Legislative Update

National health care survey results: Urban and rural people think differently on health reform; consensus for more choice in insurance

Rural residents pay more of their income for health insurance than their city cousins, yet they are less likely to blame insurance companies for recent increases in health premiums. While there is little consensus on preferred reforms for the health care system, there is wide consensus that consumers should have more choice among health insurance plans.

Those were among the key findings of a survey released April 27 that was commissioned by Communicating for Agriculture & the Self-Employed (CA). Households across the USA were randomly surveyed. There were 300 rural households (in communities of less than 50,000 and more than 50 miles from a large city of 250,000 or more); 300 suburban households (communities adjacent to a city of 250,000 or more); and 300 urban households (residents of cities of 250,000 or more). Respondents were divided into three geographic groupings, and a grouping that was split by Republican/Independent/Democrat. The surveys were completed during the week of April 7-14, 2000. The overall margin of error is about 4 percent.

"We are a long, long way from a national solution on who and what is to blame and how to fix it," said CA President Wayne Nelson.

"However, there appears to be strong belief in the need for choice and a range of health insurance options available to consumers. And there is wide support for the idea of using tax credits to help those who can't afford health insurance, a concept now gaining more favor in Washington."

The survey found:

• Seventy one percent of respondents said their health insurance premiums had recently increased, and 14 percent said they had recently dropped their health insurance because of higher costs.

• Rural people also pay a greater percent of their income to get health insurance coverage. Suburban residents, while claiming the highest income of the three groups, also claimed to pay the least amount of their household income for health insurance.

• Survey respondents differed on whom they blame for the cost increases and on what solutions they would favor to reform health insurance. When asked who is most to blame for rising health care costs, 36 percent of suburban, 45 percent of urban, but only 25 percent of rural respondents tended to blame insurance companies most. In contrast, 37 percent of rural residents, 25 percent of suburban and 24 percent of urban respondents blamed doctors and hospitals the most for increasing costs. Other primary cost inflation reasons: cost of government rules and regulations, cited more evenly by between 16 percent overall; higher costs of drugs, cited by 11 percent; and improved medical care, cited by 9 percent.

More choice, tax credits widely favored:

• Overall, 89 percent of respondents, almost equally among all groups, favor of giving consumers more choice choosing the type of health plans they can buy, including plans that would reduce the level of coverage to make them less costly.

• Seventy three percent of respondents said they support giving tax credits for people who can't afford insurance to address the rising level of Americans without health insurance protection.

• Rural residents were the strongest critics of a plan, 57 percent opposed, to replace the current health care delivery system with a government-run plan, like in Canada.

"The results tell us several things," said Nelson. "First of all, when Congress considers reforms it is clear that Îone-size-doesn't-fit-allâ. The impact of rising health care costs hit people in different locations in unique ways.

"Second, in this Internet-age of individual empowerment, consumers believe they can choose for themselves, and they don't want ÎBig Brotherâ to pick their health plans for them.

"And last, it reminds us that the growing number of uninsured Americans is a direct result of the rising costs of health care. The major reason more and more Americans are uninsured is that they cannot afford the coverage. And the costs increase are not caused by the insurance industry - the causes are often the very factors - rising drug costs and greater government intervention - that consumers are not eager to blame."

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CA presses Congress to pass small business tax reforms

Congress is close to passing much needed tax help for small business. CA has had a strong presence in Washington during this Congress pressing for meaningful, realistic tax reforms that will benefit CA's self-employed, small business and agricultural members. At press time, the tax reforms in play are included in the minimum wage and small business tax reform bill passed by the House and awaiting consideration by a House/Senate conference committee. The key provisions include:

• 100 percent tax deduction for health insurance premiums for the self-employed - After years of effort on the part of CA, success on the full deduction is now within reach.

• Section 179 - raises the amount of depreciable equipment eligible for immediate expensing from $19,000 to $30,000 per year.

• Business meal deduction - raises the allowable expense deduction to 60 percent.

• Installment sales - reinstates the installment sales method of taxing sales by small businesses using the accrual method of accounting.

• Alternative minimum tax - reforms provisions that hurt certain small businesses.

• Raise 401K limits - would raise the limit on contributions to employee 401K funds from $10,000 per year to $14,000.

U.S. House passes CA-backed bill to eliminate the Death Tax

The U.S. House of Representatives passed H.R. 8, the "Death Tax Elimination Bill" on June 9. Chiefly authored by Representatives Jennifer Dunn-R-Wash. and John Tanner, D-Tenn., H.R. 8 calls for a gradual phasing out of federal estate taxes over a 10-year period.

CA was a prime member of a coalition of more than 100 national organizations that have been pushing estate tax reform legislation in Washington. CA President Wayne Nelson has testified numerous times for estate tax reform and elimination of the tax before the House Ways and Means Committee and other committees of Congress over the past few years. Considered an expert on the issue, Nelson has also been featured in stories on estate planning in national publications like Progressive Farmer and others.

The bill received bipartisan support with more than 40 Democrats joining a majority of the Republicans in the House to vote for the legislation. While the House vote was large enough to override a veto in that body, prospects are uncertain in the Senate, however, and the President has signaled opposition and a likely veto. The House vote represents a major achievement for CA and other groups that have worked diligently on estate tax reform for many years.

Congress passes crop insurance overhaul, emergency farm aid package

The long-awaited overhaul and expansion of the Federal Crop Insurance Program has been approved by Congress. As anticipated, the measure also included an emergency farm aid package for the third year in a row that was made necessary due to persistent and extraordinarily low prices across most of the major farm crops and commodity sectors.

The farm emergency aid included $7.1 billion to raise support payments, similar to the two previous years, for grain and cotton growers. It also includes payments for soybeans, peanuts, tobacco, fruits and vegetable growers. While export markets have shown signs of coming back, ag economists say a recovery in the farm economy is at least a year away and without the enhanced farm payments of the past two years the farm economy would have been in shambles.

Crop insurance reform has been a key goal of CA's Campaign for Family Agriculture, which seeks a stronger economic safety net and improved financial management tools for farmers and ranchers. Crop farmers for years have complained that even under the newer federal crop insurance program, the protection levels in the case of crop failure were either too low, or the premiums for the higher coverage were so expensive it simply didn't make economic sense. The new bill, H.R. 2559, the Agricultural Risk Protection Act, provides more subsidies to cut the premium costs of the higher levels of crop production for farmers

The conference bill also includes the Biomass Research and Development Act of 2000 which will support research on the co-production of food and biochemicals from a single plant to find ways to use the entire plant for more cost efficient production of bio-based new uses fuel and chemical end products.

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