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Healthcare Reform Update - February 4-12, 2010


Email Alert

February 12, 2010

Compiled by Brian Betner*

Obama Invites Republicans to Share Ideas at Televised Health Reform Summit
February 8, 2010

The New York Times reports that the President's invitation is for a half-day televised summit February 25. It is "a high-profile gambit that will allow Americans to watch as Democrats and Republicans try to break their political impasse." The move is seen as a way for Obama to force Republicans to help govern and to "put more scrutiny on Republican initiatives" on health care. There remains, however, a split among lawmakers--even among Democrats--on what should be in health reform legislation with even House and Senate Democrats differing on several key tenets, including inclusion or exclusion of a tax on high cost insurance policies (Zeleny, 2/7).

The Washington Post : Republican leaders on Sunday welcomed "the outreach" but maintained their position that lawmakers must start over on the health reform effort to win Republican cooperation. Meanwhile, Democratic leaders seem to welcome the step. "'As we continue our work to fix our broken health care system, Senate Democrats will not relent on our commitment to protecting consumers from insurance company abuses, reducing health care costs, saving Medicare and cutting the deficit,' Senate Majority Leader Harry M. Reid (D-Nev.) said in a statement shortly after the interview." House Speaker Nancy Pelosi and Reid are trying to "negotiate fixes to the Senate bill that the Senate could approve under special budget rules to protect the package from a GOP filibuster. Then the House could pass the fixes, along with the Senate bill." Many have called that process too partisan, however (Shear, 2/8).

Politico : "Obama said he wants to 'look at the Republican ideas that are out there. . . . If we can go, step by step, through a series of these issues and arrive at some agreements, then, procedurally, there's no reason why we can't do it a lot faster the process took last year,' he said. . . . Speaking to [CBS' Katie] Couric, Obama acknowledged public unhappiness with all the special deals in the legislation. 'What we have to do is just make sure that it is a much more clear and transparent process,' he said. 'I've got to push Congress on that'" (Budoff Brown and Allen, 2/7).

Bloomberg : "Senate Republican Leader Mitch McConnell of Kentucky, responding to Obama's idea, said legislation should start from scratch if Obama wants a measure that can get support from both parties. 'If we are to reach a bipartisan consensus, the White House can start by shelving the current health-spending bill,' McConnell said in an e-mailed statement. 'There are a number of issues with bipartisan support that we can start with when the 2,700-page bill is put on the shelf'" (Anderson Brower and Jensen, 2/8).

Roll Call quotes a statement from Pelosi: "The House-passed health insurance reform legislation included a number of Republican amendments--added as the bill worked its way through three committees. In the last Congress, we worked with President Bush in a bipartisan way to pass initial economic recovery legislation, a bill to deal with the financial crisis and historic energy legislation that increased our nation's fuel efficiency standards for the first time in more than 30 years. We remain hopeful that the Republican leadership will work in a bipartisan fashion on the great challenges the American people face" (Pierce, 2/7).

The Wall Street Journal: But from others in the Democratic party,
"[t]here was immediate skepticism . . . that the forum would break the impasse. House Majority Leader Steny Hoyer (D., Md.) said he had reached out to Republicans 'on several occasions' last year to seek their ideas and feedback. 'I was, however, disappointed that these meetings did not result in any serious follow-through to work together in a bipartisan fashion,' he said" (Reddy and Meckler, 2/8).

Los Angeles Times : "The summit invitation serves two political purposes. For months, the president has endured criticism that he reneged on a promise to televise healthcare negotiations on C-SPAN. By opening up the summit to the cameras, Obama can argue he is making good on that commitment at a crucial point in the process. Also, the summit gives the president a chance to paint Republicans as obstructionists who refuse offers of compromise. If that's how the event is perceived, it could pay off for Democrats in the November midterm elections" (Nicholas, 2/8).

Kaiser Health News provides highlights of the weekend's headlines and highlights of health policy news, including President Obama's speech to the Democratic National Committee and Sunday's week-ahead reports.

Sebelius To GOP: 'Don't Get Wrong Impression' About Obama Health Summit
By Phil Galewitz
KHN Staff Writer
February 8, 2010

A day after President Barack Obama invited Republicans in Congress to a bipartisan health care summit, Health and Human Services Secretary Kathleen Sebelius said no one should get the wrong impression. "A lot of people ask if this is starting over (on a health overhaul), the answer is absolutely not," she said Monday in a talk at the AcademyHealth policy conference in Washington.

Instead, she said the Feb. 25 televised event is to "get Republicans to re-engage in the process. It is not acceptable that half the legislative body pushed away from the table months ago and said 'we do not want to participate.'"

