From Deirdre Walsh and Dana Bash, CNN
House Majority Leader Steny Hoyer told reporters he remains "hopeful" that Massachusetts Attorney General Martha Coakley, the Democratic nominee, will defeat Brown.
But if she does not, passing the Senate version would be "clearly better than nothing," he said.
House Speaker Nancy Pelosi added, "Whatever happens in Massachusetts, we will have quality, affordable health care for all Americans, and it will be soon."
Several Democratic congressional sources tell CNN that having the House approve the Senate bill is probably the best of a series of bad options to pass health care reform in the event of a Brown victory.
Before Christmas, Pelosi rejected the idea of passing an unamended version of the Senate bill. At the time, she cited several key differences between the Senate and House bills.
But Democratic congressional sources now say the White House is privately laying the groundwork for the idea, hoping that enough House Democratic lawmakers may change their minds if confronted with the idea of not passing any bill.
A House decision to pass the Senate bill with no changes probably would have to be tied to a promise from the Senate leadership to pass changes favored by the House in the future, sources say.
"I would be willing to listen to ways to maybe do a two-bill strategy if that were necessary," Connecticut Democratic Rep. Joe Courtney told CNN in an interview.
"I just think there are so many flaws, I think a lot of House members would really struggle to do one vote and walk away with the Senate bill as is."
Courtney is a vocal opponent of the Senate bill's tax on high-cost plans, saying it would hit too many working Americans.
One senior Democratic source told CNN that one of the many problems with this plan is House Democrats' distrust of the Senate. Courtney said he agrees.
"The inter-chamber tension is real. There is just no denying it," he said.
"The White House and the president would play a key role in terms of just trying to create a lead-pipe certainty that if there is a multistep process, that they're going to be there to ensure everybody lives up to their end of the deal."
Relations between the chambers have become so bad, the source said, that House Democrats may not believe Senate Democrats will follow through on promises to make changes later.
Hoyer said it would be possible for both chambers to pass a bill within 15 days after Tuesday's election, which could be the deadline for the Massachusetts secretary of state to certify a Brown victory and thereby allow Brown to be officially seated in the Senate.
But Hoyer's office later sent out an e-mail noting that the majority leader "did not say that [the bill] would be passed in that time."
Regardless, several Democratic sources have told CNN that option is extremely unlikely because of the political fallout of trying to push something through at a time when voters in Massachusetts may be demonstrating that the health care bill is unpopular at the polls.
Hoyer said that Democratic leaders are making progress in negotiating a final bill. "Our objective is to get agreement, not to take the Senate bill or the House bill, but to come to an agreement, as is normal legislative process," he said.
Hoyer pushed back against the notion that the Massachusetts special election is a harbinger for what Democrats will face in the November midterms.
"I don't need the Massachusetts race to tell me the psyche of the American people. I just need to go to the grocery store," he said. "People are angry, people are fearful, people are very concerned about where the economy is."
But, Hoyer said, Democrats are responding to the sentiment by focusing on jobs, fiscal responsibility and health care reform.
Tuesday, January 19, 2010
House may be considering passing unamended Senate health care measure
Wednesday, January 13, 2010
Health Care Debate Divides Small-Biz Groups
Entrepreneur – Daily Dose Blog
By: Carol Tice
No issue has polarized the small-business community in recent years like healthcare reform. With Congress back in session, all eyes will be on the lawmakers tackling the daunting task of reconciling the House and Senate versions of the healthcare reform bill.
Change won't come fast enough to help small businesses caught in the buzz-saw of steep premium hikes that hit the sector for 2010. But change is likely coming. Will it help small businesses, or will it hurt them?
One of the most vocal groups opposed to healthcare reform is the National Federation of Independent Business, which says 94 percent of their members are against the idea of a mandated payroll tax for businesses that don't offer employees healthcare.
For healthcare reform but opposed to the current legislation, especially the House's "public option" language is the U.S. Chamber of Commerce, calling the current bills' mandates "counterproductive" and saying they fail to address the root problem: rising healthcare costs.
More strongly pro-reform is Build a Stronger America, a newly formed group spawned by the Ewing Marion Kauffman Foundation. BSA lists the need for healthcare reform as one of its founding tenets.
