Health Reform Issues Not Settled. All Eyes on Massachusetts

With the race for the Senate seat once occupied by Edward Kennedy looking tight just days before the election, Obama and Democrats met for a marathon negotiating session yesterday. If the Democrats lose their 60th vote in the Senate next Tuesday health reform will take a dramatic turn.

Meanwhile, according to the New York Times and the Wall Street Journal the day of negotiations focused on how to pay for reforms, the employer mandate, how to increase subsidies for low-income families, the excise tax, and a possible increase in the Medicare payroll tax rate and scope.

If this reporting is accurate it means that, in particular, the details of the employer mandate are not settled. If that is the case, I hope the Democrats are considering eliminating the 30-hour threshold that exists in the Senate version (actually, I wish they’d switch to the House version but we heard yesterday that’s not going to happen). Because the Senate’s pay-or-play (with loophole) requirement only applies to full-time (30+ hour/week) workers, it includes incentives for gaming around the full-time/part-time cutoff. That should be remedied in the final bill.

Another thing to note is that there was no mention of abortion. If they haven’t dealt with that thorny issue yet then they’re far from completing a deal. In that case, it doesn’t seem like one can be delivered by next Tuesday. So, Democrats are relying on holding the Massachusetts seat. That should make Tuesday’s vote in Massachusetts a referendum on health reform. The question is will potential Massachusetts Democrats recognize it and show up?

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