Is Reform of U.S. Health Care System on the Horizon?

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By Hedley Lawson: Contributing Editor

President Barack Obama and Congress are moving rapidly to reform the U.S. health-care system. The president has expressed flexibility on individual mandates, employer mandates and changing the tax treatment of employer-provided health benefits as he seeks to motivate Congress to define a new plan. And the provisions of any health-care reform are of direct importance to every company in the world of optical and the optical industry as a whole.

Senators Max Baucus of Montana, chairman of the Finance Committee, and Ted Kennedy of Massachusetts, chairman of the Health, Education, Labor and Pensions Committee, have joined Senators Chuck Grassley of Iowa, and Mike Enzi of Wyoming, in a commitment to create comprehensive bipartisan committee bills, and then one comprehensive bill. The problem will be the need to secure between $1.2 trillion and $1.5 trillion to pay for such coverage over the next 10 years.

Proposals that have been advanced by the Senate Finance Committee include the elimination of Flexible-Spending Accounts (FSAs) and Health-Savings Accounts (HSAs) as possible ways to raise revenue, along with limits on the basic premium tax exclusion.

The most apparent issues standing in the way of reform are believed to be:

• Should there be a public plan, and if so, how should it be designed and who should be eligible?

• Should any employer be able to opt to send workers to the public plan? Or should it be limited to small employers? Should all workers be able to choose to go to the public plan regardless of what their employer desires? Should the plan “pay low” in order to keep premiums down and in order to “drive the market?” Or should premiums be set at an average of the market so as to not displace private insurers?

• Should there be individual and/or employer mandates? What types of subsidies would be needed in order to make insurance affordable for low-income individuals and families, and who should provide the funds?

• Should there be a regulatory structure that manages the system with authority similar to the Federal Reserve?

It will be important to watch Congress closely between now and its August recess to monitor and plan how your company
will implement the reforms once enacted. ■