Views have differed so greatly in the community that the Wall Street Journal recently ran a pro-and-con article with a business owner on each side of the debate airing their views. I thought that summed up the situation--it's a big split out there.
The New York Times' Robb Mandelbaum, in his You're the Boss small-business blog, notes there are key differences in the Senate and House bills, so the reconciliation process will be interesting to watch. The Senate bill is considered easier on small businesses and insurers, while the House bill with its public option is more in line with the original intent of healthcare reform.
Will the public option stay or go? Comments to previous blogs on the Daily Dose have indicated some business owners would like to see healthcare unhooked from employment, and want the public option, while others hate the idea.
Tuesday, January 5, 2010
How to start offering a health plan
bizjournals.com - Small Business Center
Health care presents a classic conundrum for employers. On the one hand, providing a health plan as a benefit for employees is very expensive, and it costs more every year. On the other hand, if you don't offer health benefits, and your competitor does, you might find yourself watching some of your best potential employees walk out of a job interview and not look back, says Matt Tassey, a past president of the Life and Health Insurance Foundation for Education (LIFE), a nonprofit organization that educates individuals about seeking and purchasing insurance.
"Virtually any employee who is attractive to a business is attractive to other organizations as well, and health care is the No. 1 thing employees ask about after compensation," Tassey says.
Quick tips
But if you've never offered a health plan at your business before, the research process can plunge you into an unfamiliar world of acronyms - HMO, PPO, HSA- and the options can be overwhelming.
So if it's your first trip into the waters of health insurance shopping, you would probably be wise to work with a broker or insurance adviser. Health insurance can be a confusing consumer decision to make, and having a trained professional on your side can make all the difference, notes Tassey, who recommends that people ask trusted friends, family, or professional contacts what broker they work with to obtain a good list of potential candidates. If you can't get a referral that way and have to resort to cold-calling brokers, ask for the names of two or three of their clients who you can call to ask how satisfied they are with the service they're receiving. Tassey says it's the least you can do when choosing the individual who will handle one of your most important internal business decisions.
"You want to be dealing with an insurance adviser who has experience in your market, and it's very, very appropriate and very much expected for you to ask that person for a couple of references," he says. "If you're in a small business, you've got your family and your business, and probably a pet. But if you're going to marry your life to a business, it pays to take the extra minute and check those references."
Once you've found a broker, Tassey says he or she will help you consider what kind of plans to offer. He says a good broker often can give you a picture of what kind of health care plans are most common in your industry or for businesses of your size so that you can stay competitive.
If you're offering a health benefit for the first time, you'll also need to think about how much of the cost of your employees' health insurance expenses you're willing and able to pay, and whether or not you're willing to pay for health care for dependents of employees. And will you require new employees to work for your company for a certain amount of time before qualifying for benefits?
If you have a small business and choose to research insurance plans independently, without a broker, one piece of information might save you some time. Tassey says the fact of the matter is that where a 500-employee business has some bargaining power when it comes to their health plan rates, small groups are usually quoted a uniform price based on size, and it typically doesn't leave a lot of room for negotiation.
Speaking of price tags, another tip is this: When it comes to choosing a health plan, the bottom line is not always the bottom line. That's to say that while cost is a major concern for almost anyone shopping for health insurance coverage these days, what you get for the money should be considered along with the price tag.
Janice Torrez. of Blue Cross and Blue Shield of New Mexico, recommends groups and individuals consider the restrictions or options that come with certain plans. For instance, Torrez says, a plan that places no restrictions on what physician a member can see might come at a higher cost. Likewise, a plan with a low monthly premium could sport some whopping out-of-pocket expenses should one need a service like home health care, hospital stays, or medical equipment.
The LIFE organization advises when shopping for a health care plan, businesses and individuals start by considering what health-related services are important to them. Included in the list of services to consider are inpatient hospital services, outpatient surgery, office visits, medical tests and X-rays, prescription drugs, home health care visits, physical therapy, maternity care, preventative care for infants and children, and health screenings. Then compare the cost of plans that offer you those benefits.
