Senate Finance Committee Chairman Max Baucus (D-Mont.) has spent the better half of the last year holding several hearings and events in preparation for overhauling the US health care system. The Chairman recently introduced an outline for his comprehensive health care reform proposal titled http://finance.senate.gov/healthreform2009/home.html“Call to Action – Health Care Reform 2009.”

On November 12, Chairman Baucus unveiled his white paper that outlines a policy requiring all Americans to have meaningful health insurance, emphasizing better quality care, greater value, and – over time – less costly care, and committing to reducing and eliminating waste, fraud and abuse.

The cornerstone to the Baucus plan is an individual mandate for all Americans to purchase meaningful health insurance. The plan maintains some consistency with President-elect Obama’s health care proposal by keeping the employer tax exclusion for health care premiums. However, the Baucus plan is unclear on requirements on employers to offer coverage to their employees. The plan indicates a ‘pay or play’ requirement but offers no details other than any contribution requirements would be based on a percentage of payroll that takes into account the size and annual revenues of the firm. Tax credits will be made available to small businesses based on firm size and earnings per employee. All except the smallest employers will be required to offer a Section 125 plan. Low-income subsidies will be available to eligible individuals that meet designated income requirements.

The creation of a national health insurance pool – called the Health Insurance Exchange – is envisioned to offer individuals and small business owners and their employee more options for affordable health insurance. Plans in the Exchange will be under the authority of a new Independent Health Coverage Council that will be tasked with oversight of the Exchange.

Several insurance market reforms will apply to the Exchange, as well as the private insurance market. Insurers will be prohibited from denying coverage due to pre-existing conditions and from discriminating against individuals solely due to their health status. The Council will determine new rating rules that will be detailed in statute after consultation with the National Association of Insurance Commissioners, consumer advocates, plans and others.

Medicare will be expanded, under a temporary basis, to cover individuals between the ages of 55 to 64 under a buy-in provision. Medicaid will be expanded for everyone with incomes below the federal poverty level. SCHIP will also be expanded to include all children in families with incomes less than 250 percent of the federal poverty level.

Many delivery system reforms are proposed to cut cost and improve quality. The plan provides an emphasis on prevention, wellness and chronic care management through an investment in primary care. Additionally, the Baucus plan specifies an outlay for health care infrastructure reforms that include comparative effectiveness research, Health Information Technology and long-term care support. Finally, the Baucus plan seeks to eliminate fraud, waste and abuse in public programs while taking steps that will give greater transparency to the entire health care system.

The Baucus proposal supports several principles that NSBA has advocated for many years, including an individual mandate to purchase health insurance, insurance market reforms, delivery system reforms, and the eliminations of waste, fraud and abuse. However, NSBA maintains reservations on certain provisions since there is no legislation language that would give further details.

Overall, NSBA has offered support and appreciation to Chairman Baucus and his staff in developing “A Call to Action – Health Care Reform 2009.” While the plan is only representative of Baucus, several other members of Congress whom intend to offer proposals have expressed support for the direction of the white paper. NSBA believes that any proposal being considered must be comprehensive in its scope in order to make the appropriate reforms to the health system that will benefit the small business community.