeller IV (.pdf file)

http://www.politico.com/static/PPM138_091019_additional1.html

Additional views by Senators Kerry, Schumer, Menendez, Stabenow and Rockefeller on the High Cost Insurance Excise Tax (.pdf file)

http://www.politico.com/static/PPM138_091019_additional.html

Side-by-Side Comparison of the Major Health Care Proposals

http://www.kff.org/healthreform/sidebyside.cfm

Filed under: health care reform, News by admin