The 2016 general election effectively kicked off this week after the District of Columbia closed out the last of the presidential primaries on Tuesday. Donald Trump and Hillary Clinton are likely to grab the bulk of the spotlight during this anything-but-ordinary election cycle, but the presidential race is not the only thing at play in healthcare politics this year. NAHU remains on the front lines of several threats from both the right and left, including some Republicans pushing to eliminate or cap the employer-exclusion as well as some Democrats advocating for a ballot initiative in Colorado to implement single-payer in the state. You can help Colorado in its efforts to stop this threat by contributing to the Coloradans for Coloradans campaign here. As campaign 2016 heats up, NAHU is committed to advocating on behalf of agents, brokers, and your employer clients to protect consumer choice in healthcare.
With continued premium increases and greater cost-shifting, calls for single-payer healthcare have been slowly gaining momentum, with the ballot initiative in Colorado currently the most pressing threat. Amendment 69 will be a question on the November general election ballot asking Colorado voters to approve a single-payer State Health Care System, also known as "ColoradoCare." The $25 billion program, funded through a 10% payroll tax, would operate a single-payer cooperative, extending coverage to anybody who earns income and lives in Colorado up to age 65, replacing the existing state-based marketplace, Connect for Health. Private market coverage could still be available, but only to supplement the public coverage and individuals enrolling would still be taxed for ColoradoCare coverage in addition to any private premiums. Further, existing private insurers may opt out of the market given the competition from the taxpayer-funded program.
A similar push for single-payer is under consideration by the New York legislature. A bill passed the Democratically-controlled House by a two-to-one margin in May 2015, but is not expected to pass the Republican-led Senate. However, Democrats are poised to reclaim the chamber with the November elections and could push for a new iteration of the bill in their next session beginning in January. The New York single-payer would effectively eliminate private market coverage in the state to allow for the public program to provide universal coverage. It would be funded through payroll assessments (80% employer-paid and 20% employee), and a progressive income tax, at 9% for incomes between $25,000 and $50,000, and increasing to 16% for incomes over $200,000.
Meanwhile, some Republicans, including House Speaker Paul Ryan, have been advocating for proposals that would threaten the very basis of the employer-sponsored healthcare system. An early draft of the House Republican white paper on healthcare, which is expected to be made public next week, indicates that Republicans will seek to put a cap on the amount of the employer-exclusion of health insurance. As we’ve mentioned previously, the employer exclusion forms the basis of the employer-sponsored health insurance system by allowing an employer’s contributions to an employee’s health insurance to be excluded from that employee’s compensation for income and payroll tax purposes. A cap or elimination of the exclusion could restrict employers from offering insurance altogether and push consumers entirely onto the individual market. The Republican white paper is not expected to indicate at what level the cap would take effect, but any cap would effectively serve the same purpose as the Cadillac/excise tax, which NAHU has also been a leading advocate for its full repeal.
Finally, in addition to the presidential contest, there are another 469 federal elections taking place in the states this November. All 435 members of the House of Representatives are up for election and a third of the Senate is also up. In the Senate, Republicans will be defending 24 seats to Democrats’ 10 seats, due to their landslide win in 2010 of which those seats are now up for re-election. Democrats would need to win at least five seats to re-claim the chamber and could be in a good position to do so. The most likely seats to change party hands are: Florida, Illinois, Nevada, New Hampshire, Ohio, Pennsylvania, and Wisconsin. Of those, only Nevada is currently held by a Democrat (Harry Reid), which means that Democrats will be able to play on offense to win those seats and reclaim the chamber. In the House, Republicans currently hold a 247-188 seat advantage, meaning that Democrats would need to win at least 30 seats to take back the chamber, which is not expected.
While Donald Trump and Hillary Clinton battle it out to be America’s next president, NAHU will be on the front lines defending America’s healthcare system. Both Republicans and Democrats threaten to fundamentally change how health coverage is provided and we believe that consumer choice should always be at the forefront of the debate. While NAHU does not endorse any political candidate or party, the Health Underwriters Political Action Committee (HUPAC) is able to support candidates who support agent and broker issues and the employer-based healthcare system.