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Big Employers Back Health Cost Measures in Stimulus Package

By John Reichard, CQ HealthBeat Editor

JANUARY 12, 2009 -- The National Business Group of Health (NGBH), which represents many if not most of the nation's biggest companies, urged President-elect Obama and congressional leaders Monday to include investments in comparativeness effectiveness research and health information technology in the economic stimulus package now being drafted on Capitol Hill.

The organization, which represents 300 large employers including 63 of the Fortune 100 companies, also urged policy makers to include subsidies to help newly jobless workers pay premiums for health care coverage available under COBRA, a law that guarantees many workers who have lost their jobs continued access to their health coverage at group rates provided they pay the full cost themselves. While group rates are often lower than rates on the market for non-group insurance, they are nevertheless unaffordable for many people who have lost their jobs. COBRA subsidies would reduce premium costs to workers.

Congress should begin addressing health care quickly in the stimulus package rather than delay, NBGH President Helen Darling said in a letter Monday to congressional leaders. "We must tackle these extraordinarily complex issues now because the nation will not be able to pull out of this deep recession while health care costs continue to work against businesses' ability to grow jobs and compete globally," she said.

Big employers are a powerful force in health care policy, and helped derail President Clinton's health overhaul plan in 1994. NBGH, whose members cover some 55 million workers, describes itself as the only national organization representing large employers that focuses exclusively on health care issues.

Darling said at a mid-day press briefing that the inclusion of various health care provisions in the stimulus would not take the steam out of efforts later for a larger overhaul. "There'll be plenty of pressure for health care reform," she said. She described herself as "very optimistic" about the chances for a broader overhaul later, calling Obama's health appointments thus far first rate. "I've never seen such a good collective package" of such appointments, she said.

In a letter to congressional leaders, Darling specifically endorsed an increase in the stimulus in federal funding of comparativeness effectiveness research overseen by the Agency for Health Care Research and Quality. The research helps "determine the best course of treatment. It improves quality and reduces health care costs as less effective, unnecessary and duplicative health care services are eliminated," she said.

Darling said at the briefing that the absence of a broad set of "interoperability" standards to ensure that health IT systems are compatible should not be a reason to keep health IT funds out of the stimulus. A major hospital group also weighed in Monday in support of including health IT money in the stimulus.

"Health IT is an area where there are a lot of different ways to spend money and still be effective," she said. Funds could be spent on technology where standards do exist and the industry could be prodded to move quickly to adopt more standards, Darling said. "We can do things when somebody says we have to," she said, adding that "we are in a war. We are in a war for our recovery."

Darling said that COBRA subsidies would have to cover most of the costs of health coverage because the unemployed wouldn't be able to afford it otherwise. She said the subsides would be a very expensive part of the stimulus package but that workers need to be able to maintain access to health care services. She noted that under the COBRA law now, employees have to stick with their current health plan until the company's next open enrollment period. Congress should consider changing the law to let workers pick a cheaper health plan offered by their employer, she said.

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