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Healthcare Reform Update - January 28-February 3, 2010


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February 3, 2010

Compiled by Brian Betner*

Obama On Health Care: What A Difference A Year Makes
January 28, 2010

Saying Congress "should not walk away" from health reform, President Barack Obama reiterated his belief that the country still needs a health care system overhaul and described his determination to make it happen. He said "I take my share of the blame for not explaining it more clearly to the American people" and concluded: "Let us find a way to come together and finish the job for the American people. Let's get it done."

Less than one year ago, about a month after he took office, the president spoke to a joint session of Congress in what the American Presidency Project calls a "non-State of the Union address." The project adds "the impact of such a speech on public, media, and congressional perceptions of presidential leadership and power" were similar to an official State of the Union.

Here are excerpts of both speeches, with the 2010 address first:

And it is precisely to relieve the burden on middle-class families that we still need health insurance reform. Yes we do.

Now, let's clear a few things up. I did not choose to tackle this issue to get some legislative victory under my belt. And by now it should be fairly obvious that I didn't take on health care because it was good politics.

I took on health care because of the stories I've heard from Americans with pre-existing conditions whose lives depend on getting coverage; patients who've been denied coverage; and families--even those with insurance--who are just one illness away from financial ruin.

After nearly a century of trying--Democratic administrations, Republican administrations--we are closer than ever to bringing more security to the lives of so many Americans. The approach we've taken would protect every American from the worst practices of the insurance industry. It would give small businesses and uninsured Americans a chance to choose an affordable health care plan in a competitive market. It would require every insurance plan to cover preventive care. And by the way, I want to acknowledge our First Lady, Michelle Obama, who this year is creating a national movement to tackle the epidemic of childhood obesity and make kids healthier. She gets embarrassed.

Our approach would preserve the right of Americans who have insurance to keep their doctor and their plan. It would reduce costs and premiums for millions of families and businesses. And according to the Congressional Budget Office--the independent organization that both parties have cited as the official scorekeeper for Congress--our approach would bring down the deficit by as much as $1 trillion over the next two decades.

Still, this is a complex issue, and the longer it was debated, the more skeptical people became. I take my share of the blame for not explaining it more clearly to the American people. And I know that with all the lobbying and horse-trading, the process left most Americans wondering "what's in it for me?"

But I also know this problem is not going away. By the time I'm finished speaking tonight, more Americans will have lost their health insurance. Millions will lose it this year. Our deficit will grow. Premiums will go up. Patients will be denied the care they need. Small business owners will continue to drop coverage altogether. I will not walk away from these Americans, and neither should the people in this chamber.

So, as temperatures cool, I want everyone to take another look at the plan we've proposed. There's a reason why many doctors, nurses, and health care experts who know our system best consider this approach a vast improvement over the status quo. But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know. Let me know. I'm eager to see it. Here's what I ask of Congress, though: Don't walk away from reform. Not now. Not when we are so close. Let us find a way to come together and finish the job for the American people. Let's get it done. Let's get it done.

President Obama's remarks before a joint session of Congress,
Feb. 24, 2009:

The cost of health care eats up more and more of our savings each year, yet we keep delaying reform. . . .

The only way this century will be another American century is if we confront at last the price of our dependence on oil and the high cost of health care, the schools that aren't preparing our children and the mountain of debt they stand to inherit. That is our responsibility . . . .

Now, none of this will come without cost, nor will it be easy. But this is America. We don't do what's easy. We do what's necessary to move this country forward.

And for that same reason, we must also address the crushing cost of health care. This is a cost that now causes a bankruptcy in America every 30 seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes. In the last 8 years, premiums have grown four times faster than wages. And in each of these years, 1 million more Americans have lost their health insurance. It is one of the major reasons why small businesses close their doors and corporations ship jobs overseas. And it's one of the largest and fastest growing parts of our budget. Given these facts, we can no longer afford to put health care reform on hold. We can't afford to do it. It's time.

Already, we've done more to advance the cause of health care reform in the last 30 days than we've done in the last decade. When it was days old, this Congress passed a law to provide and protect health insurance for 11 million American children whose parents work full time. Our recovery plan will invest in electronic health records, a new technology that will reduce errors, bring down costs, ensure privacy, and save lives. It will launch a new effort to conquer a disease that has touched the life of nearly every American, including me, by seeking a cure for cancer in our time. And it makes the largest investment ever in preventive care, because that's one of the best ways to keep our people healthy and our costs under control.

