Health Care Reform in Congress
Week of 9.28.09

Mobilization Action Plan: State Federations and Labor Councils are working to generate calls and letters to Congress from 10% of union membership over the next few weeks and organizing leadership delegations to come to Washington for Labor Lobby Days October 7-8. Pres. Trumka has also asked national unions to help generate congressional contacts from 10% of members and add release staff to the campaign.

Congress returns Tuesday, September 29 after a three day weekend.

The Senate Finance Committee resumes its mark-up at 10 am.

• Four of the five Congressional Committees with jurisdiction over health care have reported out good health reform bills that meet labor’s criteria
• The last Committee has been deliberating since March and finally produced a draft bill on 9.16.09. While the bill takes many of the good provisions from the earlier bill and, in some cases, improves them, it fails to meet labor’s test on key issues:
  • Fair Financing – The bill relies on an excise tax on insurers of “high-cost” plans, defined as $8000 for an individual and $21,000 for a family (in high cost areas, for “dangerous” occupations, and for retirees covered within plans, an additional $2000 is added to the threshold). This tax would be passed on to workers and families.
  • Employer Responsibility – Instead of requiring employers to provide health benefits or pay into a national insurance fund, the bill would impose a penalty of $400 per employee on employers who don’t provide benefits for each employee who applied for gov’t subsidies established under the bill.
  • Cost Containment through A Public Plan Option – Instead of a public health insurance plan option that would force private insurers to compete and therefore lower their prices, the bill would establish state by state non-profit health care co-operatives, which no one, in Congress or outside, takes seriously in terms of cost containment.
  • Affordability – workers and families would be required to get coverage (or pay a tax penalty of up to $1900 per family) and to pay up to 12% of their income before qualifying for gov’t subsidies.

The Public Health Insurance Plan Option will be debated Tuesday when amendments will be offered to add it to the Chairman’s proposal. Win or lose, the debate will set the stage for our attempt to get it in the bill that goes to the Senate floor.

• The public health insurance plan option would offer consumers sick of private insurance hassles a choice of a public plan, similar to Medicare.
• It is the only credible near-term cost containment proposal in Congress. By forcing private insurers to compete it would lower insurance prices for everyone – those with coverage today as well as the uninsured.

Debate over the 40% excise tax on higher cost plans will likely be on Wednesday.

• Union analysis of the Finance excise tax shows that many workers with good health plans with higher than average costs through no fault of their own could pay over $1000 per year in added taxes.
• After introducing the bill the Finance Committee Chair, Senator Max Baucus, made modest changes in the bill that lessened the impact of the tax hit. But not nearly enough.
• Senator Baucus stuck the Committee in a box by declaring last Spring that the cost of subsidies for the uninsured must be paid from money within the health care system, e.g., by taxing benefits, instead of progressive new revenue sources such as President Obama proposed (limiting itemized deductions on the wealthy, which would raise $350 billion over ten years) or as the House passed (a tax on millionaires). Senator Baucus also forced the Committee to come up with more revenue than would be necessary with a robust “public option,” which reportedly saves $110 billion in the House bill.

The Committee Schedule is expected to carry over until next week:

• The Mark up is predicted to finish Wednesday or Thursday
• The Congressional Budget Office (CBO) will then work up a preliminary estimate of the bill’s finances
• The final bill as agreed to (“plain English” version; formal legislative language follows the Committee’s vote on the bill) and the CBO analysis will be posted on the Committee’s website.
• Final vote on the bill will likely be early-mid next week.

Combining the Finance bill and the HELP (Health, Education, Labor & Pensions Committee) bill will then begin (although staff has been working on merging the bills for awhile).
Senate President Harry Reid hopes to have the bill on the floor for debate and vote the week of October 12, after Columbus Day.

House negotiations are underway under Speaker Nancy Pelosi direction to merge the three different versions of HR 3200 passed by three committees of jurisdiction.

The merged House bill is also likely to come up for floor debate
the week of October 12.

President Trumka will meet with the Executive Council today to review strategy and encourage participation in the upcoming campaign