Health Care Reform Update From the Capitol for the Week of June 24
- In recent days, President Obama has reintroduced his proposal to limit the itemized tax deductions available to the nation's three million highest-income households as a way of funding the estimated $1 trillion cost of health reform, the Washington Post reports. However, many Democratic lawmakers say they prefer a tax that Republicans would potentially support, such as changing the tax-exempt status of employer-provided health benefits (Montgomery/Connolly, Washington Post, 6/15).
- Obama sent an e-mail to members of Organizing for America asking them to undertake the same type of "grassroots movement that shocked the political establishment" during the campaign to help pass health reform this year. OFA is a unit of the Democratic National Committee built off of Obama's network of supporters from his presidential campaign (Lovenheim, "Daily Dose," Washington Post, 6/16). Obama wrote, "To prevail, we must once more build a coast-to-coast operation ready to knock on doors, deploy volunteers, get out the facts and show the world how real change happens in America" (Pear/Herszenhorn, "The Caucus," New York Times, 6/16).
- Insurers will be unable to block a public health insurance plan because they want a seat at the table in shaping the nation's health care system, HHS Secretary Kathleen Sebelius said in an Associated Press interview on Tuesday, the AP/ABC News reports. According to Sebelius, President Obama does not want to drive health insurers out of business, but wants them to compete with a public plan to offer working families and small businesses insurance without the high overhead costs of marketing, administration and profit (Alonso-Zaldivar/Werner, AP/ABC News, 6/17).
- In a speech to the Democratic Leadership Council last week, Sebelius said there is no time to waste on health reform efforts (Alexander/Smith, Reuters, 6/17). She added that Obama is determined to enact health reform without adding to the national deficit and that he continues to support a public plan option (Norman, CQ HealthBeat, 6/17).
- Testifying before the House Budget Committee on Friday, White House Council of Economic Advisers Chair Christina Romer said slowing health care costs would provide significant economic benefits and provide families with additional savings, CongressDaily reports. According to Romer, slowing the growth of health care costs by 1.5% would save a family of four $2,600 in 2020 and $10,000 by 2030 (Leonatti, CongressDaily, 6/19).
Senate HELP Committee
- The Senate Health, Education, Labor and Pensions Committee might be able to finish work on its health care reform legislation this week before Congress leaves for the July 4 recess, according to Sen. Christopher Dodd (D-Conn.), CQ Today reports (Armstrong, CQ Today, 6/22).Â Currently the committee is awaiting a Congressional Budget Office score of the public option, a pay-or-play employer mandate and a proposal that would require employers who don't offer coverage to contribute to a fund for workers' health insurance, which Dodd expects to receive by late Tuesday (Hunt, CongressDaily, 6/23).Â However, committee Republicans say that there is not enough time to complete work on the legislation considering the committee has only worked its way through one of the bill's several titles (Werner, AP/San Diego Union-Tribune, 6/23).
- Last week, the U.S. Chamber of Commerce sent a letter to lawmakers stating its formal opposition to the proposed HELP Committee bill. The letter states that the chamber is "gravely concerned about the process," which it believes would be "harmful to businesses of all sizes, to the economy and to American workers" (Young, The Hill, 6/16).
Senate Finance Committee
- Senate Finance Committee Chair Max Baucus (D-Montana) has begun working with six Finance Committee members in what he calls the "Coalition of the Willing," which he hopes will produce bipartisan support for his committee's health reform bill. The group includes Baucus,Â ranking memberÂ Chuck Grassley (R-Iowa), Sens. Jeff Bingaman (D-N.M.), Kent Conrad (D-N.D.), Orrin Hatch (R-Utah), Olympia Snowe (R-Maine) and Mike Enzi (R-Wyo.) (Murray, "Daily Dose," Washington Post, 6/18). CQ Today reports that Baucus has sought Republican support by offering compromises on issues such as a public health insurance plan and by offering a hand in writing the bill. Baucus said the coalition likely will not have a bill ready for several weeks (Armstrong/Wayne, CQ Today, 6/18).
- Last week, House Republicans released a four-page outline of a health care reform proposal that does not include cost estimates, funding mechanisms or an estimate of how many U.S. residents it would cover, Roll Call reports (Dennis, Roll Call, 6/17). The measure aims to strengthen the private insurance market, make health coverage less costly, increase access to coverage and prevent the government from increasing its role in health care. Many of the elements included in the plan draw upon previous Republican proposals, including limits on medical malpractice lawsuits, expansion of health savings accounts and efforts to increase medical transparency (Wayne, CQ Today, 6/17). The measure will not include an individual mandate, a requirement that employers offer coverage to workers or a public health insurance option (Roll Call, 6/17). While the outline did not specify how many people would be covered under the plan, Republicans believe that up to seven million people could be covered by allowing children to remain on their parents' insurance policies until age 25 (CQ Today, 6/17).
