Senate Majority Leader Reid Unveils “Patient Protection and Affordable Care Act

Senate Majority Leader Harry Reid yesterday (November 18, 2009) unveiled the text of his proposed 2,074-page “Patient Protection and Affordable Care Act, H.R. 3590” health care reform bill that he indicated that he and certain other key Senate Democrats now back. 

Based on text of the legislation shared by Senator Reid yesterday available for review here,  the public insurance option provisions in H.R. 3590 would offer states the opportunity to opt out of the program rather than the mandatory public option provided for in the “Affordable Health Care for America Act,  HR. 3962 passed by the House of Representatives on November 7, 2009.  The Congressional Budget Office (CBO) estimates, H.R. 3962 costs at just over $1 trillion.  In comparison, CBO estimates the cost of H.R.3590 at $848 billion. For more details of the Congressional Budget Office estimates the cost of H.R. 3590 as proposed by Senator Reid,  see at here.

Meanwhile, Senate Finance Committee Chairman Max Baucus (D-MT) today (November 19, 2009) introduced his latest health care reform proposal, the America’s Healthy Future Act of 2009 (S.1796).  

Many perceive that substantial negotiation and compromise may be necessary before  Senate Majority Leaders will be able to craft a health care reform bill that can both garner the necessary votes to pass the Senate and have a viable chance of surviving the required negotiation with House leaders necessary to reconcile that legislation with the provisions of HR 3962. As was the case with HR. 3962, members of the Senate are likely to debate and weigh a variety of amendments and refinements to the provisions of S.1796 as it deliberates its enactment.  If you or someone else you know would like to receive updates about health care reform proposals and other related legislative, regulatory, and enforcement developments, please:

  • Register for this resource at the link above;
  • Join the Coalition for Responsible Health Policy group at linkedin.com to share information and input and join in other dialogue with others concerned about health care reform;
  • Share your input by communicating with key members of Congress on committees responsible for this legislation and your elected officials directly and by actively participating in and contributing to other like-minded groups; and
  • Be sure that we have your current contact information – including your preferred e-mail- by creating or updating your profile at here

If you have questions about or need assistance evaluating, commenting on or responding to health care or other legislative or regulatory reforms, or any other employment, compensation, employee benefit, workplace health and safety, corporate ethics and compliance practices, concerns or claims, please contact the author of this article, Curran Tomko Tarski LLP Labor & Employment/Employee Benefits  Practice Chair Cynthia Marcotte Stamer. 

Ms. Stamer has more than 22 years of experience advising and assisting business, government and other clients to evaluate and respond to health care, pension reform, workforce and other proposed or adopted changes in federal or state health care, employee benefit, employment, tax and other federal and state laws.  A member of the leadership council of the American Bar Association Joint Committee on Employee Benefits, Chair of the ABA Real Property, Probate & Trust Section and Employee Benefits & Compensation Group and past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group Ms. Stamer is highly regarded legal advisor, policy advocate, author and speaker recognized both nationally and internationally for her more than 20 years of work assisting U.S. public and private employers, health care providers, health insurers, and a broad range of other clients to respond to these and other health care, employee benefit and workforce public policy, regulatory and compliance and risk management concerns within the U.S. as well as internationally.  Her work includes extensive involvement providing input and assistance about health care, workforce, pensions and social security and other reforms domestically and internationally.  In addition to her continuous involvement in U.S. health care, pensions and savings, and workforce policy matters, Ms. Stamer has served as an advisor on these matters internationally.  As part of this work, she served as a lead advisor to the Government of Bolivia on its social security reform as well as has provided input on ethics, medical tourism, workforce and other reforms internationally.

In addition to her extensive work on health and other employee benefit matters, Ms. Stamer also is Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization and has continuously has advised and represented employers and others on labor and employment, compensation, employee benefit and other personnel and staffing matters throughout her career. Ms. Stamer is experienced with assisting employers and others about compliance with federal and state equal employment opportunity, compensation and employee benefit, workplace safety, and other labor and employment, as well as advising and defending employers and others against tax, employment discrimination and other labor and employment, and other related audits, investigations and litigation, charges, audits, claims and investigations by the IRS, Department of Labor and other federal and state regulators. Ms. Stamer is a widely published author and popular speaker on health plan and other human resources, employee benefits and internal controls issues.   Her work has been featured and published by the American Bar Association, BNA, SHRM, World At Work, Employee Benefit News and the American Health Lawyers Association.  Her insights on human resources risk management matters have been quoted in The Wall Street Journal, the Dallas Business Journal, Managed Care Executive, HealthLeaders, Business Insurance, Employee Benefit News and the Dallas Morning News.

