Sen. Max Baucus

On September 16 Sen. Max Baucus (D-MT), chairman of the Senate Finance Committee, introduced a chairman’s mark of the committee’s long-awaited health reform bill.

Titled the America’s Healthy Future Act, the legislation drew immediate criticism from both sides of the political fence even as it was widely acknowledged as a critical turning point in the ongoing attempts by Congress to overhaul the nation’s health care system.

As with the other bills making their way through Congress, Baucus’s bill follows the general outlines of President Obama‘s health reform proposal, although with some significant differences. It would cover around 95 percent of Americans and would include a mandate for individuals to secure health insurance. It would create health insurance co-ops as an alternative to a public health insurance option. It would not require employers to provide health insurance, and would charge a fee to companies with 50 or more full-time employees only if the government ended up subsidizing the employees’ insurance.

Demonstration grants for direct-care workers

While the bill does not adequately address the core issues of access to affordable comprehensive coverage that so many Americans — especially direct-care workers — need, it does include two significant grant programs that invest in the jobs of direct-care workers. The first addresses the needs of elders and people with disabilities by subsidizing the training of low-income people in high-demand health care jobs (including direct care), and the second establishes a set of core training competencies and certification programs for personal and home health aides.

Commenting to PHI on the demonstration grants, Senator Herb Kohl (D-WI), chairman of the Senate Special Committee on Aging, said, “America is facing a severe shortage of workers who are equipped to manage seniors’ unique health needs. These provisions will implement recommendations made by the Institute of Medicine to bolster the health care and long-term care workforce.”

Kohl went on to say he is glad the Senate is moving forward and “pleased that so many provisions in the Senate Finance bill will improve health care and long-term care for seniors.”

Next steps

A preliminary analysis by the Congressional Budget Office said the plan, priced at $856 billion, would manage to pay for itself through a combination of fees on health industry companies, taxes on insurance premiums, and reductions in Medicare and Medicaid spending. However, the CBO expressed skepticism about the lack of a public insurance plan, noting that cooperatives “seem unlikely to establish a significant market presence in many areas of the country” (“Baucus Outlines Health Plan Without GOP Support,” New York Times, Sept. 16).

Carol Regan, PHI Government Affairs Director, also expressed concern: “The chairman’s mark is disappointing in several respects. While it has an individual mandate, it doesn’t require employers to cover their employees, and most importantly, it does not include a public-sponsored health plan that could provide more affordable coverage to direct-care workers and other low-income Americans.”

The chairman’s proposed bill is only the first salvo from the Senate Finance Committee. Over 560 amendments have been filed and will be taken up this week as the committee begins its mark-up of the final bill.