Federal Healthcare Update

March 5, 2010

Pardon Our Dust

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In the wake of last week’s health care summit, Congressional Democrats announced their intentions to move forward with health care legislation even if it didn’t have bipartisan support. Democrats said that the seven hour summit confirmed to them that Republicans were not likely to contribute to the effort to pass comprehensive reform, prompting them to move forward on their own. Under the plan outlined by Speaker Pelosi (D-CA) last weekend, the House would pass the Senate health care bill, and then the House and Senate would approve a package of changes to the bill through the budget reconciliation process, which would prevent the possibility of a Republican filibuster. Speaker Pelosi said that the House was beginning work on a compromise that would incorporate elements from the House and Senate bills and President Obama’s proposal, and would enable both the House and the Senate to pass the bill. 
The compromises in this bill would include adjusting subsidies, raising Medicare payroll taxes on wealthy families and individuals, reducing an excise tax on high-cost employer-sponsored insurance policies, and increasing federal aid to states for their Medicare costs. However, Speaker Pelosi will likely still face challenges rounding up votes, as the language from the House bill restricting insurance coverage of abortions favored by some Democrats is not present in the Senate bill. This provision will not be eligible to be changed through the compromise bill because bills passed through the reconciliation process must have a budgetary impact.
In a letter to Congressional Republicans on Tuesday, President Obama said that he was open to supporting four Republican ideas that were brought up in the health care summit. He said that he supports an idea from Senator Tom Coburn (R-OK) to have health care professionals pose as patients in an effort to expose fraud and supported offering high-deductible insurance policies used in conjunction with health care savings accounts in the insurance exchanges that would be created in the health care reform legislation. President Obama also said he supported providing $50 million in grants to states to set up pilot programs of alternative ways to resolve medical malpractice claims, and said that he agreed it would be best to increase payments to doctors under a planned Medicaid expansion in a fiscally responsible manner.
On Wednesday this week, President Obama gave a speech highlighting the financial reasons for moving forward with health care reform. The non-partisan Congressional Budget Office (CBO) has said that the bills passed by the House and the Senate would reduce the deficit by over $100 billion over 10 years.  The CBO has not yet scored the President’s proposal. 
Congressional Republicans have remained unimpressed with the President’s outreach efforts and have consistently said that using reconciliation to pass the health care reform bill would be bypassing the normal legislative process. Senator Lamar Alexander (R-TN) said that, “the American people have been saying, look, we’re trying to tell you in every way we know how, in elections, in surveys, in town hall meetings, we don’t want this bill.”