House and Senate leaders and their staffs continue to work on melding the House and Senate health reform bills approved late last year into one final compromise measure. A number of high profile issues still need to be resolved; these including (1) whether to include a single national Exchange (House) or a system of individual state-based Exchanges (Senate), (2) final thresholds for high cost health insurance plans subject to a proposed excise tax paid by insurers, (3) Medicaid eligibility income thresholds and (4) additional measures to improve and ensure affordabililty of required insurance coverages. While reports indicate that progress has been made, it is not clear when a final bill will be sent to the Congressional Budget Office (CBO) for scoring, i.e. an analysis of the proposed measure's impact and cost. A final bill will not be released until an politically-viable CBO score is received. Any final bill must then be approved by both the House and Senate.
In a January 12, 2010 letter sent to House and Senate leaders, as well as the chairs and ranking members of each of the five House and Senate Committees with jurisdiction over health, NAR stressed the importance of improving the affordability of policies available thru the Exchange by providing (1) small non-profit employers with access to the same affordability credits available to small non-profit employers, (2) equitable payroll tax treatment of health insurance premiums for the self-employed and (3) a single national Exchange, in any final bill.