If your organization needs assistance with monitoring, assessing, or responding to these or other health care, employee benefit or human resources reforms,  please contact Ms. Stamer via e-mail here, or by calling (214) 270-2402.  For additional information about the experience, services, publications and involvements of Ms. Stamer specifically or to access some of her many publications, see here. For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here.

Other Information & Resources

We hope that this information is useful to you. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to participate in the distribution of our Solutions Law Press HR & Benefits Update distributions here.  Some other recent updates that may be of interested include the following, which you can access by clicking on the article title:

Proposed Chemical Facility Anti-Terrorism Bill Would Obligate Chemical Facilities To New Background Check, HR & Other Safety & Security Safeguards

IRS Rules For Employer Reporting Of Wages Paid to Nonresident Alien Employees Performing Services In U.S. Change

House Passes Affordable Health Care For America, Health Care Reform Debate Focus Now Moves To The Senate

SHRM Tells Members Say “NO!” To Pelosi-Backed Health Care Reform

IRS Updates Procedures Qualifying Small Employers Can Use To Qualify To Report Employment Taxes Annually Rather Than Quarterly

OSHA Proposes To Change Hazard Communication Standard

IRS Proposes Changes In Actuarial Enrollment Standards For Performance of Actuarial Services Under the Employee Retirement

EEOC Prepares To Broaden “Disability” Definition Under ADA Regulations

IRS Proposes To Update Regulations On Exclusion of Damages Received on Account of Personal Physical Injuries or Physical Sickness To Eliminate Tort Test

OSHA Final Rule Updates OSHA Personal Protective Equipment Standards

DOL Proposes Changes To H-2A Temporary & Seasonal Agricultural Nonimmigrant Worker Certification Procedures & Related Rules

ADAAA Amendment Broader ADA “Disability” Definition Not Retroactive, Employer Action Needed To Manage Post 1/1/2009 Risks

New Study Shares Data On Migrant Health Care Challenges Along The Border

Employer & Other Health Plans & Other HIPAA-Covered Entities & Their Business Associates Must Comply With New HHS Health Information Data Breach Rules By September 23

HHS Reassignment Of HIPAA Enforcement Duties Signals Rising Seriousness of Enforcement Commitment

Speak Up America: Where & How To Read & Share Your Feedback About The Health Care Reform Legislation

For important information concerning this communication click here.   If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject here.

©2009 Cynthia Marcotte Stamer. All rights reserved. 

Senate Finance Committee Chair Baucus Introduces New Version of Health Care Reform, The America’s Healthy Future Act of 2009

Senate Finance Committee Chairman Max Baucus (D-MT) today (November 19, 2009) introduced his latest 1504 page health care reform proposal, the America’s Healthy Future Act of 2009 (S.1796), the text of which is available for review here.   Chairman Baucus’ introduction of S. 1796 follows the November 7, 2009 passage by the U.S. House of Representatives of the massive health care reform proposal sponsored by Representative John Dingell (D-MI) and supported by Speaker Nancy Pelosi, the Affordable Health Care for America Act (HR. 3962).   

Totaling 1504 pages in length, S.1796 proposes a lengthy and complex array of reforms to the U.S. health care coverage and delivery system, which would affect virtually each U.S. employer, health care provider, payer, and resident. As with the provisions of HR. 3962 and other versions of health care reform, the reforms outlined in the provisions of S.1796 include complexities and nuances which may not be apparent in partisan or non-partisan discussions or summaries of its goals or purposes. Consequently, individuals or businesses concerned about the proposed reforms are encouraged to begin and base their review and analysis on the actual text of S.1796, a copy of which as introduced is available for review here.   

The continuing emphasis of President Obama and other members of the Democratic Party Leadership in Congress on the passage of health care reform means that Senator Baucus and other Democratic Leaders in Congress are likely to continue to make passage of health care reform a priority.  U.S. businesses and individuals concerned about the proposed reforms should carefully review both the Senate and House bills and act quickly to provide their input on any matters of special interest and concern.

