A new Congressional Budget Office analysis showing that the health-care bill pending on the Senate floor would not substantially boost premiums for most Americans could generate more support from moderate Democrats, who are crucial to passing the measure. But industry and union officials remain concerned about key provisions of the $848-billion measure and say passage before Christmas is more and more unlikely.

The Patient Protection and Affordable Care Act, a combination of bills that cleared the Senate Finance and Health, Education, Labor and Pensions committees, would cover an additional 31 million Americans and impose new requirements on insurance companies and employers. It also would create insurance exchanges through which individuals could buy coverage, including a federally subsidized “public option.”

The CBO report, released on Nov. 30, concluded that although premiums probably would rise for individuals seeking insurance on their own, costs would fall for many through federally subsidized insurance exchanges. Others would see their premiums remain about the same or decline within a few years, the CBO said. Sen. Evan Bayh, a moderate Democrat from Indiana, says the findings alleviate many lawmakers’ concerns that the bill would cause insurance costs to go up across the board.

Senate debate is expected to continue for weeks. Observers say already tardy appropriations bills as well as other fiscal priorities leave little time for the chamber to finish health-care legislation by Christmas. “It’s going to be tough,” says Jeff Shoaf, Associated General Contractors’ senior executive director for government affairs.

Patient Protection and Affordable Care Act would:
Establish a mandate that most legal residents of U.S. obtain health insurance
Set up insurance exchanges through which certain individuals and families could receive federal subsidies to reduce the cost of purchasing coverage
Levy an excise tax on insurance plans that have relatively high premiums
Provide tax credits for some small companies that provide health coverage
Exempt employers with fewer than 50 employees from substantially providing coverage
Source: Congressional Budget Office, Democrats.Senate.gov

Geoff Burr, Associated Builders and Contractors’ vice president for government affairs, says, “I could see a scenario where they strip out the public option, water down the employer mandates, get rid of some of the tax increases and pass something that’s not really as broad as what they have right now.” ABC opposes the bill, contending it imposes too many new mandates on employers.

Although organized labor generally supports the Senate measure, Bevin Albertani, the Laborers’ International Union of North America’s legislative and political director, says the union is concerned the bill would allow too many small construction contractors “to evade the responsibility of providing health-care coverage to workers.”