Phia Group Russo & Minchoff

Legislation on Public Health Plans Takes Shape

by Elizabeth Galantine of Employee Benefit News, www.benefitnews.com

Members of the Senate Health, Education, Labor and Pensions Committee are meeting this week to discuss the details of a health reform plan spearheaded by Chairman Sen. Edward Kennedy (D-Mass.) that closely mirrors the system adapted in Kennedy’s home state of Massachusetts.

A draft of legislation circulated late last week includes a requirement that every American have health insurance, and mandates that employers contribute to employees’ coverage, according to The Washington Post. The proposal includes a government-sponsored public plan option, a senior adviser told the Post, and calls for an expansion of Medicaid to cover 500% of the federal poverty level.

In a Boston Globe op-ed piece on May 28, Kennedy outlined what will be included in his legislation, including the public plan. “We’re also hearing that some Americans want the choice of enrolling in a health insurance program backed by the government for the public good, not private profit – so that option will be available too,” he wrote.

The public plan got some support from the Congressional Budget Office recently as well. CBO reported last week that a government health plan won’t bloat the federal budget as long as it competes with a variety of private plans, and isn’t in charge of collecting premiums, according to the Post.

Tom Schuetz, co-president of Iowa benefit firm Group Services, doesn’t buy it. “I’ve never seen a government program that didn’t bloat the federal budget,” he says. “Does anyone think the health care reform debate will address the issue of increasing claims activity driving increasing cost?”

While many brokers and employers balk at a public plan option, Cyndy Nayer, president and CEO of the Center for Health Value Innovation, says employers are embracing their role in educating policy developers on their perspective.

“There’s a sense of, ‘OK, we’re going to get a public option, but let’s make sure it’s not a plan that drives higher costs in either the public or the private sector,’” says the EBA health reform panelist. “There’s a new energy of driving the value message and promoting health and wellness in every sector, and a determination to begin down a path labeled ‘success,’” she adds.

As for Kennedy’s legislation, spokesman Anthony Coley told the Post, “We are still actively negotiating with members [of the committee]. There is no final policy.”

According to a timetable released by Kennedy’s staff, HELP Committee Democrats met Tuesday, with a bipartisan session scheduled for Friday. Committee markups could happen as early as June 16, reports the Post.

James Klein, president of the American Benefits Council, says Kennedy’s preview was the most significant health reform news of the week. Although ABC will not comment on the details until they are confirmed, “we continue to oppose an employer mandate, which we believe would only hasten the exit of employers from the system,” Klein says.

The staff of the Finance Committee, the other Senate committee charged with producing health care legislation, is kicking into action as well, says Bill Sweetnam, principal with Groom Law Group. “[T]he Finance Committee staff has been starting to develop a proposal for their bosses to review,” he says. “Once we see what the proposal is, we will be able to more fully understand whether reform will be enacted this year.”


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Adam V. Russo

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