Weekly update on federal reform

Congress returns from recess to mull 5 reform plans
Congress returned from its weeklong Independence Day recess on Monday with five separate health reform plans to consider (Source: “Congress back to wrestle with healthcare reform,” Washington Post, July 6, 2009).

As legislators begin to weigh provisions from each plan with an eye toward melding them into a single bill, financing of the plan has become hotly debated, particularly whether taxing benefits will be required. At the same time, revised Congressional Budget Office estimates for health reform dropped the price tag from $1.6 trillion to $1 trillion, renewing optimism by some in Congress that a financing strategy could be achieved.

"The issue is going to be getting a bill that looks affordable without a substantial increase in taxes," said Bob Blendon, a health policy and political analysis professor at Harvard University. "The lower the total cost, the less you are going to have to find the financing to do this."

Federal insurance czar concept floated
Congressional Democrats are floating a proposal to create a presidentially appointed “health choices commissioner,” to oversee an independent agency charged with regulating the insurance marketplace (Source: “Need for federal insurance czar is questioned,” Associated Press, via Google, July 7, 2009).

House Democrats have released an 800-page draft bill outlining the establishment of the Health Choices Administration. Among the responsibilities of the commissioner and the new agency would be to run a national purchasing pool through which individuals and small businesses could pick medical coverage from among private and government-sponsored plans. The agency also would decide at what point the pool would be opened to all employers and who would qualify for federal subsidies for buying coverage.

State regulators say the federal commissioner would duplicate efforts now being done at the state level.
"We have concerns that a federal commissioner would not provide adequate protection for our consumers, and that the bill as drafted duplicates functions that exist in states across the nation," said Oklahoma Insurance Commissioner Kim Holland, speaking on behalf of the National Association of Insurance Commissioners.

Proponents of having a federal commissioner, however, say a national health insurance purchasing pool needs a regulator at the federal level. "If we're going to have a national insurance exchange, you can't have it run by 50 regulators in the states," said William Vaughan, a senior policy analyst with Consumers Union, publisher of Consumer Reports.

White House, hospitals agree to $155 billion savings plan 
Vice President Joe Biden announced today that hospital officials have agreed to a deal that would create $155 billion in savings to the national health system (Source: “White House, hospitals reach deal on health care,” Associated Press, via Google, July 8, 2009).

Among the cost savings would be a $50 billion reduction in payments currently paid through Medicare and Medicaid to hospitals for treatment uninsured and low-income patients. That move is being criticized by the National Association of Public Hospitals and Health Systems and the National Association of Childen’s Hospitals, which were not directly involved in talks with the administration.

As support for tax wanes, Congress eyes other financing options
With several new polls showing strong opposition to taxing employer-provided health insurance, Congressional Democrats have begun exploring other means of financing health reform legislation (Source: “Congressional Dems eye health care funding options,” CNN, July 7, 2009).

According to a New York Times/CBS News poll, 70 percent of respondents oppose the tax and only 20 percent said they would support it. A Kaiser Family Foundation survey found 54 percent of respondents opposed the tax.

"When you get numbers like that, it certainly causes you to look for alternatives," said Sen. Kent Conrad, D-North Dakota, who chairs the Senate Budget Committee.

Conrad said a House Democratic proposal to tax sugary drinks is no longer being considered because of strong opposition in Congress, but a move, favored by President Obama, to lower tax deductions for Americans with annual incomes greater than $250,000 is still on the table. Another option being considered is increasing the Medicare payroll tax.

House Majority Leader Steny Hoyer, D-Maryland, told reporters the House committees are planning to finalize health care legislation next week. A vote on the House floor is expected at the end of the month.

Group of Congressional Democrats opposes abortion inclusion in federal plan
Although none of the five reform proposals being considered by Congress specifically mentions abortion, 19 anti-abortion Democrats, including two from Ohio, are voicing concern that tax dollars could be used to fund abortions (Source: “Anti-abortion Democrats in Congress vow to oppose health care packages that don't exclude procedure,” Cleveland Plain Dealer, July 8, 2009).

Ohio representatives Marcy Kaptur and Steve Driehaus are among a group of legislators that sent a letter to House Speaker Nancy Pelosi late last month stating that they would oppose any reform package that included spending tax dollars on abortions.

"We cannot support any health care reform proposal unless it explicitly excludes abortion from the scope of any government-defined or subsidized health insurance plan," says the letter. "By ensuring that any health care package will not fund or require funding for abortions, we will take this controversial issue off the table so that Congress can focus on crafting a broadly supported reform package."

Both Sen. George Voinovich and Sen. Sherrod Brown, though differing in their overall views on abortion, said through their offices that they oppose including abortion coverage in any new federal health plan. Although Brown supports abortion rights in general, he said that any future federally funded health plan should follow the lead of current federal programs  and only pay for abortions in cases of rape, incest or to save the life of the mother.