Congress Returns, Prepares To Tackle Health Reform, Other Administration Priorities
Democratic lawmakers returning from recess this week are expected to focus on developing health care overhaul legislation by summer because they believe it is the major policy goal most likely to succeed this year, the Wall Street Journal reports. Lawmakers believe that they are more likely to achieve bipartisan support on health reform than on climate change -- the other major goal put forward by President Obama -- and that health reform is a "more tangible accomplishment to present to financially stressed voters" leading up to the 2010 midterm elections, the Journal reports (Hitt, Wall Street Journal, 4/20).
The Senate Finance Committee this week will begin a series of three "round tables" that will serve as hearings for an overhaul bill being drafted by committee Chair Max Baucus (D-Mont.). The first meeting, scheduled for Tuesday, will address health care delivery and how payment systems could emphasize coordinated care, greater use of preventive care and other initiatives. Two May sessions will focus on increasing access to health coverage and how to fund an overhaul bill. Baucus and committee ranking member Chuck Grassley (R-Iowa) also will hold "walk-throughs" in which panel members will discuss proposals being considered for the final bill. Baucus hopes to mark up legislation in June.
The Senate Health, Education, Labor and Pensions Committee also hopes to mark up its bill in June, before combining the measure with the Finance Committee bill on the Senate floor (Armstrong/Wayne, CQ Today, 4/17). Sen. Jeff Bingaman (D-N.M.), who is leading a HELP Committee working group on expanding coverage, said, "As this work period closes, we'll have a very good picture of what this bill is going to look like and where this bill stands," and "we'll be moving very quickly on this bill after the Memorial Day recess" (Drucker, Roll Call, 4/20).
Sen. Ron Wyden (D-Ore.) said, "There is a very appealing philosophical truce within the Senate's grasp. Democrats are right on the idea that we've got to cover everybody. Republicans have been right on the role of the private sector, not freezing innovation and staying away from price controls." He added, "You meld those philosophical views and you are on your way to 68 to 70 votes." Grassley said, "This is the toughest issue we have ever taken on -- every part has got a chance of blowing up" (Werner/Alonso-Zaldivar, AP/Albany Times Union, 4/20).
House Majority Leader Steny Hoyer (D-Md.) this week will meet with House Education and Labor Committee Chair George Miller (D-Calif.), House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) and House Ways and Means Committee Chair Charles Rangel (D-N.Y.) to discuss details of the health care overhaul bill the chairs have said they intend to draft together. Hoyer said party leaders hope to develop a proposal with input from the Obama administration, key policymakers, intraparty groups and outside stakeholders. Miller said, "We are trying to act as a committee of one" (Ota, CQ HealthBeat, 4/17).
Some senior lawmakers and aides are concerned that House and Senate budget language requiring health care overhaul legislation to be budget neutral will mean that "Congress will have no choice" but to change the federal tax-exempt status of employer-provided health insurance, the New York Times reports. However, White House Office of Management and Budget Director Peter Orszag said, "By combining Medicare and Medicaid savings and these game-changing efficiency improvements with some additional revenue, I think a deficit-neutral health care reform is eminently doable" (Hulse, New York Times, 4/20).
Republicans also have remained opposed to the introduction of a public health insurance plan, which they say would be able to leverage its size and draw customers from private insurers, leaving U.S. residents with limited coverage options. House Minority Leader John Boehner (R-Ohio) said, "I think we believe, along what Democrats believe, that all Americans should have access to high-quality, affordable health insurance," but "we're not for a plan that puts the government in charge of our health care, decides what doctors ought to be paid or what treatments ought to be prescribed" (Lengell, Washington Times, 4/20). Republicans also oppose House plans to use the budget reconciliation process to pass overhaul legislation in the Senate. Anthony Coley, a spokesperson for Senate HELP Committee Chair Edward Kennedy (D-Mass.), said, "Our first preference is to continue to work with our Republican colleagues on this effort, and if bipartisan talks don't produce desired results, then reconciliation would be an important measure to have." Instructions for reconciliation were not included in the Senate's budget resolution, but the House-Senate conference is expected to include it in a final resolution (Drucker, Roll Call, 4/20).