In January, two days after Republican Scott Brown changed the dynamics of the debate by winning a special Senate election in Massachusetts and ending Democrats filibuster-proof majority, House Minority Leader John Boehner, R-Ohio, said that the health bill that passed the House in November was "dead" but "maybe not quite as dead as I want it."

Boehner said Republicans in the House were not interested in working with Democrats to modify the existing bill, which he called a "monstrosity"--although he said Republicans were ready to work with the White House and congressional Democrats to craft a bill from scratch.

Sebelius said she hopes Republicans will put forward "a real plan, not just criticisms."

She said any health overhaul that prohibits insurers from charging higher rates or denying coverage for people with pre-existing medical conditions also must have an individual insurance mandate. Republicans have staunchly opposed the mandate as an infringement on individual rights.

"It is disingenuous to say you are for insurance reforms, but not support the notion that everyone has to come into the marketplace," Sebelius said.

While polls that show Americans' waning support for the health overhaul bills, Sebelius insists there is "overwhelming support" for the provisions in the bills.

The problem, Sebelius said, is the process Congress took to craft the legislation. "When people look up close at the personal activities of Congress they are confused and disgusted with the whole process and too afraid that whatever is going on can't possibly be good for them or their families."

Obama: No 'Short Cut' to Deal With Health Reform Issues
February 9, 2010

President Barack Obama surprised reporters by coming into the White House briefing Tuesday afternoon following a meeting with Democratic and Republican congressional leaders. He spoke about several issues, including the stalled health care overhaul efforts and his plans for a televised bipartisan meeting on health care later this month.

The Washington Post : "The president's two-hour session with the congressional leaders was spirited, by many accounts, covering health care, job creation, trade and other matters." Obama said he told House Minority Leader John Boehner, R-Ohio, that his core goals--lowering health-care costs for businesses and individuals and expanding coverage to the uninsured--remained non-negotiable. But Obama said he would consider GOP alternatives that accomplish the same results. He also said he would sign what he considered to be a less-than-perfect bill. "I am going to be starting from scratch in the sense that I will be open to any ideas that help promote these goals," Obama told reporters. "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" (Murray, 2/9).

Politico : "Obama said he's also open to talking about Republican concerns, such as limiting medical malpractice lawsuits, but also made clear that if that's not the majority of the reason costs are going up, that he expected Republicans to address the other causes as well. 'There is no short cut in dealing with this issue. I know the American people get frustrated debating something like health care because you get so many competing claims,' Obama said. 'It's a complicated, tough issue, but what is also true is that without some action by Congress, it's very unlikely we see an improvement over the current trajectory' of higher premiums and more uninsured Americans" (Gerstein, 2/9).

The Hill : "Obama rejected Tuesday the notion that an upcoming healthcare summit would be little more than 'political theater.'" He expressed hope that a Feb. 25 televised, bi-partisan meeting with House and Senate leaders would result in "some substantive progress" regarding health reform. He also said "he and Democrats would be willing to give up some--but not all--of [their] desired parts of health reform if it were to help reach consensus. 'I'm willing to move off some of the preferences of my party in order to meet them halfway,' he said. 'But there's got to be some give on their side, too'" (O'Brien, 2/9).

Congress Daily : A top adviser to House Speaker Nancy Pelosi outlined "a plan that would allow both chambers to make changes to the Senate healthcare overhaul before the overhaul becomes law." Pelosi's aide described the plan this way, according to Congress Daily: "The trick in all of this is that the president would have to sign the Senate bill first, then the reconciliation bill second, and the reconciliation bill would trump the Senate bill,'" he told a meeting of the National Health Policy Conference hosted by AcademyHealth and Health Affairs. "Some have questioned whether rules would allow Congress to pass changes to a bill that is not yet law" (Edney, 2/9).

States Push Ahead on Health Care Reforms and Policy Issues,
Pre-Empting Some Provisions of Congressional Efforts

February 9, 2010

Politico : "State lawmakers in at least three dozen states are pushing ahead with a series of measures aimed at pre-empting whatever might come out of Washington. On the left, Democrats in the California Senate recently approved a measure to establish a state-run, single-payer health care system favored by liberals on Capitol Hill. And on the right, conservatives in Virginia and other states are pushing legislation to stave off federal efforts to mandate that individuals secure insurance coverage or require businesses to provide it" (O'Connor, 2/9).

Columbia Missourian : "The Missouri Senate spent nearly all of its session time Monday on resolutions that would urge the state's attorney general to sue the federal government for legislation that may never see the light of day in the U.S. Congress." The legislation would urge the state attorney general to join with "other state attorneys general in threatening a lawsuit against the federal government if a version of the health care reform is passed into law. The attorneys general, led by Henry McMaster of South Carolina, have said they would sue over a provision inserted into the U.S. Senate version of health reform that was designed to win the support of conservative U.S. Sen. Ben Nelson,
D-Neb." That language would have exempted Nebraska on a permanent basis "from funding the expansion of Medicaid that would be required under the proposed bill" (Bushnell, 2/8).

