Final House Panel OKs Health Care Reform Plan With Some Amendments
It was the final day before the chamber adjourned for its August recess (Pear/Herszenhorn, New York Times, 8/1).
Five Democrats joined every Republican member of the panel in voting against the bill (Shalleck-Klein, The Hill, 7/31). The Democrats who opposed the legislation -- mostly members of the fiscally conservative Blue Dog Coalition -- were:
- Reps. John Barrow (Ga.);
- Rick Boucher (Va.);
- Jim Matheson (Utah);
- Charlie Melancon (La.); and
- Bart Stupak (Mich.).
Blue Dog Negotiations
Four of the seven Blue Dogs on the panel supported the bill, but only after two weeks of rigorous negotiations with committee Chair Henry Waxman (D-Calif.) (Wayne, CQ Today, 7/31).
Last Wednesday, Waxman made an agreement with the Blue Dogs to reduce subsidies to low- and middle-income U.S. residents, require the HHS secretary to negotiate reimbursement rates for the public plan with hospitals and physicians and increase the number of small businesses that would be exempt from an employer contribution mandate, among other proposals (California Healthline, 7/30).
After liberal Democrats voiced opposition to Waxman's deal with the coalition, Blue Dogs early Friday morning agreed to alter the deal to restore between $50 billion and $65 billion in subsidies to help such residents purchase coverage.
Blue Dogs agreed to find other cuts to fund the subsidies. However, the coalition preserved one of its main objectives to prevent Medicare from setting payment rates for a public plan option (California Healthline, 7/31).
The Blue Dog changes were set in an amendment that was passed 33-26.
Liberals opposed to the concessions to the Blue Dogs offered two amendments on Friday.
The first was a collection of minor savings proposals, such as requiring CMS to simplify its administrative procedures through such steps as requiring that claims for the programs be submitted electronically. The amendment passed 32-36.
The second amendment -- adopted 32-23 -- would authorize the government to negotiate prices in the Medicare prescription drug program, a suggestion long opposed by drug companies and insurers that administer the program.
The amendment also would require that insurers offering plans in a health insurance exchange established by the bill get permission from the government before they increase premiums above the rate of medical inflation.
The committee also adopted an amendment by Rep. Anna Eshoo (D-Calif.) that would authorize FDA to approve generic versions of biologic drugs that are derived from human proteins. However, the amendment would grant new biologics 12 years of market exclusivity before generic manufacturers could market competing drugs (CQ Today, 7/31).
The amendment also would forbid a process known as "evergreening," in which pharmaceutical companies make small adjustments to their drugs -- such as creating extended-release versions -- to lengthen their exclusivity period.
President Obama, as well as Waxman and other Democrats, wanted a market exclusivity period of five to seven years, saying it would speed up access for consumers to lower-cost generic brands and help reduce health care costs (Mundy, Wall Street Journal, 8/1).
Waxman opposed the amendment on the grounds that it would not be effective at lowering the price of biologics or increasing innovation in the industry.
However, the amendment passed by voice vote and then by a 47-11 recorded vote.
The panel also adopted an amendment by Rep. Bobby Rush (D-Ill.) by voice vote that would prohibit brand-name drug companies from settling patent litigation with generic competitors by paying them to delay marketing their drugs.
The committee defeated an amendment by Rep. Phil Gingrey (R-Ga.) and others that would have allowed U.S. residents not enrolled in a group health plan to enroll in a health plan identical to that offered to federal employees.
Single-Payer Vote to the House Floor
Waxman said that House leaders have agreed to table an amendment offered by Rep. Anthony Weiner (D-N.Y.) to replace the bill's coverage provisions with a single-payer system modeled after Medicare that would cover all U.S. residents in favor of a floor vote after the recess (CQ Today, 7/31).
Waxman said, "A lot of members on our committee want a vote on that," adding, "I believe their wishes will be accommodated." He said that House Speaker Nancy Pelosi (D-Calif.) has promised the vote (Soraghan , The Hill, 7/31).
Pelosi Says Blue Dog Provisions Are Not Guaranteed
Pelosi indicated on Friday that some provisions generated by agreements with Blue Dogs might not make it through the consolidation process of the three versions of House legislation, The Hill reports.
She said, "I have three chairmen to deal with," adding, "We have three committees that have to look at it" (Soraghan , The Hill, 7/31).
However, House Education and Labor Committee Chair George Miller (D-Calif.) said, "I don't think [consolidation is] going to be as difficult as people suggest it will be." He added, "This is a continuing discussion. ... Blue Dogs, progressives and everyone else will be involved" (Dennis, Roll Call, 8/3).
In a statement released on Saturday, Obama called the House Energy and Commerce Committee's passage of health care reform legislation a "historic step" that "moves us closer to health insurance reform than we have ever been before," the AP/Chicago Tribune reports (Werner, AP/Chicago Tribune, 8/1).
Obama praised the bill as one that will "strengthen consumer protections and choice, while lowering costs and improving care." He said that over the coming weeks, "we must build upon the historic consensus that has been forged, and do the hard work necessary to seize this unprecedented opportunity for the future of our economy and the health of our families" (Mason, Reuters, 8/1).
Veterans Groups Have 'Grave Concerns'
Six veterans groups have publicly objected to the House reform bill, saying they have "grave concerns" about the legislation because it could jeopardize the care of millions of veterans, The Hill reports.
In a letter to Pelosi, the groups wrote that "the legislation could limit the health care choices for veterans, increase the cost of health care for veterans, deny coverage to dependent family members of veterans and threaten the quality of health care offered to veterans through the VA health care system."
The groups that signed the letter are the:
- Disabled American Veterans;
- Blinded Veterans Association;
- Vietnam Veterans of America;
- Jewish War Veterans of the USA;
- American Veterans; and
- Military Order of the Purple Heart of the USA (Tiron, The Hill, 7/31).