While supporters of the Clinton healthcare reform bill continue to push an employer mandate as the best way to achieve universal coverage, the Senate Finance Committee may be moving away from such a requirement.
At a finance committee hearing last week, Senate Minority Leader Bob Dole (R-Kan.) said he wasn't sure there were enough votes in the Senate to pass either an employer mandate or a requirement that individuals carry health insurance.
Mr. Dole said enactment of a requirement that employers provide and help pay for their workers' health insurance was "not likely." An individual mandate might not fare any better, he added.
The finance committee, which has jurisdiction over healthcare legislation, is a key hurdle for reform proposals.
The committee's ranking Republican, Sen. Bob Packwood of Oregon, said there was "general agreement that the 80%-20% split is too disproportionate on employers."
Although committee members offered no specific alternative for financing healthcare reform, members were scheduled to meet late last week in Virginia to look for areas of consensus.
Under the Clinton plan, all employers would be required to provide healthcare insurance for their workers and to pay 80% of the costs. The plan would subsidize insurance costs for smaller, low-wage companies.
A competing plan sponsored by several Republicans on the finance committee would require all individuals to carry health insurance and would subsidize those who have low incomes.
Several finance committee members have said it may be possible to pass a reform bill if employers were required to pay less and if requirements for small businesses were gradually implemented over a longer period or if small businesses were exempted altogether.
A report released at the finance committee hearing wasn't good news for those supporting an employer mandate.
According to the study, released by the conservative Heritage Foundation, an employer mandate, such as the one included in the administration's reform plan, would cause employers to pass as much as $1,200 a year in costs to employees in the form of lower wages.
The lower wages, when added to other changes in spending that would occur under the Clinton plan, would mean that more than 53% of families would pay more for healthcare, the study said. The Clinton administration has said that only one-third of all families will pay more for healthcare under its proposal.
"The employer mandate includes large, hidden costs on families in the form of pass-through wage reductions," Heritage Foundation Vice President Stuart Butler told the finance committee.
The study, prepared by the consulting firm Lewin-VHI, also contended that an employer mandate would mean the loss of 155,000 full- and part-time jobs out of an estimated 116 million jobs in the nation. Losses would be almost entirely among workers earning less than $10,000 annually, the study found.
Supporters of an employer mandate argued that it represents the best way to reach universal coverage, and they contended that the Heritage study only took into account the short-term effects on jobs. Sen. Thomas Daschle (D-S.D.) said Democratic Policy Committee research indicates an individual mandate would force middle-class families to spend as much as 47% of their after-tax income on healthcare.