Democratic Congressional leaders are putting together the final health care reform bill. The Obama administration is hoping Congress will pass a final health care reform bill in time for the President’s State of the Union address now expected the first week of February.
The House bill would extend coverage to an estimated 36 million uninsured Americans while the Senate bill would cover an estimated 31 million uninsured Americans.
While there have been some disappointments in the process thus far, several of the Minnesota Council of Nonprofits’ health care priorities have made it to this final stage. Our new action alert gives you an opportunity to make your voice heard with our Minnesota Congressional delegation.
Here’s an update on our priorities:
Assistance for small nonprofit employers – The Senate bill includes a small-employer tax credit to assist both for-profit and nonprofit employers in purchasing health care coverage for their employees. The House bill provides assistance only to for-profit employers. Rep. Betty McCollum is leading the effort with her House colleagues to ensure that the final bill includes help for small nonprofit employers.
Expanding access to affordable, quality care – The House bill includes subsidies on a sliding scale to help families with incomes up to 400 percent of the federal poverty level (FPL) afford coverage. (In 2009, 400 percent of the FPL was $88,200 for a family of four). The Senate bill provides a refundable tax credit to qualified households and is less generous to low- and moderate-income families than the House bill. For example, according to the Center on Budget and Policy Priorities, a family of four with income of $30,000, just over the eligibility ceiling for Medicaid in the Senate bill, would have to pay $1,200 for coverage. But under the House bill, the same family would qualify for Medicaid and thus would pay no premiums.
The House bill also significantly simplifies and expands eligibility for Medicaid to individuals and households with incomes up to 150 percent of the federal poverty level (FPL) ($33,100 for a family of four). The Senate bill expands eligibility only up to 133 percent of FPL.
Federal funding for Medicaid expansion – In both bills, the federal government covers all of the cost for expanding Medicaid through the first two years that the new law would be in effect. After the first two years, under the House bill the federal government would then cover 91 percent of the cost for the expansion, while in the Senate, all states would receive a 32.3 percentage point increase in their regular Medicaid matching rate (Minnesota would receive an 82.3 percent matching rate). We are pleased by the positive improvements in Medicaid and support federal funding for the expansion.
Financing that is progressive overall and that does not increase the deficit – The single largest financing provision in the House bill is a surtax of up to 5.4 percent on individuals with adjusted gross income in excess of $500,000 and couples with adjusted gross income of more than $1 million a year. The Senate bill is financed primarily by new taxes on certain high-benefit health care plans, on drug companies and on medical device manufacturers. The final version of the bill may include some mix of these various financing options.
The Congressional Budget Office estimates that both the House and Senate bills would reduce the deficit by more than $100 billion over the first ten years and would actually produce savings in the second ten years.
Containing unsustainable cost increases – One way to ensure broader competition among health insurance providers and to help contain unsustainable cost increases would have been to include the House public option as part of the new national health insurance exchange. Unfortunately, this provision is not likely to be included in the final bill. Congress will need to consider other options for containing the rapid growth in health care costs.
There is still time for you to tell our Minnesota Congressional delegation to make sure that the concerns of Minnesota’s nonprofits and the people that we serve are addressed in the final health care reform bill. Our Action Alert includes background information and several key messages for you to share with our U.S. senators and your U.S. representative. Please call today and make your voice heard.
- Steve Francisco
