February 17, 2010

The Week in Health Reform--Federal Legislative Overview

House and Senate
Things
were quiet last week in Washington due to the 30 plus inches of snow
the area received. On Feb. 9 House leaders announced that due to the
heavy snow in the area they would suspend votes in the House for the
remainder of the week. Congress will not be in session this week due to
the President's Day recess and will reconvene the week of Feb. 22.

As
a result of the congressional schedule, the timeframe for a floor vote
on the McCarran-Ferguson antitrust legislation will be pushed back
until the week of Feb. 22 at the earliest. Reports have stated that the
antitrust bill is part of House Speaker Nancy Pelosi's (D-CA) strategy
of moving smaller pieces of health insurance legislation quickly to help build momentum for a comprehensive individual health insurance
reform bill. The Speaker also continues to urge House Democrats to pass
the Senate bill as long as it is accompanied by a separate
"reconciliation" bill that would “fix” key provisions in the Senate
bill (e.g., raising the threshold for the Cadillac tax and dropping the
Nebraska Medicaid provisions) to satisfy some members of her caucus.

The
Senate remained in session last week, despite the weather, although
Majority Leader Harry Reid (D-NV) stated that the Senate would not
conduct any votes. On Feb. 11, Finance Committee Chairman Max Baucus
(D-MT) and Ranking Member Charles Grassley (R-IA) released the highly
anticipated “jobs bill” – The Hiring Incentives to Restore Employment
(HIRE) Act.

Senators Baucus and Grassley issued a joint
statement, emphasizing that this bill was drafted with bipartisan
input. They further stated: “We also agree that, once properly
reviewed, the package should be considered in a deliberate, but
expeditious manner. Any efforts to needlessly delay Senate completion
of consideration of this package through partisan means will undermine
our goal of timely action in the current economic climate. Action on
the expired provisions is long overdue. Timely action on incentives for
economic activity and job creation also is needed.”
Hours after
details of the “HIRE” legislation were released, Majority Leader Reid
publicly stated that he was scrapping the bill. Reid told reporters
that when the Senate returns from its recess on Feb. 22, “we will move
to a smaller package than has been talked about in the press.” Reid
went on to state that some of the tax provisions included in the
legislation – key to garnering Republican support for the deal –
“confuse” the bill. Reid went on to say that, “we don’t have a jobs
bill. We have a jobs agenda.”

The draft “HIRE” legislation addresses a number of key health care issues:

* The bill extends, by three months, the eligibility period for premium
subsidies for state continuation coverage and COBRA continuation
coverage to include persons who are unemployed on or before May 31,
2010. The bill also clarifies that these subsidies are available to
persons who are involuntarily terminated from their jobs after
previously losing their employer-sponsored coverage due to a reduction
in hours. The premium subsidies originally were enacted as part of the
American Recovery and Reinvestment Act of 2009, also known as the
“stimulus bill.”

* The bill provides for a seven-month
Medicare physician payment fix (sometimes known as the “doc-fix”),
maintaining physician payment rates at their current levels through
Sept. 30, 2010. Under current law, in the absence of congressional
action, physicians are scheduled to face a steep rate reduction on
March 1.

* The bill provides for a one-year extension of both
Medicare Advantage Special Needs Plans (section 626) and Medicare Cost
Plans (section 627).

* The bill includes numerous provisions addressing Medicare fee-for-service reimbursement issues.

White House Health Care Reform Summit
In
a pre-Super Bowl interview on CBS, President Obama said that he would
like to host a televised health care summit with Republican and
Democratic congressional leaders on Feb. 25. While specific details are
not yet available, the summit represents the Obama Administration’s
latest strategy to jumpstart the health care reform debate and seeks
bipartisan cooperation following the loss of the Democrats’
supermajority in the Senate. Republican leaders expressed interest in
the summit, and House Republican Leader John Boehner (OH) issued a
statement saying that, "The best way to start on real, bipartisan
reform would be to scrap those bills and focus on the kind of
step-by-step improvements that will lower health care costs and expand
access." In response, White House officials insisted that the President
is not interested in starting from scratch on health reform.

This
week Democratic and Republican congressional leaders also met with
President Obama at the White House to discuss the jobs bill, health
reform, energy, trade and other legislative priorities.

Following
the meeting, the President spoke with reporters and he made the
following comments about health reform: “I'm going to be starting from
scratch in the sense that I will be open to any ideas that help promote
these goals. What I will not do, what I don't think makes sense and I
don't think the American people want to see, would be another year of
partisan wrangling around these issues; another six months or eight
months or nine months worth of hearings in every single committee in
the House and the Senate in which there's a lot of posturing. Let's get
the relevant parties together; let's put the best ideas on the table.
My hope is that we can find enough overlap that we can say this is the
right way to move forward, even if I don't get every single thing that
I want.”