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CBO to Examine Proposals to Help Pay for Health Coverage

By Alex Wayne, CQ Staff

June 22, 2009 -- Senate Democrats have asked the Congressional Budget Office to examine three proposals that would require large businesses to contribute to their employees’ health coverage, according to a document released Wednesday.

The document was distributed by staff of the Health, Education, Labor and Pensions Committee, which is marking up a draft health care overhaul bill by its chairman, Sen. Edward M. Kennedy, D-Mass., this week.

According to the document, CBO has been asked to estimate the budget effects of two competing proposals that would require businesses to help pay for their workers’ private insurance, plus a third that would require businesses with many employees on Medicaid to pay extra taxes to the government.

Such requirements are known in the business community as "pay-or-play" mandates — and are hotly contested by groups such as the U.S. Chamber of Commerce. But Democrats want a business mandate to accompany a mandate that individuals obtain insurance in order to foster what they call "shared responsibility" for health care coverage.

The document says that “small businesses” would be exempt from any of the "pay-or-play" requirements — but it does not define small business. In a section of Kennedy’s bill that would provide tax credits for small businesses to help them purchase insurance for their employees, the term is defined as a business that employs fewer than 50 people on average in a year and pays an average wage of $50,000 or less.

Under the proposals CBO is considering, businesses that fail to provide coverage meeting minimum criteria spelled out in the bill would have to pay either a flat fee to the government or a tax equal to a percentage of their payroll. A bill that House Democrats have written would require employers to pay 8 percent of their payroll to the government if they don’t provide coverage to their employees meeting the legislation’s requirements.

Also Wednesday, the HELP committee adopted 20 amendments to its bill that were considered noncontroversial. The amendments, which weren’t immediately available to the press, were adopted on a voice vote.

Sen. Christopher J. Dodd, D-Conn., who is leading the markup while Kennedy is being treated for brain cancer at home in Massachusetts, said the committee had adopted 240 amendments to the bill. Republicans alone had offered more than 350 amendments to the measure, which they have criticized for being too costly and incomplete.

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