Health Care Reform Bill Introduced in the House [4]

On Tuesday, July 14, Democratic leaders introduced into the U.S. House of Representatives comprehensive health care reform legislation. The bill, America's Affordable Health Choices Act, was introduced against a backdrop of ongoing public and political debate over policy, legislative details, and cost. Meanwhile, House Republicans announced this week that they would be introducing an alternative health care reform bill, which, they contend, will be less costly than the legislation introduced by their Democratic colleagues.

Though both the Democratic House leadership and President Obama are calling for swift passage of health care reform legislation, plenty of hurdles remain. House Speaker Nancy Pelosi (D-CA) promised a vote on health care legislation before lawmakers go on recess in August, but she also predicted that the bill introduced this week won't be the "finished product," according to The Hill [5].

America's Affordable Health Choices Act -- introduced by Representatives George Miller (D-CA), chair of the House Education and Labor Committee; Charles B. Rangel (D-NY), chair of the Ways and Means Committee; and Henry A. Waxman (D-CA), chair of the Energy and Commerce Committee -- will be marked up by each of these committees, which will allow for continued input from members of Congress and their constituents, according to a House Committee on Education & Labor press release [6].

Miller, Rangel, and Waxman said that the bill will "reduce out-of-control costs, encourage competition among insurance plans to improve choices for patients, and expand access to quality affordable health care for all Americans." Moreover, Rangel stressed in a statement that health care reform "is not only the moral thing to do, it is also critical to our economic recovery and the long-term fiscal health of our nation." To help pay for the costs of the health care overhaul, expected to cost $1.042 trillion, the bill includes a one-percent surtax on families with incomes greater than $350,000, as reported by USA Today [7]. The new tax would increase with higher salaries, and families earning more than $1 million would pay an additional 5.4 percent in taxes.

A point of contention in the health care debate for both small and large business owners is employer mandates, or "shared responsibility." The America's Affordable Health Choices Act includes a provision that individuals, employers, and the federal government share responsibility for affordable health care. Employers who currently offer coverage will be able to continue offering coverage to workers. Employers who don't currently offer coverage can choose to cover their workers or pay a penalty, with an exemption for small businesses. Moreover, all individuals would be required to get coverage, either through their employer or through a health care exchange that will offer a menu of affordable, quality health care options, including a new public health insurance plan or a plan offered by private insurers. Anyone without health care coverage will pay a penalty.

Vice President Joe Biden, speaking to business leaders at the White House, reported that health insurance premiums for employer-provided health insurance have doubled over the past nine years, rising three times more quickly than salaries, as reported by [8]. As a result, Biden said, small business owners are "being forced to make some very difficult and ... unnecessary choices. [They] are faced with deciding to provide coverage that is increasingly swallowing up more and more of their bottom line, not providing coverage at all or having to raise the cost of the service or product they're selling, making them uncompetitive."

Most small business groups agree that health care reform is necessary. However, the National Federation of Independent Business [9] opposes employer mandates, saying they will cost America jobs and revenue, while others, such as the Small Business Majority, support them.

In a series of polls [10] conducted in 16 states, the Small Business Majority said it found that 66 percent of small business owners support mandates, as well. Among other the key findings, SBM noted:

  • Reform is urgently needed to fix the U.S. economy, according to an average of 69 percent of respondents, with individual state responses ranging from 59 percent to 75 percent.
  • An average of 86 percent of small businesses owners who don't offer health coverage to their employees say they can't afford to provide it (state results ranged from 77 percent to 92 percent). Those that do offer it are struggling to afford it, say an average of 72 percent (with a range of 62 percent to 89 percent).
  • Eighty-two percent of small business owners surveyed, on average, believe people should be able to buy insurance policies regardless of preexisting conditions; state totals range from 72 percent to 90 percent.
  • An average of 81 percent of small business owners support the concept of a marketplace or exchange from which the self-employed, small business owners and individuals can purchase health insurance. Support in each state ranged from 76 percent to 87 percent. (This question was asked in eight states.)
  • Small businesses are willing to share the responsibility for making health insurance affordable along with insurers, health care providers, individuals and government, according to an average of 66 percent of respondents. By state, those agreeing with the concept of shared responsibility ranged from 59 percent to 72 percent.

House Republicans, who slammed the Democrats' proposal, announced this week they are putting together an alternative health care bill, Reuters reported [11].

Rep. David Camp (R-MI), ranking member of the House Ways and Means Committee, told Reuters that the Republican plan would include significant reforms, including tax breaks to encourage small businesses to offer insurance to their workers. "We obviously think it's important to make health care more affordable and to drive down costs," Camp stated.

Two recent polls show that Americans' support for health care reform is wavering in the face of the costs. According to a USA Today/Gallop poll [12], most Americans agree that it is important to overhaul health care, but they are "less enthusiastic about some of the proposals to pay for it."

Rasmussen Reports [13] noted that 49 percent of U.S. voters now "at least somewhat oppose the health care reform plan proposed by ... Democrats" while 46 percent "somewhat favor it." Two weeks ago, 50 percent favored the plan. Moreover, among those voters who currently have health insurance, 52 percent oppose the Democrats plan, while 43 percent favor it. And only 12 percent believe their own health care coverage will get better if the reform plan is passed.

Next week, ABA will be asking bookstore members to participate in an important, short online survey about health care reform. Be on the lookout for an e-mail with a link to the survey and further details. --David Grogan [14]