This budget builds on these reforms. It includes a historic commitment to comprehensive health care reform, a down payment on the principle that we must have quality, affordable health care for every American. It's a commitment that's paid for in part by efficiencies in our system that are long overdue. And it's a step we must take if we hope to bring down our deficit in the years to come.

Now, there will be many different opinions and ideas about how to achieve reform, and that's why I'm bringing together businesses and workers, doctors and health care providers, Democrats and Republicans to begin work on this issue next week.

I suffer no illusions that this will be an easy process. Once again, it will be hard. But I also know that nearly a century after Teddy Roosevelt first called for reform, the cost of our health care has weighed down our economy and our conscience long enough. So let there be no doubt: Health care reform cannot wait, it must not wait, and it will not wait another year . . .

Now, to preserve our long-term fiscal health, we must also address the growing costs in Medicare and Social Security. Comprehensive health care reform is the best way to strengthen Medicare for years to come.

High-Ranking House Democrat Predicts House Bill Approval This Year
January 29, 2010

Kaiser Health News staff writer Mary Agnes Carey interviewed House Education and Labor Committee Chairman George Miller, D-Calif., about health reform's prospects. Even as House Democrats turn their attention to jobs and the economy, he predicted Thursday that Congress will pass health care overhaul legislation this year. "We're going to get it done" (Carey, 1/28)

Health Bill--"On Life Support"--Continues To Highlight Political Divides
January 29, 2010

President Obama's State of the Union speech has so far failed to unite Democrats on a health reform strategy as they "stared down a political nightmare," The Associated Press reports. "The grim reality opened a divide between the rank and file and congressional leaders, who insisted health care would get done, even though last week's special election in Massachusetts denied Democrats the 60-vote majority they need to deliver in the Senate. Many Democrats saw a problem with no clear solution" (Werner, 1/29).

Politico : "Democrats in Congress said all the right things Thursday to show they were dutifully heeding the president's call to keep plugging away on a health reform bill. But listen more closely, and it's clear health care is already falling to the back of the legislative line . . . . " And Democrats seemed "as confused and divided" after the State of the Union speech as they were before. But "congressional aides say there is a legitimate process under way to find a way to finish the job on health care" (Budoff Brown, 1/28).

U.S. News & World Report: "The task, (Democrats) say, is to regroup, not to retreat. 'I think what we've learned is that change is not easy,' says a House Democratic aide. 'Bringing about real change, sweeping change, is not a quick process. There are going to be people on both sides saying you haven't done enough or you've done too much.' The challenge, the aide says, is finding the comfort zone of the American people" (Garber, 1/28).

Pelosi, Reid Search For Health Reform's Forward Path
January 29, 2010

Legislative leaders in search of momentum on health reform "conceded that they did not have an immediate strategy for advancing a health care measure and described their time frame as open-ended," The New York Times reports.

"Speaker Nancy Pelosi, at a news conference in the Capitol, said House Democrats had begun exploring the possibility of breaking out pieces of the comprehensive bill they passed in November and moving forward on smaller measures. 'It means, we will move on many fronts, any front we can,' Ms. Pelosi said. 'We'll go through the gate. If the gate's closed, we'll go over the fence. If the fence is too high, we'll pole-vault in. If that doesn't work, we'll parachute in. But we're going to get health care reform passed for the American people, for their own personal health and economic security, and for the important role that it will play in reducing the deficit.'" One of the first measures that could move as a stand-alone reform proposal could be to eliminate the antitrust exemption for health insurance companies (Herszenhorn and Pear, 1/28).

CQ Politics reports that the House could begin moving the smaller health care reform bills next month. "The legislation, which may consist of more than one bill, will include proposals that can win quick majority approval." Pelosi's aides said they plan on bringing them to the floor before the House leaves for its Presidents Day recess Feb. 11 (1/28).

The Washington Times: Though Pelosi is eager to move forward on these measures, which could allow Democrats to claim "a small victory," she also "said she would and wait to see how the Senate pursues obtaining a comprehensive bill now that Democrats no longer have a supermajority" (Haberkorn, 1/29).

The Washington Post : "Senate Majority Leader Harry M. Reid (D-Nev.) said he felt 'a little bit' more confident about the health-care bill's prospects after" Obama's speech Wednesday. "Reid and Pelosi said they remain stalled on the most likely option for moving ahead on health-care reform. That would require the Senate to pass a bill, through a parliamentary move requiring a simple majority, resolving issues in its version of the legislation that have prompted objections from House Democrats. That would allow the House to then approve the Senate's measure, thus avoiding another vote on the entire bill in the Senate, where it would almost certainly face a successful 41-vote filibuster by Republicans" (Kane and Murray, 1/29).

