Clinton lays the groundwork for introduction of national health reform proposal

Business & Health, Sept, 1993

President Clinton, who is scheduled to release his health care reform proposal the week of Sept. 20, outlined some of the basics of his health care reform plan before the National Governors Association on Aug. 16. Here are some of the highlights:

* Clinton showed a willingness to compromise on the time frame for an employer mandate. The mandate requiring empllyers to pay 80% of employees' health insurance costs would be phased in over five to seven years.

* Small business will get a break on the percentage of payroll they will have to pay. Clinton said a government subsidy would limit the health care cost for companies employing four workers or less to no more than 3.5% of their payrolls. Large companies would pay a maximum of 7% of payroll.

* Clinton reiterated his desire to fold workers' compensation and auto insurance into a reformed health system.

* The administration estimates between $30 and $40 billion in savings from Medicare and Medicaid.

Clinton told the nation's governors that a streamlined medicaid waiver process would smooth the way for many state health reform efforts.

Administration officials acknowledge, however, that changes to the Employee Retirement Income Security Act. (ERISA) may have to await passage dof federal health reform. In the handful of states where health reform laws have passed, some key aspects of the laws can not be implemented without exemptions from both Medicaid and ERISA regulations. The officials say the Medicaid waivers will be easy to speed up, but underscore that they have no real jurisdiction over ERISA.

The administrsation also promised hospitals, doctors and insurers last month that it would amend antitrust laws to allow them to form networks, share technology, and collaborate in allocating health care resources. In a speech to the American Hospital Association, Hillary Rodham Clinton said the Justice department was charged with coming up with charges to antitrust law that would allow such activity. Some of those changess are likely to occur before a federal health reform law passes through Congress.