No formal House and Senate conference, just wheeling and dealing, that is where we are with health care reform, but all this dealing may take us into February before something is presented to the House and Senate for a vote. Then, depending on what comes out of the talks the Democrats have to worry if they went too far and whether they will be able to keep the left, the right and the moderates on board (ok, scratch the right).
While there are many similarities in the House and Senate versions, there remain controversial issues as well.
There is still a public option in the House bill, but that appears dead.
The House bill contains limited grandfathering for existing health benefit plans while the Senate has permanent grandfathering – this is an important issue for employers.
The Senate bill contains the “free choice” option requiring employers to allow certain workers to opt out of the employer plan and receive tax free cash or doing so, the House version is silent.
The House bill contains an extension of COBRA eligibility until the exchanges are up and running.
The Senate bill contains the 40% excise tax while the House bill raises money with 5.4% surtax on high earning families.
The House version contains limits on the ability for employers to change current retirees’ benefits; the Senate is silent.
Both versions tax the rebate employers receive for providing prescription drug benefits to Medicare eligible retirees.
There is much to be done and as we have seen already, no deal is too bizarre to consider possible. Who knows, perhaps health care reform will teeter on a new senior citizen center in Boca Raton, Florida or a new tax credit for buying a flannel shirt before spring. Whatever happens, we have yet another full employment act for attorneys, consultants, actuaries and if employers are smart, good communications people. Benefit professionals haven’t had this much fun since ERISA…remember Section 89?
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