Week in Health Insurance Reform EasyToInsureME

December 16, 2009

This Week in Health Reform—Legislative Overview

Senate
The
Senate this week continued debate on its health care reform
legislation, H.R. 3590, “The Patient Protection and Affordable Care
Act”. The two most controversial issues continue to be the public
option and abortion, with both issues being discussed at length last
week. On December 9, Senate Democrats blocked an amendment, 54-45, by
Ben Nelson (D-NE) and Orrin Hatch (R-UT) that would tighten
restrictions for funding of abortions. The amendment’s language
mirrored what was in the House legislation that passed last month to
the opposition of many Progressive Democrats. Majority Leader Reid
(D-NV), voted down the amendment stating that the language in the
existing Senate bill already adequately states that insurance plans
(public or private) in the new exchange would be restricted from using
taxpayer money for abortions.

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Democrats
Ben Nelson (NE), Bob Casey (PA), Kent Conrad (ND) and Byron Dorgan
(ND), Ted Kaufman (DE) and Mark Pryor (AR) all supported the amendment.
An outspoken opponent on abortion, it is unclear whether or not Nelson
will support a final bill without the amendment. If he does not, then
Reid has the additional task of ensuring that at least one Republican
Senator votes in favor of his bill to secure the 60 votes needed to
block a filibuster.

In order to break the bottleneck in the
Senate over the public option last week, a group of ten moderate and
liberal Democrats negotiated a compromise agreement that they said
would appease both moderate and liberal Democrats – and perhaps
interest some moderate Republicans. The re-formatted public option
would create a national insurance plan, run by nonprofit private
insurance companies, and supervised by the Office of Personnel
Management. The program is said to be modeled after the Federal
Employee Health Benefits Program (FEHBP), which currently covers more
than eight million federal employees, including members of Congress. To
appease the liberal base of the Democratic Party, the compromise also
reportedly created an expansion of Medicare to individuals between the
ages of 55 to 64.

Senator Joe Lieberman (I-CT), an Independent
who often caucuses with the Democrats, has been an outspoken opponent
of the Medicare expansion provision and publicly stated that he would
not vote for any bill that includes it. While Senators still remain
quiet on the details of the legislation, stating that they are waiting
to receive a cost analysis from the Congressional Budget Office (CBO)
before discussing it publicly, it looks like the Medicare expansion
provision has been removed from the pending legislation.

Reid is still aiming to have a vote on the Senate’s portion of the health care reform bill ahead of the Christmas holiday.

House
Last
week Speaker Nancy Pelosi (D-CA) publicly stated that she would not
discard the option of keeping House members in Washington for part of
Christmas week – if it means that they make progress in passing health
care reform legislation. Pelosi reiterated both her support for
President Obama’s top domestic priority – health care reform – and her
enthusiasm for seeing the Senate’s version of the bill.

Overview: NFIB Opposes Senate Health Care Reform Bill
On
December 8, the National Federation of Independent Businesses (NFIB),
an association that represents small and independent businesses,
publicly stated its opposition to the Senate’s “Patient Protection and
Affordable Care Act” (H.R. 3590).

See below for excerpts from the letter:

* The letter states that “the most recent Congressional Budget Office
(CBO) study detailing the effect that H.R. 3590 will have on insurance
premiums reinforces that, despite claims by its supporters, the bill
will not deliver the widely-promised help to the small business
community. Instead, CBO findings report that the bill will increase
non-group premiums by 10 to 13 percent and result in, at best, a two
percent decrease for small group coverage by 2016. These findings tell
small business all it needs to know – that the current bill does not do
enough to reduce costs for small business owners and their employees.”

* “Despite the inclusion of insurance market reforms in the small-group
and individual marketplaces, the savings that may materialize are too
small for too few and the increases in premium costs are too great for
too many. Those costs, along with greater government involvement,
higher taxes and new mandates that are disproportionately targeted at
small business and are being used to finance H.R. 3590, create a
reality that is worse than the status quo for small business.”
*
“...the excessively tight age rating (3:1) in H.R. 3590 will increase
more costs than it will decrease, and make coverage unaffordable for
the very populations that are most beneficial to the insurance pool –
the young and the healthy. Independent actuaries have analyzed the
negative impact of such tight bands and have indicated that there will
be devastating effects to the long-term viability of a pool without
action to correct this rating imbalance.”