Health Care Reform
- January 2009
HEALTH CARE REFORM
Mental Health Parity [updated January 2009]
For more than a decade, the employer community and health insurance industry had opposed legislative efforts to expand the mental health parity requirements enacted in 1996 as part of the Health Insurance Portability and Accountability Act (HIPAA). That changed as a result of the 2006 mid-term elections that gave majorities in both houses of Congress to the Democrats. The result: a compromise measure mandating that mental health benefits, if offered, receive insurance coverage equal to medical/surgical coverage, was enacted into law with the support of leading employer trade associations (including NAW) and several patient advocacy groups.
ERISA Preemption [updated January 2009]
The Employee Retirement Income Security Act (ERISA), enacted in 1974, includes a preemption provision that has facilitated employer-sponsored group health insurance plans. By enabling employers to operate uniform health insurance plans across state lines, employers and their employees enjoy the benefits of flexibility in plan design, and economies of scale that yield the lowest possible premium and administrative costs. Largely due to ERISA, today 160 million Americans receive health insurance coverage through employer-sponsored plans.
Because the number of the medically uninsured has risen to approximately 47 million Americans, and the difficulty the Federal government has experienced in responding to this crisis, states have been attempting to deal with the problem within their own jurisdictions. The limiting effect of ERISA on the state initiatives has led some to advocate a weakening of ERISA preemption.
During the 110th Congress, hearings were held in both houses of Congress that touched on this topic; however, a more serious attack on ERISA may be on the horizon for 2009.
Given the realities and strengths of the nation’s current workplace-based health insurance delivery system, NAW supports ERISA preemption as providing its essential foundation and have joined with our colleagues in the National Coalition on Benefits (NCB) in its defense.
Comprehensive Healthcare Reform [updated January 2009]
For years employers have complained about rapidly rising healthcare and insurance costs that have put increasing pressure on business’ bottom lines. The “flip side” of the health care coin is also problematic: as costs have risen, the ranks of the medically uninsured have swelled to approximately 47 million people. No wonder healthcare reform was routinely cited throughout the 2008 campaign as a leading domestic policy priority. During the campaign, President-elect Obama unveiled an approach to healthcare that appears to both build on the employer-based system and expand the federal government’s role.
Senator Kennedy, recovering from brain cancer surgery, has made enactment of healthcare reform a priority this year. He and his staff have been conducting meetings throughout the fall with interested parties and it is believed that legislation was already being drafted before the election. Action on this issue is increasingly likely this year.
NAW will continue to engage this issue as the legislative process unfolds in the 111th Congress. Among the controversial items to be addressed in this process will be
- the role of employers (i.e., employer mandate);
- the role of individuals (i.e., individual mandate);
- a federally-mandated minimum benefits package;
- the tax treatment of health insurance premiums;
- insurance market reform; and
- premium subsidies.