Senator Baucus Formally Unveils Healthcare Bill

After much fanfare, Senator Max Baucus (D-Mont.), Chairman of the Senate Finance Committee, yesterday officially released the America’s Healthy Future Act (pdf) for his committee’s consideration. Although designed to appeal to conservatives in comparison to the House’s Affordable Health Choices Act (H.R. 3200) and a similar measure approved by the Senate Health, Education, Labor and Pensions (HELP) committee, it is uncertain whether Baucus’s bill will draw any Republican support, and enough to reach the 60 votes needed to avoid a filibuster.

The American’s Healthy Future Act does not contain the more stringent employer mandates provided for in other prominent healthcare bills under consideration, but does impose certain requirements on large businesses.  According to a summary of the bill (pdf):

Effective January 1, 2013, all employers with more than 50 employees who do not offer coverage will have to reimburse the government for each full-time employee (defined as those working 30 or more hours a week) receiving a health care affordability tax credit in the exchange equal to 100 percent of the average exchange subsidy up to a cap of $400 per total number of employees whether they are receiving a tax credit or not.

 As a general matter, if an employee is offered employer-provided health insurance coverage, the individual would be ineligible for a health care affordability tax credit for health insurance purchased through a state exchange. An employee who is offered coverage that does not have an actuarial value of at least 65 percent or who is offered unaffordable coverage by their employer, however, can be eligible for the tax credit. Unaffordable is defined as 13 percent of the employee’s income. A Medicaid-eligible individual can always choose to leave the employer’s coverage and enroll in Medicaid. In this circumstance, the employer is not required to pay a fee.

Other key provisions of this bill affecting employers and the insurance industry would do the following:

  • Provide tax credits for small businesses to help them offer insurance to their employees;
  • Require insurance companies to offer coverage to all individuals regardless of health status or pre-existing conditions. The bill would allow limited variation in premium rates for tobacco use, age, and family composition. Variation in rating would also be allowed between – but not within – a geographic area;
  • Eliminate yearly and lifetime limits on the amount of coverage plans provide;
  • Create a Simple Cafeteria Plan through which small businesses could provide tax-free benefits to employees. Eligible employers that make contributions for employees under a simple cafeteria plan would be exempt from pension plan nondiscrimination requirements applicable to highly compensated and key employees;
  • Create web-based insurance exchanges that would standardize health plan premiums and coverage information to make purchasing insurance easier;
  • Give consumers the choice of non-profit, consumer owned and oriented plans (CO-OP);
  • Require insurers by 2014 to comply with new transparency and accountability standards or pay a penalty fee. Such standards include the requirement that each individual receives an outline of coverage presented in a uniform format not to exceed 4 pages nor include print smaller than 12-point font. Other standards would mandate that insurers publish the share of their premium revenue that is used for administrative expenses and not medical benefits. In addition, the bill would impose new requirements for the electronic exchange of payment and other health care information with hospitals, doctors and other providers;
  • Require employers to disclose the value of the benefit provided by the employer for each employee’s health insurance coverage on the employee’s annual Form W-2;
  • Eliminate the deduction for the subsidy for employers that maintain prescription drug plans for their Medicare Part D eligible retirees;
  • Levy a non-deductible excise tax of 35% on insurance companies and plan administrators for any health insurance plan that is above the threshold of $8,000 for singles and $21,000 for family plans. This tax would not apply to plans sold in the individual market;
  • Impose annual flat fees across the industry and according to market share on the pharmaceutical manufacturing, medical device manufacturing, and health insurance sectors, as well as on clinical laboratories. These fees would not apply to laboratories and manufacturers with earnings below certain thresholds.

Notably, Baucus’s bill does not provide for a public insurance option, but rather calls for the creation of health insurance cooperatives. Some Democratic lawmakers have said they would not support a healthcare bill in the absence of a public option. The bill would require all individuals – with certain exceptions – to obtain healthcare coverage or pay a fee.

Markup of this bill is scheduled to begin next week. If approved by the Senate Finance Committee, this healthcare reform bill will be merged with the more liberal bill that has already cleared the Senate Health, Education, Labor and Pensions Committee for full Senate consideration.
 

 

Protecting America's Workers Act Is Reintroduced in the Senate

On Wednesday, Sen. Edward Kennedy reintroduced the Protecting America’s Workers Act of 2009 (PAWA) (S. 1580), a bill that would amend the Occupational Safety and Health (OSH) Act by expanding its coverage, increasing whistleblower protections, and enhancing employer penalties for violations. Sen. Kennedy had introduced this bill twice before, with then-Senator Obama acting as a co-sponsor in 2007. In April of this year, Rep. Lynn Woolsey (D-CA) introduced a companion bill (H.R. 2067) in the House of Representatives.

