Talking Points
on
Key Senate Finance Committee Issues
The Senate Finance Committee will begin marking-up Chairman Baucus’s proposal on
September 22, 2009 with floor action possible very soon thereafter. Many problematic
amendments have been filed that, if adopted, would make health insurance unaffordable.
CAHR has concerns about the following possible provisions:
Oppose Any New Government Plan – Including One Connected to a
“Trigger”
 While the Baucus Plan does not include a new government-run public option, it does
include new co-ops to compete with health plans. Several proposed amendments would
replace proposed co-ops with a new Medicare-like government plan, or add a “trigger”
to a new government plan based on affordability. Depending on how this is structured,
the added cost of the new insurance reforms themselves could trigger a government
plan almost immediately.
 We continue to strongly oppose the inclusion of any government-run plan no matter how
it is structured. It is unnecessary for reform and, inevitably, it will use its built-in
advantages and exemptions from many private plan requirements (e.g., state and local
taxes, liability) to evolve into a single payer system over time.
 Senator Snowe (R-ME) is proposing a trigger that would mandate the creation of a new
government plan in any state where 5% of the people do not have access to at least two
plans in the state’s Exchange that are deemed to be “affordable.” Senator Snowe’s
amendment would trigger a government plan almost immediately. Even today, it is likely
that 5% of the population would not meet the threshold for the trigger.
 Triggering a government plan would make health care coverage less, not more,
accessible. Once a new government plan is “triggered” nationwide, the government
cost-shifting that is already caused by Medicare and Medicaid would grow worse.
Private health plans would become less affordable for Americans.
Drop New Insurer Fees / Limit Excise Taxes
 The Senate Finance package includes a new $6 billion annual insurer assessment
allocated based on market share. This is in addition to the excise tax on “high value”
plans. Self-funded plans are exempt from this new $6 billion tax.
 By taxing only insured plans, there would be a huge incentive for employers to self fund
their benefits to avoid this tax. As more self fund, the burden will be even greater on
individuals and small business.
 The excise tax on high-value benefits will lead to unaffordable premiums and will have a
disproportionate impact. The tax is likely to impact most American’s coverage in just a
few years since it is indexed to CPI, rather than medical costs and will affect people
disproportionately based on a variety of factors, such as where they live and their age.
 New fees and taxes, on top of insurance reforms, new minimum benefit levels and other
changes, will be passed directly on to the purchasers of health insurance, increasing
cost for employers and employees.