Plan Would Require Health Insurance for All Businesses, Pay Some Nursing Costs

An influential congressional commission is considering an ambitious health care plan that would require all businesses to provide health insurance for their workers and call on the federal government to pay for the first six months of nursing home care.

Businesses would be expected to pay 80% of the premium for insurance offering a specified level of coverage, with workers paying the difference. Businesses that failed to provide insurance to their workers would be taxed, with the money raised being used to help the government pay its costs of the program. Currently, 37 million Americans have no health insurance, even though most are in families with full-time workers.

The government would provide coverage to “everyone not covered through an employer plan,” according to a draft of the plan presented privately to the commission last Friday by its chairman, Sen. John D. (Jay) Rockefeller IV (D-W.Va.).

The government would provide small businesses and new firms with a subsidy to help with their health insurance expenses.

For the elderly, the government would assume the considerable costs of the first six months in a nursing home and for some home-care services. Under current law, nursing home residents must exhaust virtually all their savings before they qualify for Medicaid, the federal health program for the poor.

The draft plan, if implemented, would cost the federal government $40 billion to $50 billion a year.

The Bush Administration and Congress would view such a massive program skeptically, but growing frustration in the business community over soaring medical costs is generating serious discussion of radical changes in the health system.

One facet of the Rockefeller plan would control costs by encouraging private insurance companies to adopt the rates set by the federal government for hospitals and doctors participating in Medicare, the federal program for 30 million persons over 65 and the disabled of all ages.

Moreover, by making sure everyone has coverage, the Rockefeller plan could contribute to lower insurance rates overall. Currently, the uninsured frequently cannot pay their medical bills and the costs of their treatment are passed on indirectly in the form of higher fees to paying patients.

The commission headed by Rockefeller will offer a prescription for change to Congress on March 1. Its recommendations will receive serious attention because 12 of the 15 seats on the commission are held by members of Congress active in writing health and tax legislation. The President selected the other three members of the commission, which is named for its first chairman, the late Rep. Claude Pepper (D-Fla.).

Congress last month repealed Medicare’s controversial catastrophic care program, unpopular because it depended on a special surtax on persons over 65. However, advocates of repeal promised that they would find a solution to the most widely feared financial catastrophe of the old--the prospect of being wiped out by nursing home bills.

The Rockefeller proposal is sure to engender considerable controversy, partly because of the cost to taxpayers. Moreover, many small business owners are intensely opposed to providing worker health benefits, which they say they cannot afford.

Many major companies, such as Chrysler, are beginning to argue that they cannot remain competitive with foreign firms unless they get relief from soaring health costs.

Commission members will have two more full days of private meetings in January, where they will hammer out a final version of the blueprint for health care reform. The Rockefeller proposal could undergo significant alteration before commission members reach a consensus.