Chamber Of Commerce Sees Room To Maneuver

January 15, 2010

Kaiser Health News

Phil Galewitz

Despite unleashing a new round of TV spots last week that blasts congressional Democrats' health overhaul, the U.S. Chamber of Commerce acknowledged at a media briefing Tuesday that the fight is just about over.

R. Bruce Josten, the chamber's executive vice president of government affairs, predicted that House and Senate negotiators would finish their work and get a final bill to President Barack Obama by mid-to-late February.

Still, Chamber CEO Thomas J. Donahue suggested that there will still be time to change the legislation as it's implemented over the next four years. He predicted that some parts of the bill would be challenged in court and that there would be efforts in Congress to amend the law. "It 's a very cumbersome and expensive plan," he said.

Josten predicted the final health overhaul bill would side with the House on starting insurance exchanges in 2013 instead of the 2014 date set in the Senate bill. He also expects the final legislation to include the House's richer subsidies for lower-income Americans and a larger expansion of Medicaid.

While the U.S. Chamber has criticized the bill for adding new mandates on employers to provide insurance coverage and new taxes on the health industry, Josten said the weak individual mandate could be the effort's undoing. "It's too easy for the young and invincibles to opt out," Josten said, noting the relatively small penalties for not having insurance coverage.

The penalty starts at $95 a year in 2014 in the Senate bill and rises to $750 or 2 percent of income in 2016. Without everyone having coverage, insurance costs will only continue to increase, he said.

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