Selected Health Coverage Reform Highlights

Among other things, S.1796, as introduced, would enact sweeping health insurance coverage reforms that would create new obligations for employers, insurers, and individual workers.  In this respect, S.1796, among other things would:

  • Amend the Social Security Act (SSA) to add a new title XXII (Health Insurance Coverage) to ensure that all Americans have access to affordable and essential health benefits coverage.
  • Require all health benefits plans offered to individuals and employers in the individual and small group market to be qualified health benefits plans (QHBPs).
  • Amend the Internal Revenue Code to: (1) allow tax credits related to the purchase of health insurance through the state exchanges; and (2) impose an excise tax on individuals without essential health benefits coverage and on employers who fail to meet health insurance coverage requirements with respect to their full-time employees.
  • Prohibit QHBP from excluding coverage for preexisting conditions, or otherwise limiting or conditioning coverage based on any health status-related factors.
  • Require QHBPs to offer coverage in the individual and small group markets on a guaranteed issue and guaranteed renewal basis.
  • Amend the cafeteria plan rules of Internal Revenue Code § 125 to, among other things, require that in order for a health flexible spending arrangement (HFSA) to qualify as a qualified benefit eligible to be offered under a cafeteria plan, the cafeteria plan must limit the maximum salary reduction contribution per employee per taxable year to $2,500 beginning in 2011.
  • Increase the threshold for the itemized income tax deduction for medical expenses.
  • Require states to: (1) establish rating areas; (2) adopt a specified risk adjustment model; and (3) establish transitional reinsurance programs for individual markets.
  • Require QHBP offerors in the individual and small group markets to consider all enrollees in a plan to be members of a single risk pool.
  • Require the Secretary of Health and Human Services (HHS) to establish: (1) risk corridors for certain plan years; (2) high risk pools for individuals with preexisting conditions; (3) a temporary reinsurance program for retirees covered by employer-based plans; and (4) a program under which a state establishes one or more QHBPs to provide at least an essential benefits package to eligible individuals in lieu of offering coverage through an exchange.
  • Entitle a qualified individual to the choice to enroll or not to enroll in a QHBP offered through an exchange covering the individual’s state as well as QHBPs in the individual market while at the same time requiring that such individuals to be U.S. citizens or lawful residents.
  • Require each state to establish: (1) an exchange designed to facilitate enrollment in QHBPs in the individual market; and (2) a Small Business Health Options Program (SHOP) exchange designed to assist qualified small employers in facilitating the enrollment of their employees in QHBPs in either the individual or the small group market.
  • Direct the Secretary to: (1) establish a system allowing state residents to participate in state health subsidy programs; and (2) study methods exchange QHBPs can employ to encourage health care providers to make increased meaningful use of electronic health records.
  • Dictate the mandated contents of an essential health benefit benefits package, including little or no cost-sharing, no annual or lifetime limits on coverage, and preventive services.
  • Amend the Internal Revenue Code to codify and revise the Health Insurance Portability and Accountability Act of 1996 (HIPAA) wellness program regulations.
  • Amend the Internal Revenue Code to codify and revise the Health Insurance Portability and Accountability Act of 1996 (HIPAA) wellness program regulations.
  • With regard to abortions: (1) declare that the Act does not require health care benefits plans to provide coverage for abortions; prohibit QHBPs from discriminating against any individual health care provider or health care facility because of its willingness or unwillingness to provide, pay for, provide coverage of, or refer for abortions; (3) continues application of state and federal laws regarding abortion; (4) prohibit the use of premium credits and cost-sharing subsidies for QHBPs covering abortion services for which federal funding is prohibited; (5) require the plan offeror to determine whether or not the plan provides coverage of abortion services for which federal funding is prohibited or is allowed; and  (6) require the Secretary to assure that at least one QHBP covers abortion services for which federal funding is prohibited or allowed; and at least one QHBP that does not cover abortion services for which federal funding is allowed.

