Mr. President, I have sought recognition for the purpose of introducing or cosponsoring the Healthy Americans Act, S. 334, legislation which is directed to cover the some 47 million Americans who are…
Mr. President, I have sought recognition for the purpose of
introducing or cosponsoring the Healthy Americans Act, S. 334, legislation which is directed to cover the some 47 million Americans who are not covered by health insurance. It is a bipartisan bill which has 16 cosponsors, half Republicans and half Democrats. It has been sponsored principally by Senator Wyden, Democrat of Oregon, and Senator Bennett, Republican of Utah. I believe it provides the basis for moving ahead on this very important subject.
We have long struggled to cover all Americans with health insurance. In a detailed statement, which I am about to submit, I have recounted the efforts which this Senator has made over the course of my tenure in the Senate; beyond the bill's own coverage, the work which has been done on the Appropriations Labor, Health and Human Services Subcommittee; and legislation in which Senator Harkin and I, on a bipartisan basis, have taken the lead in increasing funding for the NIH from $12 to $30 billion.
This proposal, S. 334, has a number of issues which I think need further analysis and further study and modification, as noted in the text of the statement. But I believe it is an excellent starting point and, having some 16 cosponsors, the most I have seen on a bipartisan piece of legislation to address this very important subject, I think it has an excellent opportunity in the next Congress to provide the basis for moving ahead for the appropriate coverage of all Americans.
We are facing a grave situation in America where millions of Americans do not have health insurance coverage. As the cost of health care is increasingly prohibitive and access to insurance is reduced, the number of uninsured will continue to climb.
It is estimated that nearly 47 million Americans are without health insurance. This includes the nearly 38 million individuals who have full or part time employment and still are without health care coverage. Of significant concern is the number of young adults lacking insurance: with an estimated 28 percent of those young people without insurance.
Individuals without insurance suffer from both acute and far reaching consequences. It ultimately compromises a person's health because he or she is less likely to receive preventive care, more likely to be hospitalized for avoidable health problems, and more likely to be diagnosed in the late stages of diseases. Additionally, lack of insurance coverage leaves individuals and their families financially vulnerable to higher out-of-pocket costs for their medical bills.
It is my belief that we can and should fix the problems felt by uninsured Americans with a system that does not resort to a single payer system and one that involves the private insurance industry. We must enact reforms that enhance our current market-based health care system.
The legislation I want to discuss today is S. 334, The Healthy Americans Act, which would provide access to health insurance for all Americans. Senator Wyden introduced this legislation on January 18, 2007, and since then, it has gained support from an impressive group of bipartisan Senators, including Bennett, Alexander, Nelson from Florida, Gregg, Coleman, Grassley, Landrieu, Stabenow, Crapo, Lieberman, Carper, Inouye, Corker, Smith and Cantwell. Today I am pleased to add my name to the list of cosponsors of S.334.
The Healthy Americans Act uses the private health insurance market to ensure that all Americans have access to a quality plan they can afford. This legislation has a number of components that will address the problems that plague our current health insurance system.
To begin, S. 334 provides so-called ``portability,'' which allows individuals to retain their health insurance regardless of the job they hold. In today's changing society, many Americans no longer stay with the same employer for long periods of time. Moving from job to job may mean the loss of health insurance, a new insurance carrier, or a gap in health care. The Healthy Americans Act seeks to provide consistent insurance coverage in a fluid job market.
Additionally, the Healthy Americans Act offers assistance for those who need it most by providing premium assistance for individuals and families with incomes below 400 percent of the poverty level--or $41,600 and $84,800 respectively. This provision aids those individuals that are employed but their income is insufficient to afford insurance. The assistance is based on a sliding scale with those with lower incomes receiving the greatest help. Individuals below 100 percent of the poverty level--$10,400 for an individual or $21,200 for a family-- receive full assistance with their insurance premiums.
While I am cosponsoring this legislation, I have some concerns that need to be addressed as the debate on this important issue moves forward. For instance, the potential new tax obligations associated with the Healthy Americans Act on both individuals and on businesses warrant further consideration. Concerns have been raised that this bill is not tax-neutral, meaning that new tax obligations created by this legislation are not completely matched by new or increased tax benefits. This resulting imbalance, or lack of tax neutrality, is argued by some to be a tax increase. Specifically, individuals would be required to pay their insurance premiums through the Federal tax withholding system, as opposed to the current model where premiums are paid to insurers through their employer. Payments would pass through the IRS on the way to newly created regional purchasing organizations called health help agencies--HHAs--and ultimately to the private insurer. The payment system, or collection, is technically a tax because it is being collected by the IRS. However, it is important to note that the Government will not keep those dollars and will not have discretion over how they are spent. Nevertheless, this payment system deserves further analysis on the issue of tax-neutrality.
S. 334 would require all businesses to pay an assessment of between 2 percent and 25 percent of average per worker premiums. The rate paid depends on the number of people it employs. I have concerns that this provision is structured as a tax. However, it is important to note that businesses would see some benefits as a result of the bill. They would be freed from the administrative burden of providing health care for employees because the individual would carry the responsibility of obtaining a private plan.
Because employers would be required to pay increased wages--in lieu of providing a health plan, they would also be subject to additional payroll tax obligations--i.e. Social Security and Medicare. An employee's increased payroll tax obligation is offset by a tax deduction provided in the bill. There is no corresponding deduction for the employer to offset their additional payroll tax obligations, and one should also be considered, because the bill's purpose is not to increase payments to Social Security and Medicare. The sponsor's intention of maintaining a budget-neutral bill is also worth consideration.
The mandate of paying increased wages only lasts for 2 years under the bill, after which time market forces would determine total compensation. Consideration should be given to retaining the employer payroll increase indefinitely to defray the cost of health insurance. Market forces may not sufficiently compensate employees when an employer decides to cut wages beyond the 2-year time frame. This would harm an employee's ability to purchase health insurance.
I am also concerned with the elimination of specific tax benefits for corporations that do business abroad, though it is my understanding that the sponsors are not wedded to elimination of these specific items. The argument has been made by proponents that the Wyden bill makes U.S. firms more competitive internationally because it removes the burden on employers to administer health care plans for their employees. Often foreign firms do not have that burden. To that end, the sponsor has chosen to eliminate certain tax preferences to multinational corporations as a way to raise revenue. I believe that greater consideration should be given to whether the benefit to employers of not having to administer a health care plan outweighs the elimination of these provisions.
First, the elimination of the section 199 manufacturing deduction raises concerns for our exporters. The section 199 deduction allows manufacturing
firms of all kinds to take a tax deduction for their U.S.-based business activities. The deduction was 3 percent in tax years 2005 and 2006, 6 percent in tax year 2007, and is scheduled to be 9 percent by 2010. This tax benefit was enacted as part of the so-called FSC/ETI legislation in 2004 to replace an export tax incentive that was ruled to be in violation of our international trade commitments. At the same time, it sought to boost the ability of manufacturers to compete in the global marketplace.
Second, the bill would eliminate deferral of income from foreign corporations that are owned by a U.S. parent company. Under current law, U.S. taxes do not apply to the foreign income of U.S.-owned corporations chartered abroad. As a result, a U.S. firm can indefinitely defer U.S. tax on its foreign income as long as the foreign subsidiary's income is reinvested overseas. U.S. taxes apply when the income is repatriated back to the U.S. Ending this deferral strategy could have the negative impact of encouraging the U.S. parent firm to relocate abroad or to limit the size of their operations in the