Modern Healthcare , on the rise of uninsured residents in Minnesota: "Less than 60% of Minnesotans had health insurance through an employer in 2009, which contributed to a notable increase in the number of residents without insurance in a state that typically has rates of coverage higher than national averages, a new study indicates. Authors of the Minnesota Health Access Survey said the results likely will serve as a preview of other state and national surveys because Minnesota is one of the first states to report academic findings on the rate of uninsured people for 2009." The survey "found that the number of Minnesotans without insurance increased by 106,000 between 2007 and 2009, leaving the state's uninsured rate at 9.1%, compared with 7.2% two years earlier" (Carlson, 2/8).

The Philadelphia Inquirer reports on efforts by the "Law Enforcement Health Benefits Inc., which oversees health-care benefits for Philadelphia police. LEHB and its administrator, Thomas Lamb, are roundly praised for aggressively reining in costs. . . . Even so, LEHB's efforts cannot offset city health-care costs that are high relative to other employers', mostly because Philadelphia employees pay little out of their own pockets. That leaves taxpayers shouldering health-care costs that jumped 123 percent from 2001 to 2008, a period in which city revenue rose only 38 percent.
. . . Starting in July, Lamb will be at the forefront of a new effort to control medical costs known as self-insurance. Instead of paying a premium to its insurer, Independence Blue Cross, LEHB, using city funds, will now pay claims as they come in. The city hopes to save about
$5 million in fiscal 2001 because of the switch to self-insurance"
(Hill, 2/9).

St. Paul Pioneer Press : A legislative effort "to rescue a state-run health care program for the poor took its first hesitant step Monday toward becoming law." The measure, advanced by Sen. Linda Berglin, DFL-Minneapolis, is estimated to cost roughly $320 million and "would restore coverage, now set to expire at the end of March, for those earning less than $7,800 a year." A companion measure is moving through the House. "The bill is on a fast track as one of the big early tests of the 2010 session. It passed out of the Senate's Economic Development and Housing Budget Division on Monday, will be heard in the Senate's Finance Committee today and is headed toward a vote Thursday on the floor of the Senate" (Hoppin, 2/8).

Kansas Health Institute : "Kansas is going to need more doctors to meet the growing needs of an aging population, officials here say. Meanwhile, the University of Kansas School of Medicine in Wichita has been successful training doctors who choose to remain in the state. Almost half its graduates have stayed in Kansas; the national average for retaining medical school graduates is 29 percent. With the aim of turning out more graduates, university officials here have long wanted to convert the Wichita campus to a four-year school. It's a two-year program, now" (Ranney, 2/8).

Analysts: If Health Reform Fails, Expect More Industry Mergers
February 8, 2010

News outlets report on how the fate of the health care overhaul might affect health industry mergers and biotech firms.

BusinessWeek : "With Congress' sweeping overhaul of the health system stalled, industry will seek its own answers to a push by government and the private sector to rein in costs, said Curtis Lane, senior managing director at MTS Health Partners, a New York-based equity fund." An aging population will further increase health spending, and "[o]ne solution will be increased consolidation, with companies led by WellPoint Inc., the biggest U.S. insurer by enrollment, and Community Health Systems Inc., the largest publicly traded hospital chain, scooping up rivals unable to 'spread rising costs across fewer customers,' said Paul Keckley, of the Deloitte Center for Health Solutions" (Nussbaum and Tirrell, 2/8).

Star-Ledger/ reports that while some biotech firms, including a start-up called Soligenix, are thriving, many others in the industry are struggling. "The nation's economic downturn has dried up many of the usual sources of money the smallest drugmakers depend on to pay for their work. . . . Now, the industry is banking on a little-known provision of the Senate's health care reform bill to help ease--at least, temporarily--its inability to raise money from the usual sources, namely venture capitalists and the financial markets. The provision, known as the Therapeutic Tax Credit, is intended to help companies with 250 or fewer employees pay the salaries of their scientists, continue their research and even hire workers to help the companies push out new medicines."

"Sen. Robert Menendez (D-N.J.), who pushed to include the amendment as part of health care reform, has said the provision also could be added to the Senate jobs bill" (Todd, 2/7).

This information was reprinted from with permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery . © Henry J. Kaiser Family Foundation. All rights reserved.

*We would like to thank Brian C. Betner, Esquire (Hall Render Killian Heath & Lyman, Indianapolis, IN), for selecting the articles for this week's update.

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