Law & Order

Crucial Moment Reached on Road to Health Care Reform

The Senate Finance Committee approved its version of a health care overhaul, joining four other House and Senate Committees that have already considered the legislation. The leadership will now merge the measures into a single House and Senate bill to be debated on the floor of each chamber during the next several weeks. If the bills are approved, the legislation will then be sent to a House/Senate conference committee to be melded into a final bill before being presented to the president.

On August 4, SEMA sent a letter to President Obama with key recommendations to address small-business issues. SEMA opposes a mandate that employers provide health insurance given the enormous diversity in size and economic wellbeing for businesses across the country. The Senate Finance Committee bill would exempt all businesses with less than 50 employees. Larger companies that did not offer coverage could be taxed up to $400 per full-time worker.

The legislation includes a SEMA-supported provision requiring individuals to buy insurance as a mechanism to bring uninsured Americans into the system. The debate will now focus on whether affordable coverage will be available to the uninsured.

The Finance Committee bill rejects the so-called “public option.” SEMA believes such an option could undermine the current private sector insurance system. It includes nonprofit cooperative “exchanges” that offer a variety of plans to small businesses and individuals. The concept is a variation on Small Business Health Plans (SBHPs) which SEMA has advocated for years as a mechanism to provide smaller companies with access to a variety of health insurance options based on regional or nationwide purchasing pools.

The bill contains some cost-containment mechanisms, such as encouraging wellness and prevention programs. Nevertheless, it fails to implement a number of other delivery system reforms to spur competition. It also lacks a significant tort reform provision as a means of reducing costly defensive medicine practices. SEMA supports limitations on malpractice claims by placing a cap on noneconomic and punitive damages, and limiting a defendant’s liability to the percentage share of responsibility for the injury.

SEMA will continue to work with Congress to seek improvements in health care legislation. SEMA’s advocacy efforts are coordinated with the National Federation of Independent Business (NFIB) and the Small Business Coalition for Affordable Healthcare. For additional information, contact Stuart Gosswein.