Highlights of the current bill include the following:

  • Increased civil penalties for OSH Act violations
  • Removal of the requirement that a workplace death must occur before criminal penalties can attach
  • Provision of felony charges for repeat and willful violations that result in a worker’s death or serious injury
  • Expansion of OSH Act coverage to include airline and railroad employees, as well as Department of Energy contractors
  • Creation of regulations that give workers the right to refuse to do hazardous work
  • Requirement that OSHA investigate all cases of death and serious injuries

The Senate version of PAWA has been referred to the Senate Committee on Health, Education, Labor, and Pensions.
 

Measures Would Extend COBRA Coverage

Senator Roland Burris (D-IL) has introduced a bill that would extend temporarily the 18-month period of healthcare continuation coverage required by the Consolidated Omnibus Budget Reconciliation Act (COBRA). The COBRA Coverage Extension Act of 2009 (S. 1488) would provide up to 24 months of continuation coverage under group health plans required under COBRA, the law that amended the Employee Retirement Income Security Act (ERISA), the Internal Revenue Code and the Public Health Service Act to provide continuation of group health coverage for certain qualifying former employees, retirees, spouses, former spouses and dependent children. Specifically, S. 1488 would entitle any individual who is eligible for and has elected continuation coverage under COBRA as of the date of this bill’s enactment, and whose coverage would end before 12 calendar months had elapsed from the date of enactment due to an 18-month continuation limitation, to continue coverage until a full 12 months had passed after the date of enactment, or 24 months after the date of the qualifying COBRA event, whichever is earlier. This bill has been referred to the Senate Committee on Health, Education, Labor, and Pensions.

This bill joins another recent measure aimed at extending COBRA continuation coverage. The House’s much-publicized healthcare bill, America's Affordable Health Choices Act of 2009 (H.R. 3200), includes an amendment that would extend COBRA coverage until the individual becomes covered under another employer’s group health plan or under a health insurance exchange plan, the latter of which would be created under the bill itself. The extension would not apply to certain medical flexible spending arrangements. Offered by Rep. Susan Davis (D-CA), this amendment was approved by voice vote by the House Committee on Education and Labor on July 17. Given the development of the health insurance exchange system would not be established until the year 2013 at the earliest, it is conceivable that if this bill were to pass, COBRA continuation coverage could be extended for years. This healthcare bill has been approved by both the House Committees on Education and Labor, and Ways and Means.

Legislative and Regulatory News for the Week of June 14

The following is a summary of the legislative and regulatory news for the week of June 14, 2009:

Discrimination in the Workplace

The Equal Employment Opportunity Commission (EEOC) has voted to revise its Americans with Disabilities Act (ADA) regulations to conform with the changes made by the ADA Amendments Act (ADAAA).

Health Care

Both the House and Senate unveiled new details about their respective healthcare plans.

Labor/Management Relations

The Green Jobs Improvement Act (S. 1238) would make non-union training programs eligible for federal funding under the Green Jobs Program.

Supreme Court

The Supreme Court has held in Gross v. FBL Financial Services, Inc. that a plaintiff bringing a claim under the Age Discrimination in Employment Act (ADEA) must show that age was the “but for” cause of the adverse employment action; the burden does not shift back to the employer to prove that it would have acted regardless of age.

Work/Family Balance

The Breastfeeding Promotion Act of 2009 (H.R. 2819, S. 1244) was introduced in both the House and Senate. This bill would amend Title VII and the Fair Labor Standards Act (FLSA) and establish an employer tax credit to promote and protect breastfeeding and lactation in the workplace.
 

Bill Would Provide Employer Tax Credit for Hiring Veterans

Legislation introduced by Rep. Thaddeus McCotter (R- MI) would amend the Internal Revenue Code to provide employers with a tax credit for hiring veterans. The Veterans’ Employment Transition Support Act of 2009 (VETS Act of 2009) (H.R. 1647) would grant a one-time tax credit to employers, and apply to the employment of any veteran certified as such by the designated local agency.

Employers would be granted credit in the amount of 40 percent of the employee’s first-year wages. A greater tax credit is available for the hiring of disabled veterans. The Act creates a sliding percentage tax benefit scale based on the degree of the employee’s disability. The amendments made by this Act would apply to veterans who begin work after the date of enactment.

This bill has been referred to the House Committees on Energy and Commerce, Education and Labor, and Ways and Means.