As was reported, a loose and tentative compromise has been reached between Senate liberals Democrats and Senate moderate Democrats on the conceptual size, scope and structure of the proposed government-run healthcare plan. To date, Majority Leader Reid has made no language available, even to those Senators involved in the negotiations. The Majority Leader has sent the proposal to the Congressional Budget Office to get an official estimate on cost and coverage. Those numbers are expected to be released by CBO next Monday. At that point, the Majority leader will shop both the results and the language to Senators to gage if he has the necessary 60 votes. Once he has 60 firm commitments, he will call for a series of cloture votes to end debate. Once all the necessary cloture votes have been approved, Reid would then call for a vote on final passage. As final passage vote can not be filabustered, it only needs a simple majority to pass.

There is a strong possibility that the provision in the compromise that would open Medicare up to those ages 55 and above to purchase coverage is going to be scored at a considerable cost to the government. As most of these new Medicare beneficiaries would be eligible for subsidies, it will be significantly more expensive to cover their cost of Medicare as opposed covering to the less expensive rates that the participating plans in the exchange would charge. A high estimated cost of this provision may scare off some of the moderate Democrat Senators who are tentatively supportive of the compromise. 

Serious questions also remain with Senators Ben Nelson (D-NE) and Joe Lieberman (I-CT). Senator Nelson has publicly stated that he would oppose the bill if it does not include his language to prohibit plans from funding abortions. Since making this statement, Senator Nelson’s amendment to achieve this failed. It is at this time unclear if this will preclude Senator Nelson from actually voting against the bill. Senator Lieberman, starting in the early stages of the healthcare reform process, has been the most vocal Democrat (as an Independent, Senator Lieberman caucuses with the Democrats) to oppose any type of government-run healthcare plan. Senator Lieberman was not involved in the negotiations and it is not yet known if the amended proposal will be something he can ultimately support.

Employee Voucher Amendment Proposed to Senate Health Bill – Threatens Viability of Employer-Sponsored Plans

Senator Ron Wyden (D-OR) and Senator Susan Collins (R-ME) announced their intention to introduce an amendment to the Senate’s healthcare reform bill that would have major implications for the Employer-Based Healthcare System. Senator Wyden has been a constant critic of the employer-based system and has sponsored legislation and amendments in the past to dismantle it.

While language for the amendment is currently being drafted, we have learned that the basic provisions of it are as follows:

1. An employer who sponsors a health plan would have the option to offer vouchers (tax free) to their employees equal to the employer contribution for their coverage. The employee would then be allowed to use that voucher to purchase coverage through a participating plan in the insurance exchange. If they choose a plan that costs less, they would be allowed to keep the difference. If they choose a more expensive plan, they would be required to pay the additional cost. 

2. The amendment would also allow anyone not eligible for low-income subsidies to purchase catastrophic coverage to satisfy the proposed individual mandate to obtain insurance. The current bill only allows those under the age of 30 to do so.

3. Lastly, the amendment would modify the proposed fee on insurance providers by basing it on yearly increases in premiums as well as total market share. The current bill bases the fee solely on market share.

Update on TPA Assessment in Senate Health Bill

As was documented in SIIA’s analysis of the Senate’s healthcare reform bill, a provision has been included to assess a fee on commercial health insurance companies as well as TPAs of self-insured health plans. SIIA, along with allies in the employer community, have been pushing hard with Senate leaders to have this provision changed so that it would not apply to TPAs of self-insured plans. We have received encouraging news that this change will likely be made during the upcoming amendment process. As consideration of this bill has been and will be a very fluid process, we are at this time being cautiously optimistic that this change will be in fact made, but we will continue to get our message across to those who are in positions to make such a decision.

Liberal Congressman Hails Senate Compromise as Major Step Towards Single-Payer Healthcare

Representative Anthony Weiner (D-NY-9) a liberal Congressman and outspoken supporter of a single-payer healthcare system expressed that he celebrated the Medicare expansion provision and when asked if this was an acceptable first step towards his goal he stated “Never mind the camel’s nose; we’ve got his head and his neck in the tent.”

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This entry was posted by Adam V. Russo on Friday, December 11th, 2009 at 8:44 am and is filed under Health Care Legislation, Medicare. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.