Selected Health Care System, Reimbursement & Other Reform Highlights

S.1796 also would expand and modify existing Medicare, Medicaid, CHIP and other federal health care programs and enact a host of other new rules and requirements affecting health care providers, drug companies and other participants in the U.S. health care system.  The proposed reforms include provisions that would:

  • Require the President to: (1) certify annually in the President’s Budget whether or not the provisions in this Act will increase the budget deficit in the coming fiscal year; and (2) instruct the HHS Secretary and the Secretary of the Treasury to make required reductions in exchange credits and subsidies.
  • Establish a new mandatory eligibility category under SSA title XIX (Medicaid) for all non-elderly, nonpregnant individuals who are otherwise ineligible for Medicaid.
  • Revise Medicaid benefits.
  • Rescind funds available in the Medicaid Improvement Fund for FY2014-2018.
  • Make appropriations for Aging and Disability Resource Center initiatives.
  • Increase the federal medical assistance percentage (FMAP) for states to offer home and community-based services as a long-term care (LTC) alternative to nursing homes.
  • Create a Community First Choice Option.
  • Add a new optional categorically needy eligibility group to Medicaid for individuals: (1) with income that exceeds 133% of the poverty line; and (2) certain other individuals, but only for benefits limited to family planning services and supplies.
  • Direct the Secretary to establish a grants program to support school-based health centers.
  • Remove smoking cessation drugs, barbiturates, and benzodiazepines from Medicaid’s excluded drug list.
  • Revise requirements for Medicaid disproportionate share hospital (DSH) payments.
  • Direct the Secretary to establish a Federal Coordinated Health Care Office within the Centers for Medicare & Medicaid Services (CMMS).
  • Direct the Secretary to establish a Medicaid Quality Measurement Program.
  • Revise requirements for the Medicaid and CHIP Payment and Access Commission (MACPAC) under SSA title XXI, Children’s Health Insurance Program.
  • Set forth special rules relating to American Indians and Alaska Indians.
  • Require the Secretary to establish procedures for sharing data collected under a federal health care program on race, ethnicity, sex, primary language, type of disability, and related measures and data analyses.
  • Amend SSA title V with respect to the Maternal and Child Health (MCH) block grant program.
  • Provide funding for abstinence education.
  • Incorporate reforms originally proposed under the Elder Justice Act of 2009 pursuant to which amendments would be made to the provisions of SSA title XX relating to Block Grants to States for Social Services with respect to elder abuse, neglect, and exploitation and their prevention.
  • Establish within the Office of the Secretary an Elder Justice Coordinating Council.
  • Direct the Secretary to establish a hospital value-based purchasing program under Medicare.
  • Extend the Medicare Physician Quality Reporting Initiative program (PQRI) incentive payments beyond 2010.
  • Modify the Physician Feedback Program.
  • Require the Secretary to develop a plan to implement a Medicare value-based purchasing program for home health agencies and skilled nursing facilities (SNFs).
  • Amend SSA title XVIII (Medicare) to direct the Secretary to establish a national strategy to improve the delivery of health care services, patient health outcomes, and population health.
  • Direct the President to convene an Interagency Working Group on Health Care Quality.
  • Amend the General Provisions of SSA title XI to provide for the establishment of a Center for Medicare and Medicaid Innovation within CMMS.
  • Amend SSA title XVIII to direct the Secretary to establish a shared savings program that promotes accountability for a patient population and coordinates items and services under Medicare parts A (Hospital Insurance) and B (Supplementary Medical Insurance).
  • Create a Hospital Readmissions Reduction Program.
  • Direct the Secretary to establish a Community-Based Care Transitions Program.
  • Revise requirements with respect to residents in teaching hospitals.
  • Increase the Medicare physician payment update.
  • Direct the Secretary to establish a Working Group on Access to Emergency Medical Care.
  • Extend the Medicare-Dependent Hospital Program.
  • Amend the Tax Relief and Health Care Act of 2006 with respect to the hospital wage index.
  • Establish a Medicare prescription drug discount program for brand-name drugs for beneficiaries who enroll in Medicare part D (Voluntary Prescription Drug Benefit Program) and have drug spending that falls into the coverage gap.
  • Establish an independent Medicare Commission to reduce the per capita rate of growth in Medicare spending.
  • Amend SSA title XI to add a new part D, Comparative Effectiveness Research, under which would be established a Patient-Centered Outcomes Research Institute.
  • Establish in the Department of Treasury the Patient-Centered Outcomes Research Trust Fund.
  • Establish a nationwide program for national and state background checks on direct patient access employees of long term care facilities and providers.
  • Direct the Secretary to establish new procedures for screening providers of medical or other items or services and suppliers under the Medicare, Medicaid, and CHIP programs.
  • Direct the Secretary to establish a self-referral disclosure protocol to enable health care service providers and suppliers to disclose violations.
  • Requires the Secretary to expand the number of areas included in Round Two of the durable medical equipment (DME) competitive bidding program.
  • Extend the period for collection of overpayments due to fraud.
  • Amend the Internal Revenue Code with respect to: (1) an excise tax on the excess benefit of high cost employer-sponsored health coverage; (2) distributions from health savings accounts for drugs and insulin that are prescribed drugs and insulin only; (3) a limitation on salary reduction contributions by employers to a health flexible spending arrangement; (4) expanded information reporting requirements; (5) additional qualifying requirements for charitable hospital organizations; and (6) a qualifying therapeutic discovery project tax credit.
  • Impose annual fees on: (1) manufacturers and importers of branded prescription pharmaceuticals or of medical devices; and (2) health insurance providers.
  • Prescribe a special rule to limit excessive remuneration by certain health insurance providers.
  • Exclude from an individual’s gross income the value of any qualified Indian health care benefit.

