Wednesday, September 16, 2009
Baucus Healthcare Bill Falls Short on Public Option, Employer Mandates and the Effective Date for the Legislation
Although there are many interesting provisions in the Baucus Bill, including a requirement that individuals have health insurance coverage, the establishment of a health care exchange, proposed reforms for the private insurance system including not allowing exclusions for preexisting coverage, and expansion of the Medicaid program for the poor, I want to focus on three parts that trouble me that directly deal with current employee benefits law.
First, the plan does not adopt a public option for health care. Instead, it establishes state-based cooperatives to compete with private health plans. I think this a huge mistake and such coops will be a failure from the start. For the best explanation as to why, here is former Labor Secretary Robert Reich explaining why the public option is so superior to co-ops.
Perhaps even more disappointing from my perspective is that the Baucus Bill does not require employers to provide coverage to workers, like some of the House counterparts bills. Instead, employers with more than 50 workers who do not offer coverage will have to reimburse the government for each full-time employee receiving a health care affordability tax credit in the exchange starting in 2013.
Two thoughts on this one. One, there is no reason to limit this to employers with 50 employers with more. That is the cutoff currently for the Family and Medical Leave Act and it has left a huge number of workers without leave protection. Similarly, this arbitrary cut-off will continue to leave millions of workers at smaller employers without health coverage. As long as we are going to stick with our unique employer-provided coverage, we should make sure all employees can get coverage through their employers. The only other options is for these people to qualify through some other government program like Medicare, Medicaid, or Social Security. Yet, those programs do not provide the necessary and timely health treatment that many employees need.
Second, why does this not start until 2013? Assuming the bill passes in 2010, why should a vast number of workers suffer at these larger companies without healthcare? Or put at little more forcefully, how many employees will die in those three years from that delay in providing coverage.
Needless to say, I sure hope that these two provisions are not in the health care reform bill that President Obama eventually signs into law.
The text of the bill, America's Healthy Future Act of 2009, is available here.