Several states' legislatures are close to enacting single-payer healthcare bills. This is a complete healthcare solution that eliminates the for-profit insurance industry, lowers the cost of pharmaceuticals, reduces bureaucracy, and provides universal coverage. As President Obama explains: "Now, the truth is that, unless you have a — what’s called a single-payer system, in which everybody is automatically covered, then you’re probably not going to reach every single individual."
In addition the state of Vermont has enacted a public health plan and the city of San Francisco has enacted Healthy San Francisco.
The soon-to-be-passed state single payer plans and the current plans, including Healthy San Francisco are unfortunately threatened by the federal preemption clause in ERISA.
The Senate bill requires states to set up exchanges by 2014, but does not allow waivers for state single payer programs until at least 2017. Would a state go to the trouble of setting up an exchange by 2014 and then switch to single payer after 2017? If a Repug were to be elected president in 2016 would their HHS secretary actually grant waivers for single payer programs ?
Two Present Endangered Public Plans:
Healthy San Francisco gives employers the option of paying about $1 an hour per uninsured employee into the comprehensive city-run plan. Residents then pay from $0 to $645 per quarter for coverage, depending on income.
http://www.kff.org/...
Vermont has a plan with no mandate, a limitation of 20% difference in premiums (the Senate bill allows 300%), and guaranteed issue.
Vermont assesses employers $91.25 per quarter ($365 per year) per "uncovered FTE." "Covered" is not the same as "Insured by the employer," however. As long as the employer offered to cover the employee with a plan that insures hospital and medical benefits, and the employer would have contributed any amount at all toward that plan, the employee is considered "covered" even if the employee does not accept the plan, as long as the employee has other insurance, such as through a spouse.
The assessment is levied regardless of whether the "uncovered" employees are even eligible for, or are covered by, the new insurance subsidy plan, which is called Catamount Health. So "uncovered" employees aren't necessarily covered by the state, either.
http://content.healthaffairs.org/...
Even though the conservative 4th Circuit overturned Maryland and New York "play-or-play" (WalMart) laws as in violation of ERISA preemption, the liberal 9th Circuit upheld Healthy San Francisco saying it did not compel employers to provide insurance, but gave them the option of paying into a public plan, and therefore did not violate ERISA.
Employers in San Francisco have appealed to the Supreme Court but after several months no advisory opinion has been forthcoming from the Obama administration
The US Supreme Court has delayed a decision on the Golden Gate Restaurant Association's legal challenge to the Healthy San Francisco program, instead asking for the Obama Administration's opinion on whether the required employer contributions that fund the universal health care plan violate federal law.
The GGRA suit contends the employer mandate violates the Employee Retirement Income Security Act (ERISA), a view that was supported by the Bush Administration but opposed by the city and the Ninth Circuit Court of Appeals, whose ruling against GGRA the Supreme Court is deciding whether to hear, a decision that had been expected today. President Barack Obama has publicly cited Healthy San Francisco as a model for health care reform and City Attorney Dennis Herrera has personally lobbied the administration to reverse the previous administration's position, and now the court wants a formal opinion from Obama's Solicitor General Elena Kagan.
http://www.sfbg.com/...
There's real fear that part of the "big deal" may be that there are will be no public option, no drug re-importation, and no state single payer plans. One national health scheme fits all.
There's a very detailed legal anaylsis of ERISA pre-empting state plans here:
http://assets.opencrs.com/...
Endangered Future State Plans Including State Single Payer
Last July the House Committee on Education and Labor voted 25 to 19, with 13 GOP members supporting, to pass an amendment proposed by Congressman Dennis Kucinich to waive federal restrictions and allow states to provide healthcare if they choose. Nothing in any other versions of the healthcare bill from other committees conflicted with this language, but it was quietly removed nonetheless. (House Speaker Nancy Pelosi said the White House told her to remove it.)
