Federal Healthcare Update

 

The Senate Finance Committee has just completed its first week considering the health care reform Chairman’s Mark. 526 amendments were submitted last week to be considered by category, starting with delivery systems. Coverage and financial issues will be considered at the end of the markup, which is expected to last through at least the next week.

Yesterday, Senator Baucus’s (D-MT) Mark faced down its first big challenge: an amendment from Senator Bill Nelson (D-FL) that would have circumvented the deal that the White House made with Pharmaceutical Researchers and Manufactures of America (PhRMA) in June. Under this agreement, drug makers pledged to contribute $80 billion over the next 10 years to the cause of health care reform, in exchange for no further regulations or requirements for the companies. Sen. Nelson’s amendment would have required drug makers to provide Medicare with discounts in the form of rebates totaling more than $100 billion over 10 years. The deal was rejected 13-10. Many pundits are painting this as a great victory for President Obama and Sen. Baucus, although it remains to be seen whether the deal will be able to pass the full Senate during floor consideration.

Senator John Rockefeller (D-WV) is expected to offer an amendment next week that would add a government-run public option to the bill. This amendment is supported by many more liberal Members of the Committee, although most of them recognize that the amendment will probably not be adopted by the Committee. Senator Chuck Schumer (D-NY) said on Thursday that he fully expects the issue to come up during floor debate on the bill, saying “Lots of people who are not on the committee follow the committee, and that gets people thinking. As the process moves on, for the public option and for some of these other things, it gets better and better.”

Before the bill can move to the Senate floor, it must be merged with the preexisting Senate HELP Committee bill. This will require formulating legislative language; currently the Finance Committee has only the conceptual language in the Chairman’s Mark. Finally, the Congressional Budget Office (CBO) must score the bill, a process that Director Doug Elmendorf has said could take up to two weeks.

House leadership is gearing up to merge their three bills in advance of floor consideration. According to Rules Committee Chair Louise Slaughter (D-NY) and Ways and Means Chair Charles Rangel (D-NY), House leadership hopes to merge the bills over the weekend and have something ready to send to the CBO by Monday.

The public option has been a topic of interest in the House lately, as Democratic leadership has been trying to gauge whether they have enough support for the provision on the floor. The public option was discussed at two Democratic Caucus meetings this week, and Speaker Pelosi has been in frequent meetings with Members who have concerns about the provision. Many Blue Dog Democrats and Members from rural areas are concerned about the version of the public option passed by the Ways and Means Committee, which pegged payments in the plan to Medicare reimbursement rates, which they say is too low. They would prefer independently negotiated rates, which Speaker Pelosi says will cost at least $80 billion more. Speaker Pelosi has been very vocal about her support for the public option lately, stating her intention to include it in the final bill, as well as dismissing the ‘trigger’ option favored by Senator Olympia Snowe (R-ME).