Employers, here we go again: as long as you offer employees tax-free health care benefits, you will always have someone calling for an end to this lucrative tax break.

This time it's the International Monetary Fund. In a report last week on the U.S. economy, debt and unemployment, the IMF expressed overall concern about the challenge of bringing U.S. debt "to more sustainable levels without jeopardizing the recovery."

President Barack Obama took fire from Republicans this week for his recess-appointment of Donald Berwick to run the Center for Medicare and Medicaid Services, but employers should be pleased by the outcome.

The recess appointment helped President Obama avoid a bitter confirmation fight that would have centered on Republican criticisms-and fears among Americans, justified or not-that Obamacare under Berwick would lead him to ration health care for seniors.

The federal government is now accepting applications from employers
that want to get reimbursed for medical claims paid on behalf of early
retirees.

The $5 billion Early Retiree Reinsurance Program, enacted as part of health reform, will repay employers for 80 percent of medical claims between $15,000 and $90,000 made on behalf of retirees who are 55 years and older but not yet eligible for Medicare.

The Supreme Court this week rejected a challenge by employers to San Francisco's universal healthcare program. The justices denied an appeal from the Golden Gate Restaurant Association of a lower court ruling that upheld the program's requirement that employers help pay the bill or give their workers health coverage.

In a brief last month, the International Monetary Fund said that US debt is expected to exceed 100 percent of GDP within the next five years-as this chart clearly shows.

Republican Senator Orrin Hatch made good on his promise to try to kill
health reform. Last week he introduced a bill that would remove the
requirement that employers provide health insurance and that
individuals buy it-even though in 1993 he introduced a bill that would
have required individuals to purchase health insurance.

Remember Wellpoint?
 
It may be said that no other company helped ensure the passage of health reform more than the insurance giant. Now the gift of Wellpoint keeps on giving, at least for small businesses in New York.

Before there was national health reform, there was San Francisco health reform. The Golden Gate city required employers to provide some form of health insurance or face fines and the Golden Gate Restaurant Association objected and sued.
 
The restaurant association has been largely unsuccessful in challenging the law but they have persisted. They have argued that federal ERISA law allowing multistate employers to skirt local laws concerning benefits trumps Healthy San Francisco.
 
There next and final recourse is to take it before the Supreme Court, something the Obama administration has decided to weigh in on. A couple weeks ago, the administration filed a brief saying the Supremes should not take up the case. This was of course a different tack than George Bush, whose solicitor argued that the Supreme Court should overturn the ordinance.
 
But the Obama administration has a much different stake in the outcome of this case. Their argument is that national health reform makes a law like Health San Francisco, passed in 2006, obsolete. The issues presented in the case-that local governments have the ability to require employers to offer insurance-are unlikely to come to the fore considering federal law now requires some form of employer participation in health care. 
 
The subtext of this brief though is much bigger. If the court did take up the case and ruled against the city and in favor of the employer group, it would no doubt fan the flames of opposition to national health reform. Though the Supremes may rule on much narrower grounds, it could galvanize legal opposition to national health reform law. Already, there is a movement afoot in some states to declare federal reform illegal. If the Supreme Court takes up this case it could become symbolic of a larger referendum on health reform.
 

The Internal Revenue Service recently released some information to help companies take advantage of a tax credit provided by the health reform law.

The IRS estimates that about 4 million businesses qualify, and is sending out notices to as many as possible advising them of the tax break. If you haven't received anything but believe your company may qualify, here's what you should know:

The employer-sponsored health care system provides health insurance to more than 60 million people--but it does not exist in a vacuum. Employers are often reminded of this fact when their health care costs go up each year. Factored into that cost increase are premiums employers pay to hospitals to help those institutions provide care to the uninsured.