Senate Republican Task Force Unveils Proposals To Help the Uninsured
A Republican Senate task force on Tuesday unveiled a package "consisting mostly of previously proposed tax incentives and insurance overhauls" that panel members say would expand health coverage to between 17 million and 23 million uninsured people and extend "safety net" health services to an additional five million uninsured, CongressDaily reports (Heil, CongressDaily, 5/11). The plan includes proposals suggested by the Bush administration to cap awards in medical malpractice lawsuits and to offer tax credits to help individuals purchase health insurance (Schuler, CQ Today, 5/11). The task force's proposal also calls for:
- Spending $5 billion on creating incentives for college students and recent graduates to purchase health insurance;
- Improving care at community health centers (CongressDaily, 5/11);
- Allowing religious health care facilities to receive federal funding by permitting them to be designated as community health centers;
- Offering medical specialists who provide charity care to patients referred by community health centers and not-for-profit clinics a tax deduction of up to $20,000 per year;
- Extending government-negotiated discounts on prescription drugs -- which are currently available to federal agencies and certain clinics eligible for federal grants -- to low-income and uninsured U.S. residents;
- Providing aid to colleges and universities that make health insurance available to full-time students;
- Forgiving student loans or deferring interest payments for college graduates who open health savings accounts;
- Allowing health professionals working at not-for-profit clinics serving the uninsured to defer interest payments on student loans; and
- Providing malpractice insurance to physicians who volunteer at community health centers (Pear, New York Times, 5/12).
Sen. Olympia Snowe (R-Maine) said the package would give lawmakers "a toolbox of legislative solutions" to lower the nation's spending on health care, which has hit an "unsustainable rate of $1.7 trillion a year," and expand insurance coverage (Shesgreen, St. Louis Post-Dispatch, 5/12). However, some panel members "doubted whether the changes -- some of which have previously stalled in the Senate as individual proposals -- would be enacted," CongressDaily reports. Senate Health, Education, Labor and Pensions Committee Chair Judd Gregg (R-N.H.), who led the uninsured panel, said that "given the backdrop of election-year politics and the educational effort that the legislation would require, action might not be likely this year," according to CongressDaily. Sen. Edward Kennedy (D-Mass.) said, "For working families worried about the soaring cost of health care and the uninsured struggling to get the care they need, this program is just more snake oil and soothing syrup" (CongressDaily, 5/11). He added that the package "provides more help for insurance companies and other Republican campaign contributors than for patients" (St. Louis Post-Dispatch, 5/12).
Meanwhile, some House Democrats on Wednesday are expected to introduce a three-part plan to extend coverage to the uninsured, the Times reports. Under the plan, states would receive $50 billion in federal funds to extend insurance coverage to parents of children who are enrolled in Medicaid or SCHIP programs; people between ages 55 and 64 would be able to purchase Medicare coverage, with the government paying up to 75% of the cost; and tax credits would be offered to small businesses and self-employed individuals to offset the cost of health insurance (New York Times, 5/12). The House on Wednesday and Thursday also is expected to consider legislation that would address health costs. Two of the bills -- HR 4281, which would allow AHPs to avoid some state insurance regulations, and HR 4280, which would cap at $250,000 noneconomic damage awards in medical malpractice lawsuits -- are "virtually identical to bills the House has already passed," according to CQ Today. The third bill (HR 4279) would allow employees to transfer up to $500 of unused funds in flexible spending accounts to health savings accounts or to their following year's FSAs (CQ Today, 5/11).
In a "Dear Colleague" letter, Rep. Robert Andrews (D-N.J.) on Tuesday urged legislators to vote against the AHP bill, saying that it would allow AHPs an exemption from state insurance laws and could increase health plan premiums for workers not enrolled in an AHP. Andrews also met with labor leaders, representatives of the National Governors Association, the NAACP and consumer groups on Tuesday to criticize the proposal (CongressDaily, 5/12). Andrews plans to try to add an amendment to the AHP bill that would open the Federal Employees Health Benefits Program to employers with up to 100 workers. Under his proposal, employers with fewer than 50 workers also would receive discounts to further offset costs (Mondics, Philadelphia Inquirer, 5/12).
In related news, a number of health policy experts said on Tuesday that "translating the rhetoric" on efforts to help the uninsured into legislation "will be difficult," CongressDaily reports. At the Carolina Health Summit at the University of North Carolina, Families USA Executive Director Ron Pollack said, "Altruism goes just so far. And to think that we can accomplish such major social change (as covering the uninsured) on the basis of altruism alone strains credulity." Chris Jennings, a health care policy adviser to former President Bill Clinton, and Dean Rosen, health policy director for Senate Majority Leader Bill Frist (R-Tenn.), said that the debate over the issue of the uninsured will focus on concerns over cost, rather than those of coverage. In addition, Paul Ginsburg of the Center for Studying Health System Change said, "I can't remember a time when there was less consensus on cost-containment than there is now." Linda Bilheimer of the Robert Wood Johnson Foundation, which sponsored the summit, added that the public has "lack of understanding of what the tradeoffs would be," which could serve as a barrier to legislation to help the uninsured. Summit participants also agreed that the federal budget deficit could serve as a barrier to such legislation (Rovner, CongressDaily, 5/11).
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