This Week in Health Insurance Reform : EasyToInsureME

January 13, 2010

This Week in Health Reform

House and Senate
The
Senate passed its health care reform legislation, the Patient
Protection and Affordable Care Act of 2009 (H.R. 3590) on December 24,
2009. With both pieces of legislation now passed – the House
legislation, the Affordable Health Care for America Act (H.R 3962), was
passed on November 7, 2009 – House and Senate leadership must now
reconcile the differences. Instead of moving into the conference
committee to reconcile the bills, Democratic leadership has agreed to
implement a “ping-pong” approach where the House will take up the
Senate bill, amend it, and then send it back to the Senate for
approval. Reiterating his commitment to signing health care reform
legislation by the State of the Union address (the date of the Address
has not been confirmed yet), President Obama has met with key Democrats
multiple times during the last week and is supportive of this approach,
which is said to be an easier procedural tactic and will take less
time.

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Senate
Majority Leader Harry Reid (D-NV) still has the challenge of
maintaining the Democrats’ 60-vote majority for two procedural votes in
the Senate. This first is a vote on a motion to proceed to debate the
legislation and the second is a vote on cloture that will allow
Senators to proceed to the vote itself. The final vote on the full
legislation will only need 51 votes. Speaker Nancy Pelosi (D-CA) needs
218 votes in the House of Representatives.

While the
“ping-pong” approach may seem easier than holding a formal conference
committee, there are still numerous provisions in the Senate bill that
might prove to be contentious issues for Democrats trying to marry the
two pieces of legislation. One main priority is the way both bills are
financed. The House Democrats prefer a tax on the wealthiest U.S.
residents, while Senate Democrats want to tax high-cost “Cadillac”
health insurance plans. It is suggested that a hybrid of the two is
most likely to appease both groups. Among other provisions, many House
Democrats are not supportive of either bill’s language on abortion,
stating that they have a coalition of 41 members who will vote against
the legislation if the abortion provisions are not amended. Other
differences include national exchanges proposed in the House, while the
Senate would like to see state-based exchanges; higher subsidies for
the lowest-income Americans and an expansion of Medicaid in the House
legislation.

The full Senate remains on recess until January 19.

Overview: NAIC Writes Speaker Pelosi and Majority Leader Reid
On
January 6, The National Association of Insurance Commissioners (NAIC)
wrote House Speaker Nancy Pelosi (D-CA) and Majority Leader Harry Reid
(D-NV) to provide their input as the House and Senate begin to
reconcile the differences in their prospective health care reform bills.

In
its letter, the NAIC highlights important points about the need for a
strong individual mandate, the implications of health care reform in
non-guarantee issue states, concern over Federal rate approval
processes and minimum loss ratios (MLR) at 80 percent for the
individual market, as well as comments about the importance of Congress
focusing on proposed effective dates for numerous insurance market
reforms. Other issues discussed include high-risk pools and new
vouchers programs.