The House Republican Health Care Task Force is set to put forward a health care platform in the next few months, but the party's health care message so far has been "vague and unformed," Politico reports. According to Politico, many Republicans worry that "the party has waited so long to figure out where it stands that it will make it harder to block what President Barack Obama is trying to do." An aide to a senior Republican lawmaker said, "There is catch-up in terms of us talking about it in public. There is a good core of ideas, but we haven't talked about the issue as much as Democrats. We are playing catch up. We are running against the wind. They have a lot of momentum." Nick Simpson -- a spokesperson for Rep. Roy Blunt (R-Mo.), who leads the Republican health task force -- said, "This group wants to come up with fresh solutions and not just party rhetoric -- and that takes some time" (Budoff Brown, Politico, 4/20).
White House Chief of Staff Rahm Emanuel on Sunday said that "the challenge will be: Will the Republicans come to the table with constructive ideas" on topics such as health care. He said, "The goals are getting health care costs under control," adding, "Now [Obama is] open to different roads to get there" (Allen, Politico, 4/19). The New York Times on Saturday examined the role of Emanuel's brother, Ezekiel Emanuel, who is serving as a special adviser on health care to Orszag (Pear, New York Times, 4/18).
Families USA and the Pharmaceutical Research and Manufacturers of America this week will begin urging Congress through lobbying and advertisements to pass three key portions on health care reform. The proposal includes:
- Increasing Medicaid eligibility to 133% of the federal poverty level and allowing beneficiaries to use Medicaid funds to purchase private coverage if it saves the program money;
- Offering income-adjusted subsidies for families buying coverage on the private market and restructuring the insurance market to prevent insurers from denying coverage to those with pre-existing conditions; and
- Capping out-of-pocket expenses to provide families with financial protection.
PhRMA President and CEO Billy Tauzin said, "We hope [Republicans] understand that our politics [are] very different this year and that's a product of the election. We got a new team in town who could, I guess, pass what they wanted to," adding, "Our job is to make sure that what they pass has as many elements of our principles in them as possible, and that means being at the table." He also said, "The last place I want to be in is where we're fighting over a public plan. It takes us all the way from the table, and that's not a good thing" (Frates, Politico, 4/20).
In addition, a health care working group, formed by the Pharmaceutical Industry Labor-Management Association, is distributing to lawmakers a list of health care principles favored by its members. The plan does not address the public option, but promotes the creation of a safety net for workers who lose their insurance. It also recommends requiring employers to cover workers or pay into a government health care fund. The proposal also rejects the possibility of taxing employer benefits and states that people buying insurance in the individual market should receive the same tax exemption. The group includes PhRMA, five state branches of the AFL-CIO and several other national unions (Edney, CongressDaily, 4/17).
Letter to the Editor
"I read with amusement the Journal's editorial, 'The End of Private Health Insurance' (April 13), which parrots the talking points of the health insurance lobby," House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif.) writes in a Journal letter to the editor. He cites the case of the insurance firm Health Net, which "rewarded employees based on how many individual policyholders they could drop from the rolls of the insured and how much money was saved." Stark adds, "Over the past decade, Health Net has been forced to pay hundreds of millions in fines and court settlements for unfairly rescinding people's coverage after enrolling them." The letter concludes, "Insurance companies have been reaping billions in profits by denying people care and coverage. No wonder they don't want to compete with a public health insurance plan that would keep them honest and be accountable to the people" (Stark, Wall Street Journal, 4/18).
ABC's "This Week" on Sunday included interviews with Boehner and Rahm Emanuel in which they spoke about potential health reform (Stephanopoulos, "This Week", ABC, 4/19). A transcript is available online.