Roll Call : "Reid said he is looking 'very, very closely'" at the budget reconciliation strategy. "Senate Majority Whip Dick Durbin (D-Ill.), however, indicated there could be a time limit on how long Democrats can wait to use the reconciliation route . . . 'The authority for reconciliation is under the old budget resolution," he told reporters. "There's no specific time limit, but you have to pass a budget resolution before you can start the appropriations committee allocations.' . . . While the deadline for passing a new budget resolution is April 15 of every year, Congress routinely blows past that date.

Asked whether he believes leaders could corral 51 votes for a reconciliation bill, Durbin said: 'It depends on what's in the package. We can't assume we have 51 votes. We need to present a package'"
(Pierce, 1/28).

CongressDaily: Senate moderate Democrats [such as Tom Carper,
D-Del.,] called a meeting Wednesday with their Blue Dog colleagues in the House to discuss health care, as well as fiscal issues. "'We need to know,' he said of House members' views. 'We spent all this time working on health care, and the idea that we're just going to let it die . . . would be the worst'" (Edney and Friedman, 1/29).

Republicans Tout Alternative Health Care Reform Plans, React To Dems
January 29, 2010

Following President Barack Obama's challenge to "let me know" if they had better ideas for a health overhaul, Rep. John Boehner, the House Republican leader, said that their plan, rejected last November by the Democratic majority in the House, would satisfy Obama's goals to "bring down premiums, bring down the deficit, cover the uninsured" and improve Medicare, BusinessWeek reports. "The Republican ideas . . . may have a bigger role in defining party differences this election year than in crafting a compromise on the health bill. That's because the gap between the two approaches is so wide."

Boehner's plan "would expand coverage to just 3 million uninsured Americans, compared with more than 30 million in bills passed in the Democratic-controlled House and Senate, according to the nonpartisan Congressional Budget Office. It would cost $61 billion over 10 years. It doesn't require Americans to obtain insurance" (Litvan and Dodge, 1/29).

In an interview with Fox News, Sen. Olympia Snowe, R-Maine, said that, during negotiations, "I had given a number of ideas in the direction that health care should take, and unfortunately those ideas weren't incorporated" (Van Susteren, 1/29).

National Underwriter Life & Health reports on a bill by Rep. Paul Ryan,
R-Wis., called the Roadmap for America's Future Act of 2010: "A Republican lawmaker's ideas for changing health insurance tax rules and federal health and retirement programs might be hard on patients, but they could be great for the budget deficit, according to congressional budget analysts." The plan would modify or revamp health insurance tax laws, Social Security, Medicare and Medicaid and other spending (Bell, 1/28).

The Salt Lake Tribune : "Sen. Orrin Hatch [R-Utah] threatened an all-out political 'war' and promised a new high in partisan tensions if Democrats employ a rarely used Senate rule to win approval of their health reform bill." In an interview with the paper, Hatch said that using budget reconciliation to pass reform would be "'one of the worst grabs for power in the history of the country' that would permanently impact relations between the two parties" (Canham, 1/29).

Groups--Including Catholic Bishops--Press Democrats To Finish Health Reform
Jan 28, 2010

CQ Politics: "Proponents of a comprehensive health care overhaul are pressing congressional Democrats to finish the measure . . . Leaders of several interest groups said at a news conference Wednesday that the House should clear the Senate-passed health care bill for President Obama's signature" (1/27).

The Hill: Many have "grown anxious and frustrated that congressional inaction and a lack of direction from the White House could doom their mission." The groups include Healthcare for America Now, the National Coalition on Healthcare, "Families USA, leaders of the American College of Cardiology, the League of Women Voters, Easter Seals, League of United Latin American Citizens and the Small Business Majority" (Young, 1/27).

The U.S. Conference of Catholic Bishops is among the organizations now pushing Congress to pass reform, according to BusinessWeek . Like others, the group "slowed work on the legislation in recent months as they demanded changes." But they now say failure isn't acceptable after the Democrats' loss of a Senate seat derailed the original plans for passage. . . . The American Medical Association sounded a similar theme, urging Obama and Congress to 'enact meaningful health-system reform this year'" (Jensen and Litvan, 1/27).

The New York Times details the letter written to all members of Congress by the Catholic Bishops: "The health care debate, with all its political and ideological conflict, seems to have lost its central moral focus and policy priority, which is to ensure that affordable, quality, life-giving care is available to all. Now is not the time to abandon this task, but rather to set aside partisan divisions and special interest pressures to find ways to enact genuine reform," they write (Kirkpatrick, 1/27).

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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