The continuing emphasis of President Obama and other members of the Democratic Party Leadership in Congress on the passage of health care reform means that Senator Baucus and other Democratic Leaders in Congress are likely to continue to make passage of health care reform a priority.  U.S. businesses and individuals concerned about the proposed reforms should carefully review both the Senate and House bills and act quickly to provide their input on any matters of special interest and concern. 

Assistance Monitoring & Responding To Health Care Reform Proposals

As was the case with HR. 3962, members of the Senate are likely to debate and weigh a variety of amendments and refinements to the provisions of S.1796 as it deliberates its enactment.  If you or someone else you know would like to receive updates about health care reform proposals and other related legislative, regulatory, and enforcement developments, please:

  • Register for this resource at the link above;
  • Join the Coalition for Responsible Health Policy group at linkedin.com to share information and input and join in other dialogue with others concerned about health care reform;
  • Share your input by communicating with key members of Congress on committees responsible for this legislation and your elected officials directly and by actively participating in and contributing to other like-minded groups; and
  • Be sure that we have your current contact information – including your preferred e-mail- by creating or updating your profile at here

You can register to receive future updates on legislative and regulatory health care reform proposals and other related information by registering for this resource or access other publications by Ms. Stamer and access other helpful resources here.

Long-time health policy advocate and advisor Cynthia Marcotte Stamer has more than 22 years of experience advising and assisting clients to evaluate and respond to health care reform proposals and other proposed or adopted changes in federal or state health care, employee benefit, employment, tax and other federal and state laws.  Former Chair of the American Bar Association’s Managed Care & Insurance Section, Ms. Stamer is highly regarded legal advisor, policy advocate, author and speaker recognized both nationally and internationally for her more than 20 years of work assisting U.S. public and private employers, health care providers, health insurers, and a broad range of other clients to respond to these and other health care, employee benefit and workforce public policy, regulatory and compliance and risk management concerns within the U.S. as well as internationally.  Her work includes extensive involvement providing input and assistance about health care, workforce, pensions and social security and other reforms domestically and internationally.  In addition to her continuous involvement in U.S. health care, pensions and savings, and workforce policy matters, Ms. Stamer has served as an advisor on these matters internationally.  As part of this work, she served as a lead advisor to the Government of Bolivia on its social security reform as well as has provided input on ethics, medical tourism, workforce and other reforms internationally.

Ms. Stamer is a widely published author and popular speaker on health plan and other human resources, employee benefits and internal controls issues.   Her work has been featured and published by the American Bar Association, BNA, SHRM, World At Work, Employee Benefit News and the American Health Lawyers Association.  Her insights on human resources risk management matters have been quoted in The Wall Street Journal, the Dallas Business Journal, Managed Care Executive, HealthLeaders, Business Insurance, Employee Benefit News and the Dallas Morning News.

Ms. Stamer also serves in a number of professional leadership roles including the leadership council of the American Bar Association Joint Committee on Employee Benefits, Chair of the ABA Real Property, Probate & Trust Section and Employee Benefits & Compensation Group and past Chair of the ABA Health Law Section Managed Care & Insurance Interest Group.

If your organization needs assistance with monitoring, assessing, or responding to these or other health care, employee benefit or human resources reforms,  please contact Ms. Stamer via e-mail here, or by calling (214) 270-2402.  For additional information about the experience, services, publications and involvements of Ms. Stamer specifically or to access some of her many publications, see here

Additional Resources & Information

We hope that this information is useful to you. For additional information about the experience, services, publications and involvements of Ms. Stamer specifically or to access some of her many publications, see here.  If you would prefer not to receive electronic distributions of these updated in the future, send your request with the word “unsubscribe” in the Subject to here.

