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Playin’ Ping Pong and Improvin’ the Bill

As we usher in the new year, it now seems certain that Congress will bypass a traditional Conference Committee and utilize ‘ping pong’ in order to merge the House and Senate health reform bills. This decision became clear after Senate Republicans vowed to fight the bill every inch of the way, for numerous procedural hurdles would have significantly delayed Conference proceedings on the Senate side. The Senate version has limited wiggle room, so Speaker Pelosi and top House Democrats will most likely use Reid’s Senate bill as a template and incorporate various House provisions (see the post below for the major differences) before subsequent House and Senate votes. The State of the Union Address is still the tentative deadline, though now it looks like the speech will be delivered the first Tuesday in February.

The following weeks will be paramount for finding ways to maximize health reform, as the current ‘phase’ allows Democratic leadership to easily include amendments in order to bolster coverage expansion, consumer protections, cost-containment mechanisms, infrastructure funding, and insurance regulation. This process may just be simply choosing the better language between the existing House and Senate bills, but there is also opportunity to include novel provisions. Ben Nelson’s compromise for full federal funding of Medicaid expansion in Nebraska, and Medicare coverage for residents of Libby, Montana sickened by a mineral mine are two examples of good policy injected late in the game on the Senate side.

Another provision receiving ample attention is a clause regarding the construction industry, which will now be subject to an employer pay-or-play mandate for firms with more than five employees (compared to 50 employees for firms in other industries). In the previous language, firms with less than 50 employees would be exempt from the mandate, effectively excluding the entire construction industry as 90% of these companies employ less than 20 workers. The new provision places a modest employer mandate on the traditionally ‘lowest bidder’ industry, which will protect many non-union workers who would have faced higher costs otherwise. Read further about the clause effects here, which should improve coverage and affordability for the nearly 786,000 construction workers in California. Moving forward, it is imperative to clarify, articulate, and ultimately include language in order to improve other ‘niche’ circumstances like these.

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