Next few weeks critical to health care, climate change legislation
The next few weeks will tell the tale on the push for health care reform in Congress and on climate change legislation, another issue of vital concern to Alaskans.
Sen. Lisa Murkowski, R-Alaska, says that if health care reform gets bogged down in extended debate, Congress may not have the time, or stomach, to take on another gut-wrenching bill, like climate change, this year.
Murkowski’s concern is that the cap-and-trade climate change bill passed in haste by the U.S. House, which is now in the Senate, would impose huge costs on Alaskans.
As for health care, Terry Gardiner, a former Alaska businessman and state House Speaker now working on health care reform in Washington, D.C., expects significant committee action on bills in the next few weeks now that President Barack Obama has laid out his priorities.
Gardiner is now working in Washington with Small Business Majority, a nonprofit research group involved in policy issues affecting small businesses.
Gardiner expects the Senate Finance Committee may move to "mark up" a bill the week of Sept. 21 even if Chairman Sen. Max Baucus cannot get Republicans to sign onto a hoped-for bipartisan bill.
The Senate Health Committee, on which Murkowski is a member, has already voted on a version of a health care reform bill. In the U.S. House of Representatives, leaders are working to reconcile three different versions of bills.
Gardiner said that Obama laid out principles in more detail and offered suggestions on items that are no longer in any of the bills moving in the House or Senate.
Obama said he favored but wouldn’t hold as a deal-breaker the idea of the contentious "public option," a government-sponsored health insurance program. Some want this option as an alternative to private insurance and to serve as a check on the rising costs of health care.
There are alternatives that would achieve the same goal, and the president’s more pragmatic approach will tone down the polarization that has developed over the issue, Gardiner said.
One of Obama’s suggestions, important to small businesses, is that the threshold for penalties for an employer not offering health coverage be set at 50 workers. This is higher than the threshold in any bill currently in the House or Senate. House versions set the threshold at $500,000 annual payroll, in effect 15 employees, while the one Senate version sets it at 25 workers.
The same tax credits and other benefits would still be available to firms with fewer than 50 workers under the president’s proposal. Gardiner said Baucus is leaning toward a 50-employee threshold in his bill.
Another idea Obama advanced that is not in any bill, but is considered necessary by many, is tort reform. Gardiner said there is evidence that many physicians practice costly "defensive medicine" in an effort to defend themselves against potential lawsuits.
Tort reform often results in huge fights between health providers, who want it, and trial attorneys, who oppose it. Obama’s idea is not tort reform on the federal level, but incentives to let states do it, which many have already, including Alaska.
On the cost side, Obama’s declaration that a health reform package would not add to the deficit has prompted skepticism. But what wasn’t heard was his idea that the package be coupled with a fiscal "fail-safe" trigger that would require a future president to take certain fiscal actions if cost savings weren’t achieved.
Obama’s target of a package cost of $900 billion was also new, and lower than estimates made for any of the House or Senate bills.
Virtually all bills pending contain "insurance reform" proposals, which are also supported by the president. These include prohibiting the practices of insurers to limit or deny coverage for pre-existing conditions or drop coverage when people become ill.
Gardiner believes there is consensus now that some form of health care reform will pass this year, but that the shape of it is still uncertain.