©2009 Cynthia Marcotte Stamer. All rights reserved.

Health Care Reform Focus Moves To Senate After House Passess HR 3962

The U.S. House of Representatives passed the massive health care reform bill, H.R. 3962, the Affordable Health Care for America Act (HR 3962),  after adopting an amendment prohibiting the use of federal funds for abortion services in the public option in a rare Saturday session. 

Introduced by Representative John Dingle and backed by House Speaker Nancy Pelosiby, House Democrats with the support of only 1 Republican passed HR 3962 with a recorded vote of 220 – 215 late Saturday, November 7, 2009.

The health care reform debate now moves to the Senate. 

As of this morning (November 9, 2009), the U.S. Government Printing Office had not released an official copy of the text of H.R. 3962 revised to reflect the amendments adopted by the House on Saturday prior to its passage of H.R. 3962.  However, a record of the amendments approved by House members before passage of H.R. 3962 along with text of the bill prior as originally introduced on October 29, 2009 are available for review online here.

We also encourage you and others to join the discussion about these and other health care reform proposals and concerns by joining the Coalition for Responsible Health Care Reform Group on Linkedin, registering to receive these updates here.

If you have questions about or need assistance monitoring, evaluating, commenting on or responding to this or any other health care reform proposal or other federal or state health care, workforce or other legislative, regulatory or other developments or concerns, please contact the author of this article, Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer.  Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization and Chair of the American Bar Association RPTE Employee Benefits & Other Compensation Group, Ms. Stamer is experienced with assisting employers and others about compliance with federal and state health care, employee benefit, workforce and other legislation and regulation. Ms. Stamer has advised and represented clients about these and other health care labor and employment, compensation, employee benefit and other personnel and staffing matters for more than 20 years. Ms. Stamer also speaks and writes extensively on these and other related matters. Her public policy experience includes ongoing involvement in these concerns within the U.S. for 30 years, as well as serving as a policy advisor on Social Security Reform to the Government of Bolivia and providing input or other representation to various other clients on workforce, health care and other policies in various other regions of the world. 

For additional information about Ms. Stamer and her experience or to access other publications by Ms. Stamer see here or contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here

Other Information & Resources

We hope that this information is useful to you. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail – by creating or updating your profile here or e-mailing this information here or registering to participate in the distribution of our Solutions Law Press HR & Benefits Update distributions here.   

For important information concerning this communication click here.   If you do not wish to receive these updates in the future, send an e-mail with the word “Remove” in the Subject here.  

©2009 Cynthia Marcotte Stamer. All rights reserved.

Largest Organization of HR Professionals Says Tell Congress “No” to Pelosi’s Affordable Healthcare For America Act

In a rare weekend meeting, the House of Representatives is scheduled to  consider H.R. 3962, the Affordable Health Care for America Act and, if Speaker Nancy Pelosi has her way, vote to pass it as early as this weekend. 

In anticipation of this action, the Society For Human Resources (SHRM) is voicing strong opposition to H.R. 3962 and  urging U.S. citizens and businesses to express their strong opposition to it as well to members of Congress immediately.

According to communications circulated this week, SHRM “strongly supports comprehensive health care reform that strengthens the employer-based system, promotes wellness programs and health promotion initiatives, strengthens the Employee Retirement Income Security Act (ERISA), increases purchaser and consumer access to cost and quality information and increases access to affordable health coverage.  SHRM says the House bill fails to achieve these goals.  Accordingly, SHRM is urging American’s to contact their Representative today to urge a NO VOTE on H.R. 3962.

 SHRM’s concerns about the proposal include that H.R. 3962:

  • Does not include provisions to facilitate greater availability of wellness programs among employers and employees. 
  • Does not include meaningful cost, quality, or transparency provisions to ensure that both employers and employees have better access to health-related information.
  • Requires employers to provide and pay for “qualified” health care coverage or face an 8 percent payroll tax.  Employers must pay 72.5 percent of the premium for individuals and 65 percent of the premium for families.  In addition, even if an employer provides and pays for health insurance coverage for their workforce, that employer could still be subject to an 8 percent payroll tax if employees decline employer coverage because it is unaffordable – defined as more than 12 percent of the employee’s income.
  • Would erode the Employee Retirement Income Security Act (ERISA) by applying state law remedies to employer purchased coverage  in a health insurance exchange; prohibiting post-retirement reductions of retiree health benefits by group health plans, unless reductions are also made to active employees’ health benefits; and requiring employer-sponsored plans to meet detailed federal requirements that will increase costs.
  • Includes a public insurance plan option that raises serious concerns about cost-shifting to private plans. SHRM objects because inadequate reimbursement practices under Medicare and Medicaid has resulted in significant cost-shifting to private plans, increasing costs for both employers and employees. 

