...by $132 billion over 10 years, according to the Congressional Budget Office.

The bill would be paid for largely through reducing fraud and abuse in the Medicare and Medicaid programs and in new taxes on high-value “Cadillac” plans and on high-income individuals and couples. The reconciliation package being considered in the Senate would delay the effective date of the excise tax on high-value plans from 2013 to 2018 to allow health plans time to grow more efficient.

The bill signed into law includes some provisions to help small business. It allows certain small companies to obtain tax credits for up to 50% of their premiums if they provide coverage to employees. It also lets small businesses pool together through statewide “exchanges.” Still, the Associated General Contractors and Associated Builders and Contractors say the bill will hurt their members, even without the Merkley language.

Massive Entitlement

Jeff Shoaf, AGC’s senior executive director for government affairs, says, “The centerpiece of this bill is a massive new entitlement program and a host of new taxes and fees to fund it.” Shoaf says that about 90% of AGC’s members already provide some level of health insurance for their employees. “We expect this will increase premiums for people who already are providing health care,” he says. It could also have a negative impact on S-corporations, which are taxed at individual, not corporate, rates.

“As of today, I think both sides think they are on the right side of history,” says Geoff Burr, ABC’s vice president for government affairs. “It will be interesting to see who’s right.”

Toughens penalties on employers that do not provide health coverage. Firms with more than 50 employees that fail to provide health insurance would be fined $2,000 per full-time worker if at least one of their full-time workers receives coverage through a health exchange. The Senate bill sets the fine at $750 per full-time employee.
Revises Excise Tax on high-cost plans. Delays effective date of the excise tax on high-cost plans from 2013 to 2018 and focuses on the most generous plans.
Adds consumer protections to “grandfathered” existing employer-provided plans. These protections include extending the prohibitions on lifetime limits and dropping people when they get sick; it also requires existing plans to provide coverage to non-dependent children up to their 26th birthday.