Health care reform legislation is much on the minds of Bemidji area nonprofit organization managers.
"I knew that would be the hot topic today, as it is at every meeting this year," said Steve Francisco, federal policy director for the Minnesota Council of Nonprofits.
Francisco briefed representatives of Bemidji area nonprofits on expected upcoming federal legislation on health care, unemployment benefits extension, estate tax and the 2001 and 2003 tax cuts for the wealthiest Americans.
Health care reform
Francisco handed out summaries of U.S. House of Representatives Bill 3200; U.S. Senate "Affordable Health Choices Act;" and the "America's Healthy Futures Act," presented Sept. 16 by Senate Finance Committee Chairman Max Baucus.
H.R. 3200 features the following:
-- Everyone would be required to have "acceptable health coverage." Those without coverage would pay a penalty of 2.5 percent of gross income.
-- Premium and cost-sharing credits would be available to individuals and families up to 400 percent of the federal poverty level.
-- Employers would be required to offer employees health coverage or pay 8 percent into the Health Insurance Exchange.
-- Medicaid would be expanded to cover everyone with an income 133 percent of the federal poverty level.
-- Children's Health Insurance Program enrollees would be required to obtain coverage from the Health Insurance Exchange.
-- A new National Health Insurance Exchange would be created, including a public option.
An "essential benefits package" would be created to include a specific set of services that limits cost-sharing to $5,000 for individuals and $10,000 for families with no annual or lifetime limits on coverage and prohibiting insurers from dropping people except for fraud.
Some key differences in the Senate Affordable Health Choices Act include the following:
-- An individual mandate enforced through a minimum tax penalty of no more than $750 per year.
-- Employers would be required to contribute at least 60 percent of the premium cost or pay $750 for each uninsured fulltime employee and $375 for each part-time employee not offered coverage. Employers with fewer than 25 employees would be exempt.
-- Medicaid would be expanded to cover everyone with an income of up to 150 percent of the poverty level.
-- A state-based American Health Benefit Gateways administered by a governmental organization or nonprofit would be created for individuals and small employers to buy qualified coverage.
-- Dependent coverage would be provided for children up to age 26 for all individual and group policies.
Key features of the Baucus Bill include the following:
-- Everyone would be required to obtain health care coverage by 2013 or face fines.
-- Tax credits for low-income families and subsidies for families earning less than three times the federal poverty level would be provided.
-- Out-of-pocket health care expenses would be capped at 13 percent of household income for middle class families who don't qualify for subsidies.
-- Insurance, pharmaceutical and other health care companies would pay $93 billion in new fees.
-- A national network of member-run cooperatives would be created as an alternative to a public option.
-- A 15-member independent commission would be created to enforce health care savings goals.
The cost of the House of Representative plan is estimated at $1 trillion over 10 years; The Senate proposal is estimated to cost $615 billion over 10 years; and the Baucus proposal is estimated to cost$856 billion over the first 10 years.
Francisco said the current cost of health care is unsustainable considering the United States spends 15 percent of its gross national product for health care, as compared to 9 percent of GNP in Canada. Maintaining Medicare and Medicaid is also unsustainable for the government, he said.
"That's the highest cost of all, to do nothing," Francisco said.
In addition, he said the 45 million-47 million uninsured people in the country end up seeking care at emergency rooms.
"The cost of the uncompensated care ultimately gets passed on to taxpayers," he said.
Francisco said the health care reform issues affect nonprofits because nonprofits pay salaries and provide benefits to employees and pay employment taxes just like for-profit businesses.
Francisco referred the gathering to http://thomas.loc.gov/cgibin/query/z?c111:h.r.3200, http://help.senate.gov/BA109A84_xml.pdf and http://finance.senate.gov/sitepages/leg/LEG%202009/091609%20americas_hea....
"You can find the whole text and read it if you don't have enough to read tonight," he said.
Francisco said the House of Representative set a Friday deadline to vote on the bill, but like other Congressional deadlines, it could be pushed forward. He said he hopes to see some real action by Christmas.
Francisco also touched on a few other pieces of federal legislation of interest to nonprofits.
The unemployment insurance benefits, normally covering 26 weeks, has been extended to 52 week and might be further extended for states with exceptionally high unemployment rates. He said Minnesota is not in that category and wouldn't qualify for the additional extension.
He cited the $11 trillion national debt services at an interest rate of $280 billion per year.
"That's money that doesn't go for housing, health care, education," he said.
He said Congress has to decide whether to extend the George W. Bush tax cuts of 2001 and 2003 to the top half of 1 percent of the wealthiest Americans.
"We think that's just flat out bad policy," Francisco said. "It has contributed enormously to the deficits we see today and the national debt."
He also discussed the estate tax, sometimes referred to as the "death tax." Only those who inherit more than $7 million per couple pay it, and then only for the amount above the $7 million limit. He said 99.5 percent of Americans aren't affected by the estate tax. Francisco said this tax brings in $80 billion per year, but a contingent in Congress wants to raise the limit to $10 million per couple.
Francisco closed by encouraging the representatives of the nonprofit organizations. He said they are in a good position to alert the community to the facts of the legislative issues and continue to work for a civil society.