New Health Care Compromise Offered
June 24, 2009
As the health care reform debate heats up in Washington, D.C., a new proposal offered by the Bipartisan Policy Center (BPC) offers some very interesting—and likely doable—compromises. The proposal, "Crossing Our Lines," incorporates pieces of NSBA’s proposal for broad health care reform including a requirement on individuals to have health insurance.
The BPC, launched in 2007, is a project headed by former Senate Majority Leaders Howard Baker (R-Tenn.), Tom Daschle (D-S.D.), Bob Dole (R-Kan.), and George Mitchell (D-Maine) to address their commitment to bipartisan action, most recently addressing the failing U.S. health care system. Only Sens. Baker, Daschle and Dole were in attendance at the unveiling of the proposal, but all four worked on the proposal over the last year and held policy forums across the country.
Specifically, the “Crossing Our Lines” proposal would:
Require all individuals to have health insurance
Phase-in an employer contribution for those that do not offer insurance which would start at a 1 percent payroll tax for companies with payroll exceeding $1 million and would top-out at a 3 percent tax for companies with payroll over $3 million
Institute a policy of guarantee issue whereby no insurer could deny coverage to individuals based on pre-existing conditions
Establish a basic minimum plan that caps annual out-of-pocket premiums at 15 percent of income
Give states the option of setting up pools for individuals and small groups to purchase health insurance, but includes a “trigger” mechanism for federal fall-back pool if states do not set up their own pools
Encourage market rating reforms to be implemented by state, but includes a federal fallback if they don’t
Tax premium payments once they exceed $15,000. Premium payments under this amount would be tax deductible, and linked with the cost of the basic plan
Develop an independent health care council to address quality, efficiency, and cost containment
Improve quality reporting and data collection, and expand pay-for-performance initiatives
Implement Comparative Effectiveness Research tools
Reform Medical Liability Laws
Create new tax credits for small businesses and businesses that offer worksite wellness programs
Allow low-income families to get coverage under Medicaid
The proposal was met with praise—if not outright endorsements—of its detailed plan, the goals of the plan and the bipartisan process used. NSBA also has praised the plan and agrees that this framework is certainly the way to move forward. Although NSBA has raised reservations over certain pieces of the proposal, namely an employer mandate, this proposal is the embodiment of a true compromise and certainly is worth a long second look.
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