Senate Health Care Reform Debate Underway, AGC's Concerns Remain

The U.S. Senate began debate and votes on amendments to the "Patient Protection and Affordable Care Act." The Democratic leadership remains committed to holding a final vote on the legislation prior to Christmas, followed by sending a final bill merged with the House to the President in early January. The major hurdles for passage remain provisions on abortion, cuts to Medicare, the structure of a public option and immigration status issues. Major employer groups like AGC remain opposed to the legislation because it does not reduce health care costs, will impose new mandates on employers, will likely increase the cost of employer provided health care, and could significantly increase human resource costs. Beginning in 2013, the legislation would eliminate lifetime limits and rescissions, and extend dependent coverage to age 26. A year later, plans could no longer price policies based on preexisting conditions. The legislation includes an individual mandate with subsidies for low-income workers, and employer mandates that penalize some employers if employees receive government subsidies. The tax credits for small employers offer limited values. The bill expands Medicaid eligibility and reduces the growth in Medicare payments. It also places an excise tax on insurance plans with high premiums, as well as fees on insurance and manufactures of certain medical devices. The construction industry is unique due to its fragmentation, relatively short duration of individual projects and the use of transient workers, making it susceptible to several provisions of the legislation. The failure of the legislation to define full-time, part-time and seasonal workers is a concern for many employers, and the use of other industries' definitions on the construction industry could contrast with our diverse work force needs. The short waiting period in the proposed legislation is particularly troubling due to the high turnover of employees in the industry. The capping of contributions to FSA accounts will remove today's health care options rather than increase them. Other concerns include the administrative burdens on employers to deliver increased paperwork to the government, how to handle credits, and partial payments as well as changes to COBRA benefits. AGC remains concerned that the Senate bill shifts rather than contains costs and fails to offer more affordable choices to individuals and employers alike.  AGC is currently working on identifying ways to improve the legislation. AGC encourages members to use the Legislative Action Center to urge their senators to expand health care opportunities and innovation and not impose billions in taxes to fund the expansion of existing health care programs that should instead be reformed. For more information, contact Jim Young at (202) 547-0133 or youngj@agc.org.