The Senate Finance Committee, Chaired by Sen. Daniel Patrick Moynihan (D-NY), began last week to take active steps toward approving a compromise between the Clinton health care bill and a bipartisan compromise. Moynihan vowed to report out a bill perhaps as early as Saturday, July 2, before adjourning for the Fourth of July recess.
On last Thursday, the Committee voted 14-6 to reject Moynihan's proposed "hard trigger," an attempt to reach universal coverage through incentives to employers to purchase coverage, yielding to an employer mandate only after efforts to ensure a significant increase in coverage is obtained.
This vote resulted in a proposal that is a much different beast than those of the other three committees, all of which include an employer mandate as a means to obtain universal coverage.
With respect to self-insurance, only employers with 500 or more employees, grandfathered in Taft-Hartley or rural cooperatives plans, and grandfathered welfare arrangements can self-insure. (Again, there is no written language clarifying the role of the public sector). The bill does not require participation in purchasing cooperatives.
A Trust Fund would be set up to finance subsidies and infrastructure development for rural and urban areas. Funds would be made available to support the development of community health networks and certified community health plans, and to provide operating and capital assistance to such networks and plans. Funding would be distributed through the U.S. Department of Health and Human Services (HHS) that would be required to deposit $1.3 billion in the account annually and to administer all programs funded through the account.
The Trust Fund would also provide funds to provide operating assistance to certified community health plans and community health networks to address geographic, financial, and other barriers to health care services in designated urban and rural areas.
HHS would develop standards for identifying "designated urban and rural areas" taking into account financial and geographic access to certified health plans; the availability, adequacy, and quality of providers and health care facilities; and the health status of the area's …