In light of these concerns, SHRM is asking all members and other concerned Americans to write mMembers of Congress TODAY and urge them to oppose the Affordable Health Care for America Act. It invites members to use SHRM’s HRVoice to share thes econcernings by:

  • Log ging onto HR Voice
  • Under the heading “Take Immediate Action on these Hot Issues,” click on:   “VOTE NO on the Affordable Health Care for America Act (H.R. 3962)” and
  • Personalizing and sending individualized letters by including specific information about the organization you work for, your experiences in the workplace, and why this legislation would negatively impact your organization. 

If you have questions about or need assistance monitoring, evaluating, commenting on or responding to this or any other health care reform proposal or other federal or state health care, workforce or other legislative, regulatory or other developments or concerns, please contact the author of this article, Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer.  Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization and Chair of the American Bar Association RPTE Employee Benefits & Other Compensation Group, Ms. Stamer is experienced with assisting employers and others about compliance with federal and state health care, employee benefit, workforce and other legislation and regulation. Ms. Stamer has advised and represented clients about these and other health care labor and employment, compensation, employee benefit and other personnel and staffing matters for more than 20 years. Ms. Stamer also speaks and writes extensively on these and other related matters. Her public policy experience includes ongoing involvement in these concerns within the U.S. for 30 years, as well as serving as a policy advisor on Social Security Reform to the Government of Bolivia and providing input or other representation to various other clients on workforce, health care and other policies in various other regions of the world. 

For additional information about Ms. Stamer and her experience or to access other publications by Ms. Stamer see here or contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here.

Guaranteed Access to Health Insurance Act of 2009 (HR 4020) Would Help States Establish Risk Pools To Expand Coverage

As House Speaker Nancy Pelosi pushed forward with plans for House members to vote on the House Democratic Leadership’s proposed health care reform package, Congressman Michael Burgess (R-Tx), a physician, on November 4 introduced a much shorted health care reform proposal, the Guaranteed Access to Health Insurance Act of 2009 (HR 4020).

HR 4020 proposes various reforms intended to expand coverage by enabling States to establish reinsurance programs or high risk pools to ensure that high risk individuals are able to access health insurance.

Under HR 4020, Congress would provide grants to states to “encourage” each state to provide a backstop to help ensure the availability of health care coverage by establishing either a qualified State reinsurance program or a qualifying State high risk pool as described in HR 4020.  As proposed, HR 402 provides that only citizens and nationals of the United States could participate in a qualifying State high risk pool or qualifying State reinsurance program receiving funding under its provisions.  Congressman Burgess proposes that Congress initially authorized $20,000,000,000 to be appropriated to fund the grants.

If you have questions about or need assistance monitoring, evaluating, commenting on or responding to this or any other health care reform proposal or other federal or state health care, workforce or other legislative, regulatory or other developments or concerns, please contact the author of this article, Curran Tomko Tarski LLP Labor & Employment Practice Group Chair Cynthia Marcotte Stamer.  Board Certified in Labor & Employment Law by the Texas Board of Legal Specialization and Chair of the American Bar Association RPTE Employee Benefits & Other Compensation Group, Ms. Stamer is experienced with assisting employers and others about compliance with federal and state health care, employee benefit, workforce and other legislation and regulation. Ms. Stamer has advised and represented clients about these and other health care labor and employment, compensation, employee benefit and other personnel and staffing matters for more than 20 years. Ms. Stamer also speaks and writes extensively on these and other related matters. Her public policy experience includes ongoing involvement in these concerns within the U.S. for 30 years, as well as serving as a policy advisor on Social Security Reform to the Government of Bolivia and providing input or other representation to various other clients on workforce, health care and other policies in various other regions of the world. 

For additional information about Ms. Stamer and her experience or to access other publications by Ms. Stamer see here or contact Ms. Stamer directly.   For additional information about the experience and services of Ms. Stamer and other members of the Curran Tomko Tarksi LLP team, see here.

 

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