Federal Healthcare Update

June 12, 2009

Pardon Our Dust

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The House of Representatives 
The House has released an outline of a proposed draft of health care reform legislation from the House Ways and Means, Education and Labor, and Energy and Commerce Committees- dubbed the ‘Tri-Committee’ Bill. The Tri-Committee Bill, discussed in our last email, gives us some insight into the proposals that will be coming out of the House, but perhaps more importantly, into the way the Committees are working together to achieve health care reform legislation. The bill has no particular committee’s stamp on it, and is a collaborative effort built out of consensus. This should be a good sign for Speaker Pelosi, who is eager to move the process forward to meet the President’s hoped-for schedule of having a bill on the floor by July.   Representatives Rangel (D-NY), Waxman (D-CA), and Miller (D-CA), the chairs of the three Committees, will continue to be key players as the bill progresses.
The Senate
As the Senate proceeds on health care reform, some differences among key Democrats have begun to create potential obstacles. The split is between those who share the school of thought of Senator Kennedy (D-MA), Chairman of the HELP Committee, and those aligned with Senator Baucus (D-MN), Chairman of the Finance Committee. While Senator Kennedy sees this moment in politics as the ideal time to effect far-reaching changes to the American health care system, Senator Baucus is more focused on reaching a consensus between Republicans and Democrats on health care reform. The Finance Committee has not yet put out a bill, but Senator Baucus, along with the Finance Committee Ranking Member, Senator Grassley (R-IA), has published a series of white papers outlining the options for health care reform in some detail. The HELP Committee, under the leadership of Senator Dodd (D-CT), just released a more detailed draft bill, which we discussed in our last email. This draft bill actually contained clues that Senators Kennedy and Dodd may be moderating their stance. The bill omitted the provisions for a public health option and an employer mandate for health care, both of which are still being worked out. Senator Dodd has stated that he is hopeful that he can work with Republicans to formulate legislation for these two programs that will be acceptable to all parties so legislation can move forward on a bipartisan basis.
The White House
President Obama continues to put the full weight of his office behind the health care reform effort, holding a town hall meeting on the subject yesterday. President Obama’s sense that health care will happen “this year or never” is spurring him to push both the Senate and the House to complete bills by July. However, the President has refrained from endorsing a specific plan, preferring to let Congress hash out the details. One contribution to the debate, however, has been his statement that he prefers a plan that includes a public health option. By generally staying above the fray, the White House hopes to act as arbiter during the final conference, playing much the same as the role the President played during the passage of the stimulus bill.
The Opposition
The two most controversial aspects of health care reform, the public option and employer mandates, are vehemently opposed by many Republicans. Although the administration and Democratic leadership have been hoping for a bipartisan bill, some Republicans are pledging to block any legislation that contains these provisions, making this unlikely. Some Democrats, therefore, continue to attempt to engage Republicans on the subject, including Senator Dodd in the HELP Committee and Senator Baucus in the Finance Committee. And some Democrats are attempting to include Republican priorities to gain their support. Senator Kennedy’s initial draft bill contained a “Patient’s Bill of Rights,” hitting many of the Republican highlights- preserving patient choice, ensuring doctors choose the course of treatment, and allowing citizens to keep their current health care plan if they desire.
Much of the health insurance industry is opposed to the public health plan portion of health care reform. AHIP, the American Health Insurance Plans coalition, has met with President Obama on the subject, asking to be regulated rather than face the competition of a public health option. Yesterday the American Medical Association declared its opposition to a public option, although it is already showing signs of pulling back from this position.
Finally, many of the nation’s largest employers have formed coalitions to work to prevent the inclusion of employer mandates in the final bill. The U.S. Chamber of Commerce, the National Federation of Independent Business, and the National Retail Federation have all expressed their opposition to any requirements that employers ‘pay or play,’ saying that this provision would not address the underlying inefficiency problems in the health care system. The U.S. Chamber of Commerce’s Vice President of Labor, Immigration, and Employee Benefits, Randel Johnson, testified before the HELP Committee’s hearing yesterday, saying that, “the proposal being floated is not reform- it would make the system even worse for employers and those who value free market competition.”
Key Events Next Week
Monday (6/15):  Congressional Budget Office scores for the HELP Committee and Finance Committee bills should begin to emerge. 
Tuesday (6/16):  The HELP Committee markup is tentatively scheduled to begin.
Friday (6/19):  We should expect to see a public draft of the Senate Finance Committee bill by the end of the week.