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Speakers Back Health Mandate

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President Obama’s “play or pay” proposal could expand access to health coverage without destroying jobs, according to researchers who spoke at a forum organized by a liberal think tank.

Phillip Cryan, Jacob Hacker, and Ken Jacobs talked about the idea of requiring employers to provide health coverage, or else paying to support some other kind of health coverage system, today during a teleconference hosted by the Campaign for America’s Future, Washington.

Cryan, a public policy researcher at the University of California at Berkeley, said earlier studies, which predicted that a play-or-pay system would lead to major job losses, assumed that the cost of the system would amount to 40% of payroll

Assuming that the cost of the system proposed by the Obama administration would amount to as little as 4% of payroll, “expectations of job losses go away completely,” Cryan said.

Even if lawmakers imposed an 8% payroll tax for employers that choose to “pay,” rather than “play,” and they created no exemptions or sliding scale for small employers, a play-or-pay program would reduce employment by only about 0.1%, Cryan estimates in a paper posted on the Web by Campaign for America’s Future.

If the Obama system is adopted, there is good reason to expect significant job gains, while, at worst, there would be a minimal amount of job loss, Cryan predicted.

A play-or-pay system will create new jobs, increase productivity by improving worker health, create savings for employers, and lead to systemwide health care savings, Cryan said.

Hacker, co-director of the Berkeley Center on Health, Economic and Family Security at the University of California at Berkeley law school, and Jacobs, chair of the university’s Center for Labor Research and Education, talked about lessons from California’s experience about how a play-or-pay requirement might be structured.

Campaign for America’s Future has posted a paper by Hacker and Jacobs that presents the Healthy San Francisco program, which requires San Francisco employers with 20 or more workers to provide health coverage, as a model for an employer health coverage mandate.

“The arguments against ‘play-or-pay’ are quite weak,” Hacker said. “It is a way of insuring the continuation of employment-based coverage.”

Because play-or-pay could raise billions of dollars for improving the health care system, it ” “ is crucial for financing reform,” Hacker added.

A play-or-pay program should cover as many firms as possible, to reach more of the uninsured, Jacobs said.

A “play-or-pay” plan should apply to both part-time and full-time workers, and it should support unemployed workers as well, according to Jacobs.

“Having a system that subsidized people between jobs would be a very smart addition to the system,” Jacobs said.

The “play-or-pay” system is “a win for workers, win for business, and a win for the economy,” Jacobs declared.


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