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Giveaways that everyone should want

Looks like Nebraska wasn't the only special interest group -- and yes, states count -- to get a sweetheart deal in the health bill. Construction workers made out pretty well, too.

Early versions of the Senate’s far-reaching health care bill said that small businesses with fewer than 50 workers would not be penalized if they failed to provide insurance. That was before labor unions in the construction industry went to work and persuaded Senate leaders to insert five paragraphs.

Their provision, added to the 2,074-page bill at the last minute, singles out the construction industry for special treatment, in a way that benefits union members and contractors who use union labor.

In this one industry, the exemption from the penalty would be much more limited, available only to employers with fewer than five employees. Construction companies with five or more workers would generally have to provide health insurance or pay a penalty — an excise tax of $750 per employee.

What you're seeing in a lot of these last-minute giveaways are good policies that shouldn't be used as special-interest bribes. Fully funding Nebraska's Medicaid expansion isn't bad because it's a fully-funded Medicaid expansion, it's bad because it's limited to Nebraska. So too with the employer mandate for the construction industry.

Construction industry unions say that they need this: Otherwise, firms that don't offer insurance will have lower labor costs, and thus a competitive advantage, over firms that do. That's true, of course, for every industry where the labor doesn't have the power to demand health-care benefits. The answer isn't to give construction workers a small employer mandate but to add an employer mandate into the bill. That's what Massachusetts did, and it's worked extremely well. It's also in the House health-care bill. Hopefully it'll be in the final health-care bill, too.

By Ezra Klein  |  January 4, 2010; 5:14 PM ET
Categories:  Health Reform  
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Ben Nelson’s “marker” which will be “fixed.”

“Senator Nelson told the attorney general that it was simply a ‘marker’ placed in the U.S. Senate version of the bill and assured the attorney general that it would be ‘fixed.’”

However, that would mean no state would pay the Medicaid match, Walker wrote, and McMaster said the goal of the attorneys general is to have the Nebraska provision removed from the bill “because it was constitutionally ‘flawed.’”

“McMaster also said he saw no way that he — nor any of the state attorneys general — will support the extension of the Cornhusker Kickback to every state nor be part of a deal like that,” Walker wrote in the memo.

Nelson could not be reached for comment.


“This is what I am taking away from Nelson’s slip of the tongue.”

Interesting that you call it that.

One thing is for sure, the fix is in.

Which means the CBO score isn’t worth the paper it’s written on.

Posted by: SisterRosetta | January 4, 2010 5:37 PM | Report abuse

"add an employer mandate into the bill. That's what Massachusetts did, and it's worked extremely well."

Not sure this is true. Specifically, IIRC, the employer mandate in MA is pretty small and I don't recall reading anything that quantifies its impact.

Off hand-- given that 2/3 or the newly insured in Massachusetts get their care through Commonwealth Care and Medicaid, and the remaining 1/3 includes those that buy insurance for themselves, it doesn't seem obvious that the employer mandate has had a big effect on providing insurance coverage.

Posted by: wisewon | January 4, 2010 5:40 PM | Report abuse

Just to add to what was said already, I suspect most construction companies that don't offer insurance are going to pay the $750 fine. If that is the case, it's hard to claim construction workers "made out pretty well."

Posted by: bmull | January 4, 2010 7:16 PM | Report abuse

Ezra Klein in May 2009:

"routing health care through employers twists the system in all sorts of horrible ways. Individuals don't know how much their employer is paying for health care. They don't know how much they're not getting in wage increases. They don't know how much premiums are growing every year. (Out-of-pocket costs are a small fraction of total health care spending, as you can see in the following graph.) Protecting individuals from seeing the full cost of health care reduces the political pressure to reform the system. It leaves them more dependent on their employer and less able to start a new business or take a job with a small company."

Ezra Klein today:

"The answer isn't to give construction workers a small employer mandate but to add an employer mandate into the bill. That's what Massachusetts did, and it's worked extremely well. It's also in the House health-care bill. Hopefully it'll be in the final health-care bill, too."

If I felt like it I'm sure I could find numerous other references of you saying that linking health insurance and employment was a bad idea. Yet now you think an employer mandate and/or additional rules for specific industries requiring them to provide insurance are good ideas. You've given up on any pretense of objectivity and intellectual honesty and become a full-blown cheerleader for whatever the Democrats come up with.

Posted by: ab13 | January 4, 2010 9:37 PM | Report abuse

The special treatment for construction workers was Jeff Merkley's doing. Oregon has awesome senators!

Posted by: HBurton1 | January 4, 2010 10:06 PM | Report abuse

Regardless of who put what into the bill, regardless of who benefits or is affected by the additions to the bill, what is fascinating is that no clear, definitive, easy to understand bills are passed, that are for the singular purpose of responding to "necessary" legislation. Instead, we have people adding to a bulky multi-paged bill and wanting our elected officials to vote on the bill without having time to read, let alone understand, what the bill says or means or will require. Instead, it appears, they're voting on what they think it means, on what they think is included, and on what they "believe" ("...yeah, a health bill is better than no health bill.").

One wonders, for example, knowing what the program actually did, and how much the program cost, and how relatively little it accomplished for the cost, how many members of Congress would again vote for "Cash for Clunkers".

Posted by: Dungarees | January 5, 2010 12:12 PM | Report abuse

"That's what Massachusetts did, and it's worked extremely well"

Isn't Mass. having big problems paying for the healthcare law?

Aren't they rationing care?

Aren't they making some people visit doctors as a group?

Posted by: jeffreid1 | January 5, 2010 12:17 PM | Report abuse

You are an idiot Ezra Klein.

Posted by: columbiaheights | January 5, 2010 6:43 PM | Report abuse

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