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Letter to the Education and Labor Committee, Subcommittee on Health, Employment, Labor, and Pensions on NEA’s Goals and Priorities for Health Care Reform

March 09, 2009

Dear Chairman Andrews:

The National Education Association commends you for holding a hearing on “Strengthening Employer-Based Health Care.”  We respectfully submit these comments for the record in conjunction with the hearing.

NEA applauds Congress for engaging in a dialogue about health care reform.  We believe this effort is vital to the nation's economic recovery and a crucial ingredient for great public schools for all students.  Ensuring quality, affordable health care for everyone in America is fundamental not only to our economic future but also critically important to our nation's children and their families.  Students can't learn unless they come to school healthy.  When school nurses become primary care providers, as happens all too frequently today, we're well past the time for health care reform.

NEA members know firsthand that the lack of necessary medical and dental services for children and students of all ages creates a serious impediment to the learning process.  In addition, families with access to a regular source of medical care are more likely to keep the entire family healthy and create a better learning environment within the home.  Helping public schools attract and retain high-quality educators, along with secure, affordable health care benefits, play an important role in ensuring great public schools for all students.

NEA is committed to health reform to ensure that every person in America has quality, affordable health care coverage.  Not only is this a moral imperative, it is a key component of controlling spiraling health care costs.  Health reform must also guarantee a choice of health care plans and providers through a private health insurance plan, including one that an employee may currently have through their employer, and a public health insurance plan.  This choice is a fundamental feature of an American solution for health reform and another critical piece of cost control.  Health reform that provides comprehensive benefits to all at an affordable cost guarantees a choice of health plans and rewards quality and innovation as an attainable goal that the public supports.

More specifically, NEA believes that health care reform must:

1. Guarantee coverage for the uninsured, currently estimated at 45 million individuals, including 9 million children;

2. Control costs so that premiums and health care services are affordable to all, regardless of income or employment status;

3. Incorporate provisions and standards related to medical safety and quality;

4. Result in comprehensive health care coverage that includes but is not limited to medical, surgical, hospital, behavioral health, prescription drug, dental, vision, hearing, and long-term care services and allows choice of providers;

5. Include preventive, wellness, rehabilitative, and disease management programs;

6. Make use of health information technology to reduce medical errors and administrative costs.

We recognize that there are many ways that health care reform could attempt to achieve the broad goals outlined above, but we also know that some proposals under discussion could ultimately be more harmful than helpful.  For that reason, NEA also believes that reform must:

  • Ensure the availability and security of employment-based health benefit plans.  The employment-based system is a proven and effective way for workers and their employers to mutually agree upon the health benefit packages that make the most sense for them.  Health care reform must not disrupt this system.
  • Guarantee that the employee tax exclusion for health benefits is not limited or capped in any way.  Over the course of their careers, many public education employees have traded salary increases for the long term security of a comprehensive health plan.  Telling hard-working employees that benefits will be cut or that they will pay more taxes would unfairly penalize them.  A tax on salaries above a certain amount would also be unfair to experienced educators who, after decades of dedicated service, have climbed to the top of their salary schedules.  Limiting or capping the tax exclusion for health benefits could have a disastrous effect on public education by discouraging highly qualified workers from entering or staying in the profession. 
  • Maintain the ability of workers and employers to determine the appropriate level of health care benefits available to both active and retired employees, including the ability to negotiate above any basic benefit plan floor that might be legislated.
  • Recognize and accommodate the specific circumstances of public sector employers, including their tax status.  For example, proposals that include employer incentives to encourage continuation of employer-sponsored health care benefits should be mirrored in the public and private sectors.
  • Ensure that health care benefits are available through a current or former employer, a government-sponsored program such as Medicare, Medicaid, or the State Children’s Health Insurance Program (SCHIP), and/or a new initiative that would meet the goals outlined here.  To ensure coverage of those who need it, NEA would support the creation of a well-funded public plan with comprehensive benefits intended for individuals and for small employers who do not currently offer health care benefits to their employees.

We thank you for the opportunity to submit these comments for your consideration.  We look forward to working with Congress to ensure quality, affordable health care for everyone in America


Diane Shust
Director of Government Relations

Randall Moody
Manager of Federal Advocacy