Q: What new incentives are on the table for small business looking to cover their workers?
A: There are several very important ones. First, small businesses would be able to purchase a plan through a nationwide health insurance exchange which allows them to participate in large group plans that should lower their costs. Secondly, the prohibition on discrimination based on pre-existing conditions will be particularly helpful to employers who have employees or family members with pre-existing conditions that otherwise would make small group plans unaffordable or even unavailable. Now, that kind of discrimination would be prohibited. Third, depending on the size of the business, and the number of employees and their wage levels, there are tax credits up to 50 percent of what the employer puts in on behalf of an employee – and that's a credit, not a deduction, so that's an even greater benefit. Fourth, employers who are already providing health insurance for their workers will benefit by having the number of uninsured Americans overall reduced. In addition, the businesses that have not been providing health insurance will now have to pay a portion of the cost of health insurance for others through an 8 percent penalty, which would mostly affect larger businesses.
Q: Will these incentives be effective in halting spiraling healthcare costs crippling many small businesses?
A: In the ways I just described. The tax credits could lower costs, as would a prohibition on discrimination based on pre-existing conditions and a national insurance exchange. Those are the primary drivers. There is also the argument that the availability of a public option could also reduce costs by creating increased competition in the marketplace. And I think it's an issue worth discussing.
Q: Are you in favor of a public option?
A: I do favor a public option, as long as it's firewalled to ensure that there is no cross-subsidization different than those enjoyed by private plans, with the sole exemption that the public plan would be tax-exempt because they would be nonprofit.
Q: Are there provisions in the current versions of the bill that would widen private healthcare insurance options and create more private-market competition for small business employee coverage?
A: There are, for sure. I believe, and others would dispute this, that the challenge is to widen the options while maintaining certain core standards – the most important of which are for the financial security of the insurance pool itself and secondly, to maintain certain basic core coverage. If those standards are met, then other insurance companies are welcome to participate in the exchange.
Q: Do you feel small business interests have been pushed out of the healthcare debate in recent weeks?
A: Sadly, I think [the debate] has been distorted. One of the great frustrations I have is when people come to Town Halls that express great anger about this bill when it would very likely benefit them and their employees. I truly believe that most small business today that can't afford or can't obtain health insurance for their employees would substantially benefit from this legislation. And that goes for the self-employed as well. Whether you are Republican or Democrat, be open-minded and get the information so that you can make an objective judgment about whether you would benefit from this bill.
The other thing is, I hope people won't just say, "What's in it for me?" … There is a broader question about what's good for the country and what's good for people. I believe ending discrimination based on pre-existing conditions is good for people. I believe it's a good thing for America and American citizens to know that if tragedy strikes and they become ill their insurer can't take back their policy. I believe it's a good thing that if you lose your job through no fault of your own that you won't lose your health insurance for yourself and your family. I think these are good things.
Q: President Obama has stated he wants healthcare reform to pass Congress before the end of the year. What's the timeline on the legislation?
A: The only timeline I know is that we are going to get together after the break and hear feedback from all of us who met with our constituents. For us, in addition to our Town Halls, we've had our fifth telephone town hall this week and we have three more in-person ones scheduled. I've had focused meetings with hospitals, doctors, small businesses and community clinics present. We've spent a lot of time on this.
Q: With all the meetings, are you feeling any healthcare policy fatigue?
A: I kind of enjoy it, it's my profession, and I've spent 23 years doing this. The fatigue comes when people shout each other down, when people say things that aren't true about the bill and you have to endlessly explain, "No, that's not actually in the bill."
Q: Are you surprised about the number of YouTube hits [nearly 1 million, as of press time for VBJ's print edition] received on a clip posted by a speaker opposing healthcare reform at your Town Hall last month?
A: It would be better if the Kaiser Family Foundation or the AARP got as many hits. That's where the hits should be going, to websites that actually talk factually about the legislation.
