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WASHINGTON -- With a final multi-million dollar giveaway to Nebraska Senator Ben Nelson, Senate Democrats were able to secure the final vote needed last week to pass a landmark health care bill that provides near-universal coverage -- but adds an enormous burden to an already heavily-leveraged federal budget.
The 60-39 vote -- Nelson suddenly changed his vote in favor of the bill after his state was give a one-of-a-kind permanent exemption from his state's share of Medicaid expansion -- capped months of horse-trading and negotiations and 24 days of floor debate.
Now, the Senate bill will have to be reconciled in January with a previously passed House version of health care reform. Among the sticking points still to be settled is how to pay for the bill's provisions -- the Senate bill places fees on insurance companies, drug companies and medical device manufacturers, as well as a Medicare payroll tax increase to 2.35 percent for individuals with income over $200,000 or $250,000 for couples; while the House bill levies increased income taxes for upper income earners, fees on medical device makers and other taxes and fees.
Both bills are extremely costly: The Senate bill is estimated to cost $871 billion over 10 years while the House bill will cost between $894 billion to $1.2 trillion, according to sources.
The National Retail Federation expressed disappointment at the Senate's passage of health care reform legislation, saying the measure does little to reduce costs for businesses and is likely to result in further retail job losses. NRF said the vote would be included in its annual ranking of key issues important to the retail industry.
"The Senate thinks it has given American businesses and the public an early Christmas present, but this isn't what we asked for and it needs to be returned," NRF Vice President and Employee Benefits Policy Counsel Neil Trautwein said in a statement. "What we asked for and what Congress promised was a plan that would bring costs under control and make health care more accessible by making it more affordable. What we received are employer mandates and other provisions that will drive up costs that are already far too high and that will endanger the employer-provided health insurance system that millions of American families depend on. It's time for Congress to go back to the drawing board and come up with a health care plan that would actually make solid progress in reducing costs. That would be a gift worth celebrating."
The Wall Street Journal reported lobbyists are already gearing up to push for business-friendly modifications in the reconciliation process. Among other business groups, the U.S. Chamber of Commerce is asking for Congress to start over from scratch with the overhaul bills.
Companies are concerned that to cover an additional millions of Americans will increase the cost to employers. "We're still committed to the notion that health reform can be done right, but I know of no company that is warmly embracing what is in either the House or Senate bills," said Paul Dennett, a top health-care adviser to the American Benefits Council, according to the Journal.
Retailers, for example, want a longer time period before new workers would be able to receive company-sponsored health benefits. Also, companies are worried about what new taxes and fees will be levied to fund expanded health care coverage, which would increase premiums for small businesses especially.
The Senate measure "will not only fail to reduce and control the constantly climbing health-care costs small-business owners face, but it will result in new and greater costs on their business," said Dan Danner, CEO of the National Federation of Independent Business.
Meanwhile, convenience store trade group NACS was less vociferous than NRF in its condemnation of the bill, but vowed to continue to advocate for changes to the final employer mandate and specifically the definitions of full time and part time employees and the waiting period an employer can implement before offering coverage.