Giant retailer Wal-Mart stated in an open
letter that it supports employer responsibility as a component of health
reform:
We are for shared responsibility.
Not every business can make the same contribution, but everyone must make some
contribution.
The announcement was made jointly with the Service Employees
International Union (SEIU) and the Center for American Progress - liberal
groups that have been historically critical of Wal-Mart's policies. It came as a welcome surprise to health reform
proponents.
Not five years ago, Wal-Mart fought tooth and nail to
overturn a Maryland state law that imposed an employer mandate, which required large employers to either cover
workers or pay a fee. Now, America's
largest employer says that such a requirement is a necessary part of a health
care overhaul.
After all of these years, Wal-Mart
has suddenly found itself in the same situation its competitors once did: Dealing with unpredictable health costs and
facing new competition from businesses that have found ways to spend even
less on employee health benefits.
The Wal-Mart letter argues that,
From a business perspective, health reform could not be more critical.
Premiums are expected to rise by 20 percent in less than four years ... costing
3.5 million workers their jobs, and cutting insured workers' average annual
incomes by $1,700.
While the letter is short on details, Wal-Mart's support for
employer responsibility pushes the debate in a favorable direction. The
momentum Wal-Mart has lent health reform yesterday should not be
underestimated.
Determined to advance President Barack Obama's health care
agenda, key Senate Democrats are calling for a government-run insurance option
to compete with private plans, as well as a $750-per-worker annual fee on
larger companies that do not offer coverage to employees.
A few weeks ago, the Senate Health,
Education, Labor and Pensions set off an uproar when it submitted a
work-in-progress for scoring by the Congressional Budget Office. The bill was
missing major pieces, including a requirement that employers contribute towards
the cost of their workers' coverage.
President Obama offered a wonkish defense of his embattled
health-care reform effort during an hour-long town hall meeting in Northern
Virginia yesterday that featured seven questions, including one sent via
Twitter and several from a handpicked audience of supporters.
President Obama returned to the familiar trappings of a
political campaign on Wednesday, holding a town-hall-style meeting where he
sought to heighten the urgency surrounding the health care debate and dismissed
critics who say the issue is too complex to tackle during his first year in
office.
As lawmakers continue to struggle to find a way to pay for a
health reform that could cost $1 trillion or more over the next decade, Barack
Obama seems to be opening the door a little wider to an approach that he
rejected soundly when John McCain proposed it during last year's presidential
campaign: taxing the health benefits that employers provide their workers.
"This argument has evolved," he said Wednesday at a town hall meeting
on health care in Annandale, Virginia. And it appears that Obama has, too.
The Congressional Budget Office (CBO) made headlines
recently when it "scored" health reform proposals generated in the Senate. The CBO
numbers - and thusly the headlines - weren't favorable, and left many lawmakers
and health care advocates scratching their heads.
In just a couple of days in mid-June, the CBO seemed to rain
hard on the whole health reform parade when it made back-to-back announcements
that (1) the first draft of the Senate Health, Education, Labor and Pensions (HELP)
Committee's bill would cost $1 trillion over 10 years and would only cover 16
million people, and that (2) the first draft of the Senate Finance bill would
cost $1.6 trillion over 10 years.
So this begs a few questions....
What is the CBO?
The CBO provides Congress economic data and analyzes the costs and impacts of
legislation.
Are there any issues
with CBO scores of health reform proposals? Many health policy wonks
complain that the CBO doesn't score savings that may be wrung from the health
system at the national level. As Politico reported,
Programs like disease prevention
will save money, but the practices are more recent and have not yet been fully
incorporated by the conservative CBO, said Ken Thorpe, a professor of health
policy at Emory University.
Why do CBO scores
matter? While the CBO's analyses are imperfect, they represent our best
guess at what will happen if a particular piece of legislation is implemented,
and in the era of pay-go (short for "pay as you go"), it's important to get a
good score. This recent CBO score debacle demonstrates that, if the numbers
come out higher than bill sponsors anticipated, it looks bad. And health reform
opponents will make hay of it.
But what's a good
score? There is no magic number. As a response to CBO's cost estimate, Senator
Baucus has implied that $1 trillion over 10 years is his goal for the final Finance
Committee bill.
Advocates need to keep a close watch on this process to
ensure that consumers don't get the short end of the stick as lawmakers craft
fiscally responsible legislation. Stay tuned for more news on this after the
July 4th recess of Congress.
Attention, all employers: It is time for you to pay. Or
play!
The pay or play system will accomplish two things, both
important for health reform:
It will
give employees peace of mind, assuring them that they will not lose their
insurance coverage
It will
provide an affordable insurance option to those employees who are not yet
covered by their employer.
