With an overwhelming vote mostly along party lines, the House late last night adopted a groundbreaking bill to provide universal health insurance, including a mandate for all residents to obtain health insurance and a controversial new payroll assessment on companies that provide no health care benefits for their employees.
House Republicans joined Gov. Mitt Romney in arguing against the payroll fees that would rise over 18 months to 5 percent of total payroll for companies with 100 or fewer employees and 7 percent for larger companies that do not contribute to worker health plans. The governor said he strongly supports the overall legislation, although he believes that universal health care could be achieved without the payroll assessments. He stopped short, however, of threatening a veto if the bill included the payroll fees, but did say he views them as a "non-starter."
The House, however, modified the payroll fee before final passage with amendments reducing the total revenue they would bring in from $650 million to about $300 million. The change would ensure that no firms that provide insurance would be charged the payroll fees. Revenues would be made up using funds from the tobacco lawsuit settlements. House leaders said.
But shortly before midnight, House Democrats championed their version of a universal health care bill by a veto-proof margin of 131-22. House Speaker Salvatore F. DiMasi, D-Boston, however, defended the assessments. He argued that about $650 million from the fees is needed to expand MassHealth programs to cover more people and create a system of subsidized individual and small group health plans affordable to lower- and middle-income residents.
A Republican amendment to eliminate the fees from the bill failed on party lines by a veto-proof vote of 129-24 shortly after 7 p.m. as debate continued on numerous amendments. The speaker maintained that the payroll fees also would "level the playing field" between companies that put up funds for worker insurance plans and those that do not.
While the governor cautioned that the fees would add to the high cost of doing business in the state, Mr. DiMasi said the new programs would lower health costs for most businesses and eliminate the need for all companies to contribute to the $160 million payroll fund that now pays for free care for the uninsured. Mr. DiMasi called on House members to sell the proposals to the public and claimed the fees are needed to make the universal health care plans work. "It's the only way we will get this done," he said in a floor speech. "What we are proposing today is a bold proposal. It takes bold and courageous leadership to pass this proposal. Our system is broken and it has to be fixed," he said.
Without the subsidies supported by the payroll fees Mr. DiMasi argued many people would not be able to afford the mandate to purchase insurance. That mandate, supported by Mr. Romney, would require all individuals who do not have employer-assisted health care or qualify for the state and federally funded MassHealth program to purchase insurance starting Jan. 1, 2007.
A state clearinghouse would offer subsidized plans on a sliding scale that would provide comprehensive health plans for as little as $161 per month for an adult couple with two children earning $48,500 or $81 for an individual earning $24,000. The legislation would require all residents to verify their health insurance plan on state income tax returns, which would be checked against lists compiled from health insurance companies.
Failure to carry insurance would result in a penalty against the individual equal to half the cost of an insurance plan, and failure to pay those penalties within 60 days would result in the state notifying the Registry of Motor Vehicles not to renew that person's driver's license and car registration. The House plan calls for an estimated 205,000 people currently without insurance to be brought under the MassHealth program, by raising the income guidelines to 200 percent of the federal poverty level for adults with children and 300 percent for children. Another 220,000 currently without insurance are expected to become insured through small group and individual plans that would be available through changes in the law to allow payment using pretax payroll deductions.
Another 163,000 people are expected to qualify for the subsidized insurance plans that would be administered by a state insurance office. Republican House leader Bradley H. Jones of North Reading said there was bipartisan agreement for the individual mandate provisions and expansion of state and federally funded MassHealth programs. But he insisted the state's businesses were in no shape to shoulder more insurance fees. "Don't add a huge new tax to an already struggling Commonwealth," Mr. Jones said, asking the House to drop the payroll assessment portion of the bill.
Rep. George N. Peterson, R-Grafton, said the money being spent in the health care system today is more than enough to "cover health insurance for all of us ... without a $650 million tax on businesses." State Rep. Robert P. Spellane, D-Worcester, said that without the payroll assessments, "employers who choose not to provide insurance are getting away with a free ride." With changes adopted to provide credit from the payroll assessments for firms with seasonal workers and employees covered by insurance from spouses and parents, he said, companies that contribute to employee health plans "won't be affected."
