Bipartisan Congressonal Group Releases 5 Point Outline to fix ACA

[Sableye]

[url]https://costello.house.gov/media-center/press-releases/rep-ryan-costello-and-problem-solvers-caucus-announce-bipartisan[/url]

[quote]
Today, Congressmen Tom Reed (NY-23) and Josh Gottheimer (NJ-5), Co-Chairs of the Bipartisan Problem Solvers Caucus announced the Caucus reached consensus over the weekend on a bipartisan set of solutions to stabilize health insurance markets and provide relief to individuals, families and small businesses.

After much work, the 43 Republicans and Democrats delivered a set of principles to advance solutions to address the destabilized individual healthcare market. These bipartisan proposals focus on areas they can find broad consensus to work together to stabilize the healthcare industry.

By resetting the healthcare conversation in Congress, the Problem Solvers Caucus has set the stage for the kind of bipartisan solutions that Americans have been yearning for. The Caucus hopes to restore some predictability as insurance companies make decisions about premium prices in 2018.

Bipartisan Problem Solvers Caucus Proposal to Stabilize the Individual Market (click to view)

It is clear that the individual health insurance market is deteriorating in some areas of the country and we must act quickly to stabilize it. We all agree that the individual market needs restructuring, and we should swiftly implement changes in time to take effect for insurance plans offered for 2018. Committees of jurisdiction should begin to address the issue through regular order.

To stabilize the individual market and provide some immediate relief, we propose exploring​ realistic solutions including the following:

1. Bring cost-sharing reduction (CSR) payments under the Congressional oversight and appropriations process, but ensure they have mandatory funding. CSR payments are an important part of helping households earning between 100% and 250% of the federal poverty level afford to participate in the individual market. Bringing CSR payments under the appropriations process ensures that Congress can provide proper oversight.

2. Create a dedicated stability fund that states can use to reduce premiums and limit losses for providing coverage—especially for those with pre-existing conditions.

3. Adjust the employer mandate by raising the threshold on the requirement for employers to provide insurance under the employer mandate to businesses of 500 employees or more. The current employer mandate places a regulatory burden on smaller employers and acts as a disincentive for many small businesses to grow past 50 employees. Additionally, the definition of “full time” under the employer mandate should indicate that a full-time work week is 40 hours.

4. Repeal the medical device tax. This tax adds a 2.3% sales tax on medical device supplies. The costs of the tax are passed on to consumers and it should be repealed.

5. Provide technical changes and clear guidelines for states that want to innovate on the exchange or enter into regional compacts to improve coverage and create more options for consumers.

[/quote]

This was apparently released just after the house adjured for the month but got lost in the whole late night healthcare debacle. Just saw it pop up on an opinion piece and I tracked down the original release. Their proposal isn't actually insane, or even that difficult, but it still requires house and senate leadership buy-in and both are still bent on single party budget reconciliation instead of actually fixing anything. As it sits though, these five things are something that both democrats and republicans could get behind if leadership were serious.

[Snowmew]

I feel like a business should be seriously looking into its employees' healthcare a bit earlier than 500 employees. That's a pretty big number. 50 does sound like a small company, but (admittedly based on decade-old data), [URL="https://www.bls.gov/bdm/sizeclassqanda.htm"]only about 44% of employees in the US[/URL] work for a business with greater than 500 employees.

That change would fuck a good 26% of the workforce out of mandated coverage. That'd be letting 227,000 out of 248,000 businesses in the US with mandates off the hook, which sounds a little screwy to me, although you can't really convince these big-business free-market conservative types otherwise. I just feel like the huge bulk of companies bitching and moaning about the employer mandate (see, e.g., Papa Johns) are using this concession to try to chip away at the mandate as a whole, and they're not the ones who are going to "benefit" in the short-term anyway.

[Bob The Knob]

Can the Problem Solvers Caucus please replace the congressional leadership, at least this is an actual thought out proposal that can be debated and considered rather than the pants-on-head shit that the leadership came up with

[Sableye]

[QUOTE=Snowmew;52560742]I feel like a business should be seriously looking into its employees' healthcare a bit earlier than 500 employees. That's a pretty big number. 50 does sound like a small company, but (admittedly based on decade-old data), [URL="https://www.bls.gov/bdm/sizeclassqanda.htm"]only about 44% of employees in the US[/URL] work for a business with greater than 500 employees.

That change would fuck a good 26% of the workforce out of mandated coverage. That'd be letting 227,000 out of 248,000 businesses in the US with mandates off the hook, which sounds a little screwy to me, although you can't really convince these big-business free-market conservative types otherwise. I just feel like the huge bulk of companies bitching and moaning about the employer mandate (see, e.g., Papa Johns) are using this concession to try to chip away at the mandate as a whole, and they're not the ones who are going to "benefit" in the short-term anyway.[/QUOTE]

part of the problem also is what constitutes a business, does a franchise of 40 people squeek by when their franchiser is a massive multinational?

the actual number would in a perfect world, be up to debate, but that would have to get to even committee to do that

small business has been such a schewed term for so long, it applies to far too many very large, very wealthy companies