Many employers have offered their employees health care
coverage since World War II, when wages were frozen and the only way to compete
for workers was to provide fringe benefits. Currently, 61 percent of
non-elderly Americans obtain health care coverage through their employers.
In the current health care debate, some are calling on
employers to share in the responsibility of providing health care coverage to
Americans. Most large employers already provide insurance to their employees,
so requiring the rest of employers to do the same would level the playing field
while allowing those employees who are satisfied with their coverage to keep
it.
Families
USA recently issued a paper about the advantages of shared responsibility
that requires employers to provide insurance. Here are some of the major
points:
How employer responsibility works: Employers would provide
health insurance to their employees or pay a fee that would be used to help subsidize
the cost of their employees' health care. This is called "pay or play." Under
such a system, some small employers will receive tax credits to help them pay
for coverage for their workers, and if they still can't afford to either pay or
play, they will be exempt from such a responsibility.
Why is it a good system? Without such a requirement, employers
might be tempted to drop coverage for their workers. Employers currently pay
around $360 billion in premiums a year. If employers stop providing coverage,
it would be almost impossible for employees to cover this amount. Employees
already pay an average of $3,354 per year for family coverage and $721 per year
for individual coverage. These employees can't afford to pay more.
Past experiences have shown that such a system works: Both the
State of Massachusetts
and the City of San Francisco
have implemented such a system with much success. Due to a pay or play
provision in Massachusetts's
2006 health care reform legislation, 159,000 Bay Staters have gained insurance
through their jobs in the last two years. San
Francisco's Healthy
San Francisco program has also helped to provide 32,804 additional people
with employer-based coverage.
This idea is also supported by President Obama, who believes
that "every business has a responsibility to provide health insurance for its
workers."
Health insurance is supposed to offer protection - both
medically and financially. But as it turns out, an estimated three-quarters of
people who are pushed into personal bankruptcy by medical problems actually had
insurance when they got sick or were injured.
Obama is staying close to home till
he heads out on a foreign trip next week - but he's
still pushing health care. On Wednesday, POTUS will head to Northern Virginia Community College in Annandale for a town hall with a live audience. But the
president will also take questions via Facebook, You Tube
and Twitter.
Wal-Mart, the nation's largest private employer, joined
hands with a major labor union Tuesday to endorse the idea of requiring large
companies to provide health insurance to their workers, a move that gives a
boost to President Obama as he is pushing for health legislation on Capitol
Hill.
Liberal-leaning religious groups are launching radio ads in
five states this week in which local pastors urge senators to back efforts to
overhaul the nation's health care system.
The pharmaceutical industry and one of the country's leading
consumer health care groups on Tuesday launched a multimillion-dollar national
television advertising campaign to urge lawmakers to pass quality, affordable health care reform
White House senior adviser
David Axelrod says President Barack Obama would like to have a public
option – or government-run insurance
plan – as part
of a health reform package, but will not insist on it.
Congress will be out this week,
so the White House is filling the health-care space with a series of
events — in person and over the Internet — to keep the spotlight
on the president’s top domestic priority.
President Obama's top political
adviser declined yesterday to rule out the possibility that the White
House would agree to a tax hike on health insurance plans that would
hit middle-income Americans.
Our health-care crisis and
our energy crisis are complex dilemmas made of many complex problems.
But our biggest problem in both health
care and energy is essentially the same simple problem:
we use too much. And in both cases, there's a simple explanation for
much of the problem: our providers get paid more when we use more.
Those words rang out at a huge rally Thursday, June 25,
sponsored by the coalition Health Care for America NOW (HCAN). The rally took
place right by the Capitol, close enough for all to see the massive dome on top
of Capitol Hill.
Thousands of people from around the country-the young, the
old, labor activists, health activists, and other community leaders-gathered to
support the need for health care reform this year.
High profile speakers-ranging from politicians such as
Senator Schumer from New York, Senator Menendez from New Jersey, and Howard
Dean to labor, religious, and medical leaders-expressed a common and unified message:
People with insurance are facing
higher and higher premiums.
People have to make difficult
decisions every day about whether to pay for their prescription drugs or to pay
for their household bills.
People who are doing everything
right and have insurance often have their care denied or delayed by insurance
companies.
Citizens also shared their emotional stories about how the
health care system has affected their lives. One small business owner talked of
her fear that she would no longer be able to provide coverage for her
employees. A single mother without insurance worried that she might get ill and
be unable to care for her children. Stories like these were echoed by thousands
of people throughout the day.
Seth Michaels of the AFL-CIO
also attended the rally and caught some great quotes from members of Congress
pushing hard for reform alongside the American public. Pennsylvania Rep.
Allyson Schwartz said,
This is such an important issue for
all of us. It's always been a moral responsibility, but it's increasingly an
economic imperative.
