• This amendment applies health insurance market reforms to the large group and self-insured market. This amendment will significantly and adversely impact larger employers, self-insured plans and the millions of Americans who count on their employer provided health coverage. The federal uniformity standard under ERISA (also known as the “preemption” standard) is critical to our health care system. Its hallmark feature is that it allows employers to offer uniform benefits to their employees, retirees and families without being subjected to the conflicting patchwork of mandates, restrictions and costly rules that vary from state to state. This is vital not only for large employers operating in multiple jurisdictions, but also for small employers operating within a single state or locality who rely upon the predictability of ERISA’s rules to help make possible the sponsorship of health coverage for their employees.

Schumer C1/C2 – Public Option Amendments

• These two amendments are strongly opposed by the National Coalition on Benefits, as we oppose the creation of a public plan. C1 is a design developed by Schumer, while C2 (Schumer/Cantwell) mirrors the public plan in the HELP Committee bill.
• Both amendments strike Co-Ops and replace with full public plan options. Both amendments would use “negotiated rates”; the HELP Committee option clearly has prices set by the Secretary of HHS.
• The public plan could skew the medical marketplace and overwhelm private, voluntary employer coverage. Under a public plan arrangement, the government is likely to become the biggest payor for health services, as is the case with Medicare. We are concerned that the government’s rate-setting policies would essentially shift costs that providers cannot charge to the public plan onto private payors.

Wyden C1 – Healthy Americans Act

• This would transform the Baucus bill into something resembling the Wyden/Bennett bill. The CBO found that Wyden/Bennett would end the employer-sponsored health insurance system, even with changes aimed at pacifying the business community.
• The Healthy Americans Act fundamentally alters the primary roles and incentives for employers to serve as sponsors of uniform benefit plans for their employees. A sensible, consensus approach to health reform should build on our voluntary employer-based health care system and not undermine the essential role of employers in our health care system. Central to this is the current ERISA standard which provides a single, uniform federal framework and makes it possible for employers to offer health benefits to millions of employees which they highly value and depend on.