• Baucus Releases Health Reform Call to Action
  • December 11, 2008
  • Law Firm: King & Spalding LLP - Atlanta Office
  • On November 12, 2008, Senate Finance Committee Chairman Max Baucus (D-MT) released a 104-page document titled Call to Action, Health Reform 2009 ("Baucus Plan" or "Plan"). The Baucus Plan unveils specific policy options for consideration by the 111th Congress and the incoming Obama administration, including provisions facilitating sales of private insurance, expanding Medicaid and Medicare coverage, and requiring most employers to offer insurance to their employees or pay into a fund, with the employer's contribution based on the employer's size and annual revenue.

    Although Baucus said the Plan is not intended as a legislative proposal, he indicated plans to introduce comprehensive health reform legislation in the first half of 2009. King & Spalding has issued a separate Client Alert addressing the Plan and its implications for providers.

    Specifically, the Baucus Plan would allow individuals who already have health coverage to keep their coverage, but proposes to ensure that every individual can access affordable coverage by creating a nationwide insurance pool called the Health Insurance Exchange, which would serve as a marketplace where those individuals and small businesses looking for coverage could compare and purchase the plans of their choice. Private insurers offering coverage through the Exchange would be barred from discriminating based on pre-existing conditions. The Plan calls for employers (except small businesses) to contribute to a fund that would help cover the uninsured if the employers choose not to provide coverage themselves. This contribution would likely be based on a percentage of payroll that takes into account the size and annual revenues of the employer. The Baucus Plan also envisions a targeted tax credit that small businesses could use towards the cost of purchasing healthcare coverage.

    The Plan also proposes to make health care coverage immediately available to individuals aged 55 to 64 through a Medicare buy-in, and would phase out the current two-year waiting period for Medicare coverage for individuals with disabilities. In addition, the Plan would also ensure that all states use the State Children's Health Insurance Program ("CHIP") to cover children at or below 250 percent of the Federal poverty level. Once affordable, high quality, and meaningful health insurance options are available to all individuals, the Plan states that individuals would have a "responsibility" to have health coverage. The Plan, however, does not contain specifics on how such a mandate would be enforced, although it does suggest that it could be enforced "possibly through the U.S. tax system or some other point of contact between individuals and the government."

    Other initiatives set forth in the Baucus Plan include improving health care quality and value through various payment incentives and increased investment in health information technology, and curbing excess health care spending by, among other things, increasing investment in detecting and eliminating fraud, waste and abuse in public programs and reinstituting the DMEPOS Competitive Bidding Program.