Weekly Update on Federal Reform

Final House committee approves reform plan
On the last day before the House of Representatives is set to take a five-week recess, House Energy and Commerce Committee Chairman Henry Waxman announced that he had reached an agreement with centrist Democrats on the committee that would allow the panel to approve the House version of health reform legislation (Source: “House Panel Reaches Deal on Health-Care Bill,” New York Times, July 31, 2009).

After garnering much of the attention on the health reform debate this week, the conservative Democratic Blue Dogs won the compromise that calls for additional cost-cutting from the legislation, thought Waxman said those measures would not include cutting subsidies for the poor. Rather, the chairman said savings would be found elsewhere in the bill. On Thursday evening the panel rejected an amendment that would have eliminated the public plan option.

The news of the compromise agreement came a day after a group of liberal lawmakers threatened to pull support for any legislation that did not include a public option (Source: “Liberal Democrats threaten to reject House healthcare compromise,” Los Angeles Times, July 31, 2009).

On Thursday 57 liberals in the House sent a letter to Speaker Nancy Pelosi warning that they would vote against any bill that would weaken the proposed government insurance plan, which had been a sticking point for more conservative Democrats.

House Democrats create district-by-district analysis of reform impact
The Democratic leadership of the House Energy Committee has released district-level fact sheets (scroll to bottom of page) of its analysis of the House health reform legislation.

Prepared for each member of the House, the analysis includes information on the impact of the legislation on small businesses, seniors in Medicare, health care providers and the uninsured. It also includes an estimate of the impacts of the surtax that is used to pay for the legislation.

Kaiser releases reform analysis
The Kaiser Family Foundation also has created an analysis of the major health reform proposals being considered in both houses of Congress. Kaiser’s side-by-side comparison allows users to choose 17 topic areas for comparisons.

Kaiser also has released a new chartbook (pdf, 24 pages) on state variations on health reform.

“As the health reform debate progresses, the impact of reform on individual states will vary based on their economic situation, current health insurance coverage, and health care expenditures,” the report states. “This analysis pulls together key information related to state variation.”

Should dental care be part of reform plan?
Noting that 108 million Americans do not have dental coverage, the American Dental Association has begun a push to include an oral health amendment to health reform legislation (Source: “Giving Teeth to Health Reform: Should Dental Care Be Included?” Fox Business Channel, July 31, 2009).

"The government is completely separating dentistry and medical health in its proposed overhaul," says Dr. Thomas Connelly, a dentist based in New York. "It doesn't make sense to do so."

However, some argue that federally-funded health care will only increase costs and drive down quality.

"Congress, or the board they envision for this plan, would set up a basic, no frills system, spending billions of taxpayer dollars for a system that doesn't work," says Leslie Paige, Media Director for Citizens Against Government Waste. "A perfect example of this is Medicare. Or worse, Medicaid."

Lewin Group: Hospitals would get 32% less in payments from public plan
An analysis of the House health care reform bill by The Lewin Group concluded that a public health plan using the current Medicare payment methodology would have a “substantial price advantage” over private insurance (Source: “Hospitals Would Get Paid 32% Less in Public Plan Compared to Private Insurers,” HealthLeaders Media, July 29, 2009).

The paper, Cost and Coverage Impacts of the American Affordable Health Choices Act of 2009, (pdf, 61 pages)  estimates that hospitals would, on average, be paid 32 less than what private insurers pay for the same treatment, while physicians would be paid an average of 16 percent less. The physician payment reflects an additional 5% increase in payments under the House bill for physicians and other providers who agree to treat both Medicare and public insurance plan patients.

"Our independent study shows how the decision whether or not to include all employers in the public option will have a profound impact on the costs of this legislation on government, employers and families," said John Sheils, vice president of The Lewin Group, in a statement.

The Lewin Group is part of Ingenix, a wholly owned subsidiary of UnitedHealth Care.