- Last week, three former Senate majority leaders released a $1.2 trillion bipartisan health care reform proposal that would support states' efforts to expand access to affordable health coverage, CQ HealthBeat reports. The proposal was drafted by former Senate Majority Leaders Bob Dole (R-Kan.), Howard Baker (R-Tenn.) and Tom Daschle (D-S.D.). The proposal does not include a government-sponsored public plan option, but would provide federal support to state health insurance exchanges and generate savings through changes to the delivery and payment system. The proposal also would establish a "legal expectation that all individuals obtain basic health coverage" (Stephenson, CQ HealthBeat, 6/17). Under the plan, states' exchanges would compete on a "level playing field" with private insurers (Ackley, Roll Call, 6/18). In addition, the proposal calls for limiting out-of-pocket insurance premiums to 15% of income for a minimum benefits package and would provide additional protections for people with incomes up to 400% of the federal poverty level. The center says the plan would cost $1.2 trillion over 10 years and would pay for itself after a decade. The plan includes a cap on tax-free employer-sponsored health benefits (Villegas, Kaiser Health News/McClatchy, 6/17).
- Meanwhile, Senate Minority Leader Mitch McConnell (R-Ky.) and Sen. Jon Kyl (R-Ariz.) have introduced "The Preserving Access to Targeted, Individualized, and Effective New Treatments and Services Act," also known as the Patients Act, that would prohibit the government from using comparative effectiveness research (Lovenheim, "Daily Dose," Washington Post, 6/15). McConnell and Kyl called comparative effectiveness research a "common tool used by socialized health care systems to dictate treatment based on costs rather than effectiveness" (Rushing, The Hill, 6/15).
What It's Going To Cost
- Democratic lawmakers' plans for overhauling the health care system will require "meaningful" spending offsets to avoid putting the nation deeper into debt, Congressional Budget Office Director Douglas Elmendorf wrote in a letter to Senate Budget Committee leaders on Tuesday, the Post reports. He said that although popular proposals such as making health coverage available to more individuals, transferring health records to electronic files and encouraging doctors to use more effective treatments potentially could lower costs, "little reliable evidence exists about exactly how to implement those types of changes." However, cutting hospital and doctor payments, as well as "significantly limiting" the tax-exemption for employer-provided health benefits, "could directly lower federal spending on health care and indirectly lower private spending on it as well," he wrote in the letter (Montgomery et al., Washington Post, 6/17). In an interview with USA Today this week, Elmendorf said, "There's tremendous potential to reap savings in the health sector without harming health, but turning that potential into reality is challenging" (Wolf, USA Today, 6/16).
Informing the Debate
- A Republican National Committee staff member wrote a letter to ABC News criticizing the network for allegedly excluding opponents of Obama's health care goals from asking questions of Obama during his June 24 primetime special, in which he will talk about health reform. ABC said Obama will field questions from audience members "selected by ABC News who have divergent opinions in this historic debate" (Trende, "Real Clear Politics," Time, 6/17).
- Rick Scott, chair of Conservatives for Patients' Rights, said that the ABC network has prohibited his group from purchasing advertising time before Obama's address. The network said it does not sell "issue ads" (Lee, "Politico 44," Politico, 6/17).
- Last week, OFA announced a "summer organizer" program that aims to promote Obama's three key principles for health care reform -- reducing costs, expanding access to care, and ensuring affordable care for everyone, the Washington Times reports. A Democratic official said that OFA has received more than 100,000 letters from Obama supporters as part of the group's effort to use U.S. residents' stories to spur health reform in Congress (Bellantoni, Washington Times, 6/16).
- Healthy Economy Now -- a coalition of groups including the Pharmaceutical Research and Manufacturers of America and the Service Employees International Union -- launched a new television advertisement on Saturday in five states and Washington, D.C., calling on lawmakers to reach a consensus in the health reform debate, the Post's "The Fix" reports (Cillizza, "The Fix," Washington Post, 6/11).
- On Friday, America's Health Insurance Plans and the BlueCross BlueShield Association sent a letter to SenateÂ HELP Committee Chair Edward Kennedy (D-Mass.), saying that a government-run health plan in any form would have "devastating consequences" for the insurance system, the federal budget deficit and providers, CQ HealthBeat reports. The letter called for stronger market rules and consumer protections rather than a public plan option (Reichard, CQ HealthBeat, 6/22).
- Last week, the American Hospital Association issued a statement that its members are "deeply disappointed and concerned" that Obama is calling for a $220 billion reduction in federal outlays to hospitals, CQ HealthBeat reports. The statement came after Obama suggested a "productivity" adjustment in hospitals' annual Medicare provider payments as part of a plan to reduce health care spending by $313 billion over 10 years (Norman, CQ HealthBeat, 6/15).
- Health reform legislation should not include language that might penalize people for "unhealthy" lifestyles, more than 50 organizations -- representing unions, retirees, gays and lesbians, people with disabilities, and patients -- said in a letter to lawmakers, CQ HealthBeat reports. Groups signing the letter include the AARP; the American Cancer Society Cancer Action Network; Consumers Union; International Association of Machinists and Aerospace Workers; the National Coalition for Lesbian, Gay, Bisexual and Transgender Health; the National Council on Aging; the National Multiple Sclerosis Society; and the U.S. Psychiatric Rehabilitation Association (CQ HealthBeat, 6/15).