House Leaders Outline Bill To Overhaul U.S. Health Care System
Leaders of three House committees charged with crafting health reform legislation outlined a bill Tuesday that includes a government-run health insurance option and mandates for individuals to obtain insurance and employers to help pay for it, the New York Times reports (Pear, New York Times, 6/10).
The three-page outline presented by the chairs of the House Ways and Means, Energy and Commerce, and Education and Labor committees to the House Democratic Caucus calls for the creation of a public plan that is "self-sustaining and competes on a 'level field' with private insurers" (Tumulty, Time, 6/10).
The House bill also would establish a health insurance exchange where U.S. residents could compare and purchase health care plans, including a public option. States would be allowed to establish their own exchanges, according to the outline (Wayne, CQ Today, 6/9).
The bill would require all individuals to obtain health coverage and provide subsidies for families with incomes up to 400% of the federal poverty level (Bendavid/Adamy, Wall Street Journal, 6/10).
Employers would be required to either provide health coverage for workers or pay a tax that would help fund a public health plan. Small businesses would be exempt from the requirement (Dennis, Roll Call, 6/9).
The House bill also would make changes to Medicare, including altering the physician payment formula -- which the outline calls "flawed" -- and cutting "overpayments" to Medicare Advantage plans (CQ Today, 6/9).
According to a House aide who helped draft the proposal, the bill would expand Medicaid by basing eligibility entirely on income (Wall Street Journal, 6/10). In addition, the outline calls for an increase in Medicaid payment rates to providers to encourage participation (CQ Today, 6/9).
The proposal would prohibit insurers from denying people coverage based on pre-existing health conditions, gender or occupation, but would allow private insurers to vary premiums -- to a limited degree -- based on age (Time, 6/10).
The committee chairs suggested that the final bill would establish an advisory committee that would be responsible for setting minimum benefits for plans (Edney, CongressDaily, 6/9).
In addition, the proposal would cap patients' out-of-pocket spending to prevent bankruptcies caused by medical costs (CQ Today, 6/9).
The outline did not include details on how to finance health reform.
According to the Wall Street Journal, the omission grants lawmakers time to better assess the costs involved and sell health reform to the public.
The House is expected to release a formal version of its bill next week (Wall Street Journal, 6/10).
Blue Dog Coalition, Pelosi
The House plan presented ignores the request of the fiscally conservative Blue Dog Coalition to include a public plan only as a "fallback option" if reform of private health care fails, The Hill reports (Soraghan, The Hill, 6/9).
House Ways and Means Committee Chair Charles Rangel (D-N.Y.) said, "We're going to have a public plan and we're not going to wait two, three, five years to see what happens and then trigger it."
House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) noted that while the draft includes a public option, it incorporates other Blue Dog principles by having the public plan compete with private insurers (Dennis/Newmyer, Roll Call, 6/10).
On Tuesday, House Speaker Nancy Pelosi (D-Calif.) and Majority Leader Steny Hoyer (D-Md.) met with the three committee chairs, urging them to consider the concerns of moderate Democrats to avoid the in-party fighting that contributed to the defeat of the Clinton administration's health reform plan, Politico reports (O'Connor/Frates, Politico, 6/10).
Obama Meets With House Ways and Means
On Tuesday, President Obama met with Democratic members of the House Ways and Means Committee to discuss health care reform legislation, Roll Call reports. During the meeting, Obama indicated that he will soon announce new Medicare and Medicaid savings initiatives (Koffler, Roll Call, 6/9).
Rep. Richard Neal (D-Mass.) said that Obama focused on cost as much as coverage during the meeting and highlighted the need to invest in primary care, including providing financial incentives to physicians who decide to practice primary care (Wangsness, "Political Intelligence," Boston Globe, 6/9).
Ranking Members Want Hearings
The ranking members of the House Education and Labor, Energy and Commerce, Ways and Means committees sent a letter on Tuesday to their respective chairs requesting hearings to evaluate the health care reform measure that has been primarily crafted behind closed doors, Roll Call reports.
The letter asked that the hearings examine whether the overhaul plan will "force millions of Americans to lose their current health care coverage," whether it will limit accessibility to needed treatment, and whether mandates will increase health care costs for workers.The letter concludes that the "artificial timeline" to vote on the bill by the August recess "certainly requires we work quickly, [and] it cannot undermine our responsibility to produce the best possible legislation on behalf of the American people" (Benderly, Roll Call, 6/9). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.