While none of the items are likely to win broad support as stand-alone bills, lobbyists hope they'll be rolled into a larger tax bill. The flip side, of course, is that other groups, including major corporations, will be looking for perks, too. At the moment, some states allow them, while others don't. But a federal law is needed to allow the pools to cross state lines, the key to real purchasing power. While the House backed association health plans as part of its patients' bill of rights last year, the Senate did not.
Opposition is likely to come from large insurers.
But the biggest stumbling block may simply be a lack of interest. Lawmakers are expected to make a priority of other issues, such as expanding Medicare to cover prescription drugs. And worries over the economy may trump health-care concerns altogether. The accounts allow either employees or employers to set aside pretax dollars to pay for health-care expenses in connection with catastrophic medical insurance. Lobbyists are pushing for the program to be simplified and given permanent status.