WASHINGTON — As the Senate prepares to take up landmark health care reform legislation today, factions from all sides are weighing in on a polarizing issue that crosses economic and political divides and is a chief cornerstone of President Obama’s agenda.
The task before Congress is daunting — reconciling several competing legislative proposals to make health care affordable and available to every American while reining in the federal deficit — and it has already caused rifts within the Democratic Party, fired up Republicans and pitted several industry groups against each other.
The Senate Health, Education, Labor & Pension Committee will begin what is expected to be a two-week markup of health care reform legislation today, kicking off congressional consideration of the overhaul.
Some retail trade groups have gone on the defensive against several proposals, particularly employer mandates and a public plan option to compete against private health insurers, measures they claim could have a detrimental impact on merchants already struggling with a recession.
But organized labor is advocating a public plan option to give people a cheaper alternative to private health insurers and inject competition into the marketplace, in an effort to drive down crippling costs.
Currently, 170 million people get their health insurance through their employers, according to industry estimates. The retail industry employs approximately 24 million employees at 1.6 million establishments, said Neil Trautwein, vice president and employee benefits policy counsel at the National Retail Federation.
Of the 24 million employed in retail, 50 to 60 percent are eligible for health care benefits. The retail industry employs millions of part-time workers who are often not eligible to receive health benefits from employer plans. That means 10 million to 12 million retail employees are not eligible for employers’ health coverage.
Even retail giant Wal-Mart Stores Inc., the nation’s largest private employer, which came under fire for years from politicians and labor groups for inadequate health care benefits, is calling for universal health care. The company joined a health care reform coalition with labor groups in 2007 with the goal of providing health care to all workers by 2012.
Wal-Mart covers 51.8 percent of its 1.4 million U.S. employees, in terms of health care benefits, according to a spokesman. He said 5.5 percent of Wal-Mart’s workforce is uninsured, while 94.5 percent of its U.S. employee base has some type of health care insurance.
The politically volatile issue is sure to test the political will of many lawmakers and will partially define Obama’s presidency.
Expanding health care coverage to the estimated 46 million to 50 million Americans who are uninsured while reining in skyrocketing health care costs that account for more than 60 percent of U.S. personal bankruptcies won’t be easy, according to a team of professors at Harvard Law School, Harvard Medical School and Ohio University.
But in recent days Obama has thrown his political weight behind one of the pillars of his campaign and hit the trail of public opinion to make the sell.
“Today, we are spending over $2 trillion a year on health care — almost 50 percent more per person than the next most costly nation,” Obama said in a speech to the American Medical Association in Chicago on Monday. “And yet, for all this spending, more of our citizens are uninsured; the quality of our care is often lower, and we aren’t any healthier.”
The President proposed nearly $1 trillion in savings — the estimated cost of reform over 10 years — through spending cuts and tax increases to finance the overhaul.
Obama also said he expects business to bear some of the burden, though he will seek to carve out an exemption for small businesses that cannot afford it.
“The biggest problem we have is employer ‘pay-or-play’ mandates, which require us to either provide a prescribed extent of coverage and contribute a set amount to the coverage or to pay penalties on a per worker basis,” said Trautwein of NRF. “In addition, the HELP bill would charge us some percentage of cost of any worker eligible for Medicaid.”
The proposed public plan option is also meeting resistance from retail groups.
“If you have several folks taking advantage of the health care plan through employers who then opt out for a [public, government-funded plan], it undermines the pool you assemble as an employer and the risk calculations you’ve done,” said John Emling, senior vice president of government affairs at the Retail Industry Leaders Association. “We have to be careful that this [legislative] process of reform doesn’t undermine an employer’s ability to offer health care.”
The NRF and RILA said they are supportive of reform that reduces costs and increases access to coverage, by requiring individuals to obtain health insurance coverage and creating a personal health savings account or providing tax credits. But labor groups argue there needs to be a “shared responsibility” in the new system.
“The private system doesn’t work,” said JoAnn Volk, a legislative representative for the AFL-CIO. “There were enormous consolidations last year, and we’re not getting the best price or values. The public plan will give families another choice — one that is more affordable and one that provides robust competition.”