What the Senate’s Health Bill Means for Small Business
By ROBB MANDELBAUM
NY Times, You're the Boss Blog
Now that the Senate is finally on the verge of passing a health care bill within the next day, it’s time for The Agenda to review where the upper chamber has come out on the issues most important to small companies. To get to this point, Majority Leader Harry Reid melded competing bills produced by Senator Max Baucus’s Finance Committee and by what was then Senator Edward M. Kennedy’s Health, Education, Labor and Pensions Committee.
So what has Mr. Reid wrought? In all, small companies are treated gently here, despite strident protests to the bill from their lobbyists.
Health insurance exchanges. In addition to establishing an exchange for individuals to buy insurance, states must set up a so-called Small Business Health Options Program (a.k.a, a “SHOP Exchange”) through which small companies can buy insurance. Plans offered on the exchange will have to be standardized for easy comparison and offer minimum levels of benefits established by the bill. (A state may create a single merged exchange for individuals and small groups, or band with other states to form regional exchanges.) Beginning in 2017, a state may allow large companies (with at least 101 employees) to participate in the exchange.
The concept — and name — for a separate state-run small business exchange came from the Baucus bill, which in turn borrowed from the Small Business Health Options Program Act introduced by Senator Dick Durbin, Democrat of Illinois, in 2008. In a negotiation that raised eyebrows in Washington, Mr. Durbin and a bipartisan group of senators wrote the legislation with help from, among others, the National Federation of Independent Business and the Service Employees International Union.*
Regulating the small-group market. Every insurer would have to treat all of its customers in the small-group market as members in a single risk pool. In addition, insurers would be subject to all manner of underwriting restrictions. Beginning in 2014, for example, they could not rate or exclude based on a participant’s health status, and could vary premiums only by geography or age (older people would not pay more than three times what younger adults pay). All insurers would have to provide a minimum benefits package defined by law, and there would be limits on cost-sharing, including the total annual deductible.
Defining a small business. For the purposes of delineating the small-group insurance market that would be regulated under the bill (and for determining which firms can buy insurance through an exchange), a small employer has one to 100 employees. Until the year 2016, however, states can limit the small-group market to firms with 50 or fewer employees. Firms need not worry that they will outgrow their exchange: As long as they continue to offer the insurance, they can buy it on the exchange, even if they exceed 100 employees.
Employer mandate. The smallest firms will still have no obligation to buy health insurance for employees. In fact, technically, this measure doesn’t require any firm to offer insurance. Practically, however, it would have that effect on companies with more than 50 full-time workers. Should such a firm not offer insurance and have just one employee rely on a public subsidy to buy individual insurance through an exchange — and in most cases, he or she will be required to buy it — that company would be subject to a penalty of $750 a year for every full-time employee, regardless of how many take subsidies.
Moreover, the company’s insurance policy has to be affordable: A firm that does offer insurance faces a $3,000 penalty for each full-time employee who takes a public subsidy to pay their share of the premiums, though this, too, is capped at $750 multiplied by the entire full-time work force. In this case, “full-time” means 30 or more hours a week. Finally, the construction industry faces a stiffer requirement: The employee threshold drops from 50 to five.
Small-business tax credits. From 2010 through 2013 — before, that is, the exchanges are established and companies are effectively required to buy insurance for employees — very small businesses would receive a tax credit to offset 35 percent of their health insurance costs, provided the firm contributes at least half of the premium. Then, for the first two years the firm buys insurance through an exchange, the credit increases to 50 percent. The full credit is available to firms with the equivalent of 10 or fewer full-time workers paid, on average, less than $25,000; it phases out as the payroll, excluding seasonal workers, grows to 25 and wages rise to $50,000.
Next year, the House and Senate will have to reconcile their competing bills, and while most analysts expect the conference to go the Senate’s way on the most contentious elements, these provisions may not rise to that level. So before those negotiations begin, we’ll take a close look at the measures in the House bill most affecting small business.
In the meantime, our colleagues on the politics desk have put together this handy interactive comparative guide to the two bills — check it out. And please tell us in your comments what you think all of this will mean for your business.
*Not that the N.F.I.B. supports the present Senate bill. In a press release issued Monday, the organization lamented that the bill headed for passage “does not adequately lower insurance costs and increases the cost of doing business.”
