While the Senate Health, Education, Labor and Pensions Committee healthcare overhaul could emerge with an employer "pay or play" mandate, it will not be a payroll fee, Sen. Christopher Dodd, D-Conn., said today.
Dodd said the committee is looking at a proposal similar to the one used in Massachusetts, where companies are required to pay $300 for every employee not offered insurance. He said the HELP Committee bill would require employers to pay a dollar amount "higher than $300."
The change means the healthcare employer mandate coming out of the Senate will likely look different than the one emerging from the House, where Democrats want to require employers to either offer a set contribution toward a benefit plan that met a minimum standard or pay an 8 percent payroll fee.
Senate HELP Democrats have sent the pay-or-play proposal and a plan to require employers to pick up the tab for employees on Medicaid to CBO for scoring. While both proposals exempt small businesses, Dodd said the committee is still deciding how to define a small business. Tweaking those numbers affects how much the mandate will cost, he said.
The mandate proposal is likely to draw fire from the business community, which argues it will force companies to fire low-wage workers or go out of business. In testimony before a House committee today, the U.S. Chamber of Commerce said the Massachusetts-style mandate did not generate as much revenue as the state government expected.
Other key pieces missing include a possible public plan and rules for generic biologic drugs. Dodd said the committee is considering all ideas related to a public plan, including the Medicare-like option that HELP Chairman Edward Kennedy released before the markup began.
Dodd said he is personally committed to a public option but is open to other ideas, including the co-op proposal presented by Senate Budget Chairman Kent Conrad.
Dodd also praised White House efforts to move the bill forward, including a meeting Tuesday between White House Chief of Staff Emanuel and HELP and Finance committee Democrats.
"The bully pulpit of the presidency is important, to keep taking about the importance of this issue. And, urging of us to work together, to try and develop a bill that would enjoy broad-based support ... it was that kind of meeting," Dodd said.
Now in its second week of markups, the committee turned today to workforce issues. Lawmakers want to use healthcare reform to reduce the shortage of primary care physicians and other healthcare workers. Dodd said he hoped lawmakers could wrap up the less controversial portions of the bill, including a section dealing with fraud and abuse, by the end of the week. The more controversial sections would be taken up after the Independence Day recess.
This article appears in the June 27, 2009 edition of National Journal Daily PM Update.