In contrast to Hillarycare, which required most employers to offer health insurance to their employees, Gramm-Santorum maintained the voluntary nature of employer-sponsored health insurance. However, the bill required that an employer that chose to offer coverage must also offer a consumer-driven health plan consisting of high-deductible insurance and a health savings account. Section 201 of the bill states that employers who failed to do so would “not be allowed” to deduct “the expenses paid or incurred by an employer for a group health plan.”The Forbes writer states, "While the Gramm-Santorum plan did bar certain individuals from seeking federal assistance if they chose to forego health insurance, the bill did not include an individual mandate in the way we have come to understand the term. While the bill did not do enough to address the problem of the uninsured, it did contain a number of important market-oriented proposals that most certainly would have improved our health-care system: and no obvious ones that would have made it worse. In the checkered world of health policy, that counts as a pretty good show."In those days, consumer-driven plans were strongly discouraged by the tax code, and almost no one had them. (Interestingly, Forbes was one of the few employers that offered such plans at that time.) Santorum, a CDHP pioneer, sought to drive their uptake as a way to make health insurance more affordable. As it was described in a contemporaneous account in Congressional Quarterly, “Under Gramm’s proposal, which is not aimed at universal coverage, no employers would be required to offer health insurance to their employees. But if they did, they would be required to offer a catastrophic plan with a medical savings account, in addition to whatever health insurance plan they now offer.”
See post 11, it seems to trump everything.