House Republicans joined Gov. Mitt Romney in arguing against the payroll fees that would rise over 18 months to 5 percent of total payroll for companies with 100 or fewer employees and 7 percent for larger companies that do not contribute to worker health plans. The governor said he strongly supports the overall legislation, although he believes that universal health care could be achieved without the payroll assessments. He stopped short, however, of threatening a veto if the bill included the payroll fees, but did say he views them as a "non-starter."
The House, however, modified the payroll fee before final passage with amendments reducing the total revenue they would bring in from $650 million to about $300 million. The change would ensure that no firms that provide insurance would be charged the payroll fees. Revenues would be made up using funds from the tobacco lawsuit settlements. House leaders said.
But shortly before midnight, House Democrats championed their version of a universal health care bill by a veto-proof margin of 131-22. House Speaker Salvatore F. DiMasi, D-Boston, however, defended the assessments. He argued that about $650 million from the fees is needed to expand MassHealth programs to cover more people and create a system of subsidized individual and small group health plans affordable to lower- and middle-income residents.
A Republican amendment to eliminate the fees from the bill failed on party lines by a veto-proof vote of 129-24 shortly after 7 p.m. as debate continued on numerous amendments. The speaker maintained that the payroll fees also would "level the playing field" between companies that put up funds for worker insurance plans and those that do not.
While the governor cautioned that the fees would add to the high cost of doing business in the state, Mr. DiMasi said the new programs would lower health costs for most businesses and eliminate the need for all companies to contribute to the $160 million payroll fund that now pays for free care for the uninsured. Mr. DiMasi called on House members to sell the proposals to the public and claimed the fees are needed to make the universal health care plans work. "It's the only way we will get this done," he said in a floor speech. "What we are proposing today is a bold proposal. It takes bold and courageous leadership to pass this proposal. Our system is broken and it has to be fixed," he said.
Without the subsidies supported by the payroll fees Mr. DiMasi argued many people would not be able to afford the mandate to purchase insurance. That mandate, supported by Mr. Romney, would require all individuals who do not have employer-assisted health care or qualify for the state and federally funded MassHealth program to purchase insurance starting Jan. 1, 2007.
A state clearinghouse would offer subsidized plans on a sliding scale that would provide comprehensive health plans for as little as $161 per month for an adult couple with two children earning $48,500 or $81 for an individual earning $24,000. The legislation would require all residents to verify their health insurance plan on state income tax returns, which would be checked against lists compiled from health insurance companies.
Failure to carry insurance would result in a penalty against the individual equal to half the cost of an insurance plan, and failure to pay those penalties within 60 days would result in the state notifying the Registry of Motor Vehicles not to renew that person's driver's license and car registration. The House plan calls for an estimated 205,000 people currently without insurance to be brought under the MassHealth program, by raising the income guidelines to 200 percent of the federal poverty level for adults with children and 300 percent for children. Another 220,000 currently without insurance are expected to become insured through small group and individual plans that would be available through changes in the law to allow payment using pretax payroll deductions.
Another 163,000 people are expected to qualify for the subsidized insurance plans that would be administered by a state insurance office. Republican House leader Bradley H. Jones of North Reading said there was bipartisan agreement for the individual mandate provisions and expansion of state and federally funded MassHealth programs. But he insisted the state's businesses were in no shape to shoulder more insurance fees. "Don't add a huge new tax to an already struggling Commonwealth," Mr. Jones said, asking the House to drop the payroll assessment portion of the bill.
Rep. George N. Peterson, R-Grafton, said the money being spent in the health care system today is more than enough to "cover health insurance for all of us ... without a $650 million tax on businesses." State Rep. Robert P. Spellane, D-Worcester, said that without the payroll assessments, "employers who choose not to provide insurance are getting away with a free ride." With changes adopted to provide credit from the payroll assessments for firms with seasonal workers and employees covered by insurance from spouses and parents, he said, companies that contribute to employee health plans "won't be affected."
"Employers will have a decision to make," he said. "Do you want to pay the fee or provide insurance?" Mr. Spellane questioned the governor's claim that universal coverage could be accomplished without additional spending.
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