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The Senate has been in pro forma session since last week, but most members are showing up for the first time this year on Tuesday.
Key negotiators, including Sen. Harry Reid, D-Nev., the Senate majority leader, and Speaker of the House Nancy Pelosi, D-Calif., have indicated that they hope to present a compromise bill sometime this week to the Congressional Budget Office for a final evaluation of its costs.
Among the issues expected to be discussed are compromises on state-vs.-national health exchanges and a deal with labor unions and President Obama on “Cadillac plans.”
According to Rep. Chris Van Hollen, D-Md., a key negotiator, those working on a final bill could include a national marketplace for insurance.
This is opposed by all insurance agent industry trade groups, who asked in a letter to healthcare negotiators last week that the states be allowed to regulate healthcare exchanges.
“I believe they're very close on the exchange issue, Van Hollen said. “I would say that there’s going to be uniformity to the exchange and a national component to the exchange.”
Details are still being worked out, but it appears the exchange provision will be a hybrid between the Senate’s state-based version and the House’s national approach, he said.
One issue in the Cadillac plan compromise is a provision exempting collectively bargained plans from the excise tax on high-cost insurance plans. Under the compromise, healthcare plans negotiated through collective bargaining would be exempt from the tax until 2017, which is designed to allow both employers and employees to make a transition to the new system.
The compromise also would raise the level at which plans would be taxed to $24,000 for a family and $8,900 for singles and exempting dental and vision costs from these amounts.
The compromise also would raise the thresholds for retirees 55 and older and for workers in high-risk professions, such as police and firefighters.
It would also raise the tax threshold for plans in certain high-cost states as well as plans with high numbers of women and older workers that require more expensive plans, allowing for more gender, age and geographic equity in health care.