As part of his last-minute amendments to the Senate bill Bernie Sanders got explicit language in the Senate bill providing for state waivers for programs that provide at least as much coverage as the federal plans. But the Senate bill set an effective date for these waivers as 2017, forbidding state healthcare solutions through 2017, and not - despite what the President told Kucinich recently - including the waivers that had been in Kucinich's House amendment.
Most people know that California has passed state single payer several times only to be vetoed by the present governor. With the change to a Democratic governor California SinglePayer will probably become law. In addition several other states, including Pennsylvania, Minnesota, and Vermont are rapidly organizing state single payer programs.The Pennsylvania plan has broad support including the governor and both senators but expects ERISA problems:
http://discuss.epluribusmedia.net/...
excellent DK diary on PA single payer by rossi:
http://www.dailykos.com/...
The Vermont single payer group is up in arms about what they perceive as a trick in the Senate bill to effectively kill state single payer by delaying it until after 2017:
http://vermontforsinglepayer.org/...
When the first state passes single-payer healthcare, none of the other 49 states will lose anything they've gained through Congress. But the lucky state whose legislature tries to do something more won't see any immediate benefit, because the insurance companies will sue. ERISA's pre-emption clause allows such suits to prevail and deny states the right to provide their residents with healthcare.
While all Republicans can be expected to vote no on any bill, including reconcilation, the 14 Democrats listed below supported the state ERISA waiver amendment in the House Committee on Education and Labor. They should be the easiest to persuade that ERISA waivers before 2017 are absolutely necessary either in reconciliation or a subsequent bill. Of course any contacts with House or Senate members of either party or the White House are also important. Many Republicans actually support state experiments strongly because of states' rights.
Members of the California delegation should be especially concerned that their chances for single payer would be in jeopardy and that the administration has not taken Healthy San Francisco's side before the Supreme Court. Whatever connections anyone has to anyone in government may prove fruitful in getting state waivers moved up.
The basic request is a common sense one- "ERISA waivers for state-sponsored health programs that provide more comprehensive coverage must be moved up to earlier than 2017 and should in fact be made immediate to cover existing programs."
There's a good discussion by on getting state single payer opt-in moved up from 2017 through reconciliation here: How to Get State Single Payer Through Reconciliation
Democratic House Members who voted in committee for state single payer waivers:
Dennis J. Kucinich (OH-10) phone (202)225-5871, fax (202)225-5745
Donald M. Payne (NJ-10) phone (202)225-3436, fax (202)225-4160
Robert C. Scott (VA-03) phone (202)225-8351, fax (202)225-8354
Lynn C. Woolsey (CA-06) phone (202)225-5161, fax (202)225-5163
Raúl M. Grijalva (AZ-07) phone (202)225-2435, fax (202)225-1541
John F. Tierney (MA-06) phone (202)225-8020, fax (202)225-5915
David Wu (OR-01) phone (202)225-0855, fax (202)225-9497
Rush D. Holt (NJ-12) phone (202)225-5801, fax (202)225-6025
Dave Loebsack (IA-02) phone (202)225-6576, fax (202)226-0757
Yvette Clarke (NY-11) phone (202)225-6231, fax (202)226-0112
Carol Shea-Porter (NH-01) phone (202)225-5456, fax (202)225-5822
Marcia Fudge (OH-11) phone (202)225-7032, fax (202)225-1339
Jared Polis (CO-2) phone (202)225-2161, fax (202)226-7840
Paul Tonko (NY-21) phone (202)225-5076, fax (202)225-5077
This isn't a diary to play into Repug attempts to throw up numerous amendments to defeat or delay health insurance reform. It's about a critical issue that has consensus support from both parties- allowing states to experiment with plans that include even more coverage than the federal plan.
Recs appreciated to get this critical issue front and center asap.
Can't get YouTube Imbed to work but here's some great videos:
CaliforniaOneCare Ad with Ernestine:
http://www.youtube.com/...
Kaiser Joins Healthy San Francisco with Program Details:
http://www.youtube.com/...
Description of Vermont's CatamountCare:
http://www.youtube.com/...
Rally in Support of Pennsylvania Single Payer Plan:
http://www.youtube.com/...