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Welcome to Stat! Health Reform Weekly. On this page, Segal will provide highlights of health care reform developments in the past week, as well as information on important developments to come.
March 4, 2010
On Wednesday, March 3, 2010, in a speech at the White House, President Obama urged Congress to finish its work on health care reform legislation and schedule an up-or-down vote in the next few weeks. Although he did not state explicitly that Congress should do this through the budget reconciliation process, his call for a simple majority vote can only mean one thing: using the reconciliation process – as was done with other health bills like COBRA and the Children's Health Insurance Program (CHIP) – to wrap up this year-long legislative effort. Only a budget reconciliation bill can pass the Senate with a simple majority vote, instead of the filibuster-proof majority of 60 votes effectively required for other bills.
President Obama's speech did not contain any new information or details about the proposal that he released on February 22, 2010 – three days before the bipartisan health care summit on February 25 (http://www.whitehouse.gov/health-care-meeting/proposal).
However, he did release a letter to Congressional leadership on March 2 in which he accepted a few specific proposals advanced by Republicans at the summit (http://www.whitehouse.gov/blog/2010/03/02/president-obama-follows-thursdays-bipartisan-meeting-health-reform-0).
Agreement with Specific Republican Proposals
As outlined in a letter sent to Congressional leadership on March 2, the President agreed with the following proposals:
- High-Deductible Health Plans (HDHPs) with Health Savings Accounts (HSAs): Encouraging people to take advantage of HSAs by allowing HDHPs to be purchased through health insurance exchanges.
- Fraud and abuse: Conducting random undercover investigations of health care providers that receive reimbursements from Medicare, Medicare and other federal programs.
- Medical malpractice: Including $50 million in Congressional spending bills to provide grants to states to explore alternatives to resolving medical malpractice disputes.
- Medicaid reimbursements: Exploring fiscally responsible ways to increase reimbursements paid to doctors serving low-income populations through Medicaid.
The Way Forward
The President has effectively endorsed the reconciliation process as the way to move forward. While the precise timing and order of actions are unclear, in essence, this would require the House to pass the Senate-passed bill, as is, and both the House and Senate to pass a separate bill (the budget reconciliation bill) containing changes to the Senate-passed bill. Because this separate bill would be a budget bill, it is generally limited to measures affecting federal revenue and spending. This limits the type of fixes this bill can contain and makes the final negotiations between the House, the Senate and the White House all the more challenging.
The President called upon Congress to take these steps in the next few weeks. Some consider March 26 – the last weekday before the next Congressional recess begins – as a final target. This is an ambitious schedule given the need to draft final legislative language that can pass both the House and Senate, have the bill scored by the Congressional Budget Office, and contend with what is likely to be a drawn out amendment process when the bill hits the Senate floor.
As Congressional leaders work to draft the compromise legislation, President Obama announced he would launch a public push for health reform over the next several weeks, beginning with trips to Pennsylvania and Missouri during the week of March 8, 2010. We will follow the process and status of legislation, and continue to report on health reform efforts in the next issue of Stat! Health Reform Weekly.
Summaries of the House and Senate bills are available on our Web site at the following links: