The Power of A

Senator Olympia Snowe (R-ME) emerged from a bipartisan conference yesterday to confirm that the Senate Finance Committee negotiators will not include two major components of the Democratic health care plan in their bill: the creation of a government-run insurance company (”public plan”) nor a requirement that all employers provide their employees with health care coverage.

Instead, the committee’s bill will likely include two concepts that so far have only been discussed by the Finance Committee.  Instead of a public plan to act as a competitor to private insurance companies, the bill will include “co-ops”, or a series of non-profit, non-government insurance options for the self-employed or small businesses regulated by standards from the National Association of Insurance Commissioners. These types of arrangements are found in other sectors of the economy, including agriculture. The National Cooperative Business Association and National Rural Electric Cooperative Association provide good examples of how current cooperatives operate.

In addition, the Finance Committee bill will not have a “pay or play” employer mandate but a so-called “free rider” approach.  The concept is that while there is no absolute mandate for employers to provide insurance for employees, employers (with 50 or more employees) whose workers receive Medicaid or a tax credit through a health insurance exchange must contribute half of the average Medicaid cost for workers or 100% of the cost of the tax credit received for providing the workers with health insurance.

The Finance Committee negotiators also said yesterday a bill is close to being completed, but there was still no timetable to release the bill.  The final list of revenue raisers is also being discussed, but none of the negotiators would comment definitively on what would be included.  Snowe suggested that taxing the “Cadillac” health insurance plans was being considered, and the committee could reduce the minimum level for the tax.

An idea that surfaced in discussions (subscription) Monday was a surtax on medically-unnecessary plastic surgery, also known informally as the “Botox” tax.  The surtax would be 10% on the cost of the procedures and would include things like Botox shots, face-lifts, and teeth whitening.  The feasibility of the tax being included in the Finance bill is unknown, however, as committee chair Max Baucus seemed to shoot down the idea talking with reporters: “That hasn’t been on any list I’ve seen in a long time.”

Quick Hits

The removal of a health care bill from the Senate’s floor schedule opens room for other issues, including the Travel Promotion Act of 2009… Energy & Commerce Chair Henry Waxman (D-CA) makes an offer (subscription) to address the Blue Dogs 10 points of concerns, but there has yet to be a formal reply… The House Democratic caucus goes through the health care bill section by section… Is the reason health care reform has not passed the absence of these four critical people?… The New York Times has a picture showing and explaining some of the key negotiators in the Senate… Volunteering (especially through nonprofits) is up, showing another way associations advance America.