Late Friday the staff for the Senate Health, Education, Labor and Pensions (HELP) Committee released their draft language and principles for their health care reform legislation. The language had been hinted in previous weeks, so there were few surprises.

The bill includes:
• A mandate for individuals to purchase insurance as well as a mandate for employers to provide insurance for employees.
• A provision that employers who did not provide a minimum amount of (undefined) coverage for their employees would have to make a payment on behalf of the employees (“pay or play”).
• The creation of a public plan to compete with private insurers.
• Language prohibiting insurers from using “preexisting conditions” in determining coverage and prohibiting insurance rating by gender or claims history.
• The creation of an “American Health Benefits Gateway”, a health insurance exchange run by states to show insurance options available for individuals and employers.
• Extension of Medicaid eligibility to those up to 150% of the federal poverty level.
• A tax credit (not defined) for small employers that pay a certain percentage of the employee’s health care premiums.
• An extension of family coverage to individuals up to 26 years of age (most insurers drop family coverage currently between the ages of 18 and 22).
The draft language contains many “liberal” proposals, and the reaction from business and insurance groups is understandably concerned. In addition, this weekend the President has stepped up his advocacy in favor of expansive health care reform, focusing his weekly radio/internet addresson health care.

While it is doubtful this exact legislative language would be passed into law, the Kennedy bill is trying to set the extreme for reform on which to allow negotiations to be based. For nonprofits, some of the areas of interest in this draft are:
• How will a “pay-to-play” mandate affect their HR benefits? If all employers are required to provide insurance (and there is no exemption for small business), how will this affect their benefits packages to employees?
• How will employers participate in state exchange programs (the American Health Benefits Gateway)?
• If there is an individual mandate, how will employees going outside of their employer for health insurance affect the employer’s insurance plan?
• What is the tax credit and requirements for small businesses?
ASAE will continue to look at the draft language and issues surrounding it, and use this area to provide regular updates for members.
Quick Hits
The House Energy and Commerce Committee also released some details of its health care bill on Friday… The Roll Call health care reform insert(subscription) comes out today, and is full of opinions on reform. ASAE member Nancy Brown of the American Heart Association is a contributor to the issue… The New York Times compares the state insurance exchange with proposed national exchanges… The Congressional Black Caucus writes a letter to the president endorsing the public option… The video of CNBC’s interview with Senators Baucus (D-MT) and Grassley (R-IA).