Sen. Chuck Schumer touched on how far along we've come and
symbolically pointed to the Capitol behind him as he remarked,
We can't do this alone. We need to
do this together. We need all you to hold everybody in that building's feet to
the fire.
Attending the rally and seeing the enthusiasm for change
gave the attendees confidence that reform can happen this year. Change doesn't
occur without people coming out and fighting for what they believe in.
That fight was clearly seen this day.
So, let me again ask you two questions: What do we want? And when do we want it?
Health
equity has become a key issue in the current health reform debate, and lots of
groups are chiming in.
Over
the last few months, the Obama Administration has made a special effort to
bring health disparities into the health reform discussion, most recently
inviting stakeholders to attend a meeting at the White House and releasing a health disparities report. The disparities community has embraced the opportunity to
educate policy makers and the public about the differences in health and health
care experienced by different groups of people - think tanks are releasing
reports and advocacy groups are releasing recommendations. Now, the health insurers have something to
say.
Earlier
this month, the nation's largest not-for-profit health insurer, Kaiser Permanente,
released a series of ads in Capitol Hill publications that bring attention to health
disparities. The ads are headlined "Health Care in America Is Too Often
Unequal" and feature individuals who are African American, Asian American,
Latino, and Pacific Islander.
Each
ad calls for universal coverage, pointing out that more than 50 percent of
uninsured Americans are people of color. The ads call that statistic a "national
disgrace," particularly since the uninsured are more likely to forgo care
and the U.S. spends the most out of any nation on health care - more than two
trillion dollars in 2008.
In
order to develop the comprehensive solutions that will eliminate racial and
ethnic health disparities, ALL the stakeholders have to be at the table. Kaiser
Permanente is taking steps to make sure their concerns are heard. What about you?
Senate Democrats said Thursday that they had found ways to
pare the cost of a health care bill by more than a third - to $1 trillion over
10 years - while still covering nearly all Americans.
Senate Finance Chairman Max Baucus (D-Mont.) calls them the
"coalition of the willing," a group of four Republican and three Democratic
senators, including himself, that may well determine health care reform in the
Senate.
Capping off a month of intense negotiations on health care
reform, a bipartisan group of Senators who serve on the Finance Committee
released a statement Thursday pledging to continue their effort to reach a
consensus on legislation when Congress returns from its July Fourth recess.
The President held a forum at the White House yesterday,
where he discussed the pressing need for health care reform, and fielded
questions and concerns from some of the 164 audience members. The audience
represented a diverse array of health care stakeholders -- including doctors,
nurses, insurance company executives, small business owners, as well as
patients from across the country.
Senators who are negotiating how to overhaul the nation's
health care system broke off formal talks Thursday until after the Fourth of
July holiday, saying they lack consensus on how to pay for the $1 trillion or
more that the changes could cost over the next decade. Thousands of their
constituents rallied outside the Capitol to show their support for change, and
the Obama administration called for action.
Soon after ABC announced it would
devote a day to covering President Obama's healthcare proposals, including a
primetime townhall, Republicans began complaining that the program would be an
"infomercial" for the President's plans. And the event started on an
auspicious note for the President's argument that the healthcare system needed
to be overhauled: in a show of hands, almost no one in the audience agreed that
the system should be left as is. "Let's stop now!" Obama joked. But
what the President largely got from his questioners afterward was, in doctor's
parlance, a probing examination.
President Barack Obama signaled a new willingness Wednesday
to tax health benefits, inching further away from his staunch opposition to the
idea during the presidential campaign. "There is going to have to be some
compromise," Obama said at an ABC News town hall on health care televised from
the White House.
In a town hall forum broadcast from the White House
Wednesday night, President Obama said "government, whether you like it or
not, is already going to be involved" in administering health care and
implementing changes in the system.
While the Senate Health, Education, Labor and Pensions
Committee continued Wednesday to mark up its health care reform bill, the
Senate Finance Committee was hunkered down in negotiations on its version, with
Finance Chairman Max Baucus (D-Mont.) shuttling between closed-door meetings to
try to reach a consensus.
From David Seaman's point of view, the recession couldn't be
more brutal for the hospital industry. As executive vice president of the
Michigan Health and Hospital Association, a membership organization representing
the state's community hospitals, he's watched closely as revenue has plummeted;
cash-strapped patients are skipping visits and under-compensated cases are
increasing.
A bipartisan group of governors told President Obama
yesterday that they share his urgent desire to restructure the nation's
health-care system but warned that any changes should not place more burdens on
strained state budgets or eliminate innovative programs they already have in
place.
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Category: Affordability,Financing,Health Care Costs,Uninsured Americans
