The Health Care Debate Rages On

As members of Congress return to Washington, D.C. from the August recess, the health care reform debate, which continues to dominate headlines and took over many members’ town hall meetings, is anxiously awaiting them.

In mid-July, the Senate Health, Education, Labor and Pensions (HELP) Committee marked-up their health care reform bill, The Affordable Health Choices Act, and reported the bill on a party line vote. Over the course of the three week mark-up, the committee considered more than 100 amendments, including an amendment offered by Sen. Orrin Hatch (R-Utah) specifying that agents and brokers would be able to participate in the Navigators grant program and requiring all Navigators to be professionally licensed. The Hatch amendment passed the committee by voice vote and was a significant victory for the Big “I.” As originally drafted, the program awarded grants to public and private entities to conduct public education, distribute information and assist with health insurance enrollment but, without the Hatch amendment, the bill would have prohibited health insurance issuers, including agents, from participating.

The Senate Finance Committee, the other committee with jurisdiction over health care, is expected to release its legislation sometime this month. For the past several months, the Senate Finance Committee, led by Chairman Max Baucus (D-Mont.) and Ranking Member Chuck Grassley (R-Iowa), have been immersed in negotiations and are attempting to reach a bipartisan compromise. After the Senate Finance Committee introduces its bill and concludes the mark up process, the Senate HELP and Finance Committees will merge their two bills and then submit it for consideration by the full Senate this fall.

In July, House Democrat Leadership introduced its health care reform legislation, America’s Affordable Health Choices Act (H.R. 3200). The bill included several provisions that greatly concern the Big “I,” including the creation of a government-run plan that would pay Medicare rates plus 5%, and a tax “surcharge” that would affect individuals and small businesses making more than $350,000. Additionally, employers who do not provide health insurance to their workers would generally have to pay a penalty of up to 8% of employees’ wages to the federal government.

Shortly before adjourning for the August recess, the House Democrat health care reform bill was reported by the House Energy & Commerce Committee in a 31-28 vote, with five Democrats and all Republicans opposing it. The other two committees of jurisdiction, the House Ways & Means and Education & Labor Committees, also reported their versions of the bill earlier this summer, largely along party line votes. During the August recess, House leadership and staff continued to work on efforts to lay out a plan that reconciles the three versions of the bill in anticipation of a floor vote this month.

To pass the Energy & Commerce bill, Chairman Henry Waxman (D-Calif.) struck a deal with four of the seven Blue Dog Democrats on the committee. The deal included an agreement by Waxman to insert several provisions into the committee’s bill and a commitment from Speaker Nancy Pelosi (D-Calif.) to delay consideration of the legislation by the full House until this month. Pelosi, however, made no guarantee that the additional provisions would be included in the final version of the bill considered by the full House. The Blue Dog provisions included:

• Approximately $100 billion in cuts to the overall cost of the bill (cuts to subsidy levels, as well as Medicaid and Medicare);

• Doubling the small business exemption from the employer mandate to $500,000 in payroll (it was previously $250,000);

• Language explicitly allowing the creation of “co-ops” (though the public plan is still in the bill);

• Removing the requirement that the public plan be based on Medicare rates, and instead allowing the HHS Secretary to negotiate public plan payment rates;

• Allowing physicians who accept Medicare to opt-out from participating in the public plan (previously all physicians who accepted Medicare were required to accept the public plan); and

• Most importantly for the Big “I,” explicit language allowing insurance agents to sell both inside and outside of the “Exchange,” and to sell the public plan.

Margarita Tapia (margarita.tapia@iiaba.net) is Big “I” director of public affairs.


NFIP Tip Toes Toward an Extension

This summer, the House passed the National Flood Insurance Program (NFIP)Extension Act of 2009 (H.R.3139), which extends the program until March 31, 2010. The NFIP is currently set to expire on Sept. 30.

The Big “I” praised the temporary extension as a welcome development for millions of homeowners and small businesses who count on NFIP for protection against flooding.

Earlier this year, President Barack Obama signed a six-month extension just hours before NFIP was set to expire. In the 110th Congress, legislation to extend the program for five years and make needed reforms made progress but did not pass the House and Senate.

The Big “I” believes homeowners and businesses need higher coverage limits and business interruption insurance to adequately insure property.

The Big “I” is optimistic that as Congress considers a long-term reauthorization, it will include these reforms in legislation and looks forward to working with the Obama administration and Congress for a more permanent solution.

-M.T.