House Republicans are holding committee hearings this week on the health law’s provisions governing Medicare, abortion and small business. Meanwhile, in remarks Monday, Department of Health and Human Services Secretary Kathleen Sebelius signaled that the administration would take steps to make sure that a long-term health insurance program created in the law is financially sustainable.
JACKIE JUDD: Good day, this is Health on the Hill. I am Jackie Judd. House Republicans this week begin in earnest hearings on various aspects of the health care overhaul law. The House, of course, voted to repeal the law, but the Senate beat that back and now a more detailed process begins. Here to give us a preview of the week ahead is Mary Agnes Carey, senior correspondent for Kaiser Health News. Welcome, Mary Agnes. Let’s begin with House Ways & Means, they are meeting on Thursday to discuss Medicare.
MARY AGNES CAREY: The effect of the health law on the Medicare program. Don Berwick, who is the CMS administrator, will be speaking, as will Rick Foster, who is the CMS actuary. They no doubt will have different views on the cost of the bill and some other provisions, but this is a central area that Republicans have wanted to focus on — what does it do, what the law do for seniors and for Medicare — and this is exactly what will be happening at that hearing.
The effect of the health law on the Medicare program. Don Berwick, who is the CMS administrator, will be speaking, as will Rick Foster, who is the CMS actuary. They no doubt will have different views on the cost of the bill and some other provisions, but this is a central area that Republicans have wanted to focus on — what does it do, what the law do for seniors and for Medicare — and this is exactly what will be happening at that hearing.
JACKIE JUDD: And what concerns will we hear from the Republican members of that committee?
MARY AGNES CAREY: They will talk about the reductions to Medicare Advantage plans for example — these are the private insurance plans in the Medicare program. They will talk about other payment reductions in the Medicare program and how this could hurt access to the program.
They will look at some other provisions they think are double counting. You can’t reduce the cost of the Medicare program, or rather extend the life of the Trust Fund and cut the deficit. This has been an ongoing debate between the administration and Republicans. They talked a lot about these themes in the election and this is a continuation of that.
JACKIE JUDD: And what other aspects of the law will be taken up this week?
MARY AGNES CAREY: The House Small Business Committee is going to look at administrative burdens here. They are going to focus on the 1099 provision. This is something the Senate actually voted to repeal last week. That requirement on small business — if you buy more than $600 of goods and services from a vendor you have to produce a 1099 form. It is viewed as an onorous requirement and the Democrats and Republicans and President Obama have all said they want to scrap it.
The House Energy and Commerce and Judiciary Committees are going to look at abortion and the health care law, so there are four hearings right there focusing on health care.
JACKIE JUDD: Moving away from the Hill for a moment, President Obama and other officials in the administration are still effectively trying to sell the law to opponents.
Mr. Obama spoke today to the Chamber of Commerce, among the most vociferous critics of the health care reform law. His speech was about many things, but he included health care in that. And then Health and Human Services Secretary Kathleen Sebelius actually spoke here at the Kaiser Family Foundation about the CLASS Act, the voluntary insurance program to give people long-term health insurance, and in her comments she seemed to be speaking to critics who worry that this program will simply cost too much. Let’s take a listen.
KATHLEEN SEBELIUS: The law says clearly that the program must be able to pay for benefits over the long-term with the premiums it takes in, that no taxpayer dollars will be used to pay for class benefits. This is non-negotiable and it has been the starting point for every conversation about flexibility that we have had. So, that becomes a fundamental principle.
JACKIE JUDD: Mary Agnes, you heard Kathleen Sebelius speak in which she laid out really what the program is about, what it is intended to do — what was she saying to the critics?
MARY AGNES CAREY: I want to be flexible. I know that you are worried that this program will cost too much and won’t pay for itself and it has to pay for itself. She was very clear in her remarks. She laid out a few options, for example, would you increase premiums to match an increase in benefits? Do you close loopholes that might cause people to drop out and not get back in? Building more awareness of the program, to make sure people know it’s out there and they will participate. I think both she and the president are trying to signal that they will work with opponents where they think it is appropriate, but they are not going to back away from the law.
President Obama was very interesting at the Chamber of Commerce, he said look, I can imagine you don’t really like the idea of more regulation, that how could more regulations be good for you? Then he talked about the small business tax credits. He talked about studies that show, and there are some who disagree with this, but that show that the health law will actually reduce health care costs for workers and for their employers and that we can’t turn back, that our health care costs make us uncompetitive and we need to move forward to make changes in the system.
So, I think both of them, we have heard this theme also from Democrats on Capitol Hill, we want to work with you but we want the law to go forward.
JACKIE JUDD: The bill was signed into law a year ago next month.
MARY AGNES CAREY: That’s right.
JACKIE JUDD: My guess is the Democrats did not expect that a year later they would still have to be pushing as hard as they have to to make sure it’s implemented as they intended and also accepted by the American people.
MARY AGNES CAREY: It is very difficult, I think, for the administration now and for Democrats; there are so many things going on. We have all the disputes on Capitol Hill we have been talking about, you have Supreme Court rulings, some in favor of the administration’s law and some that are not, in particular the individual mandate.
You have state governments coming back to Washington saying we don’t know if we can comply with certain components of the law, for example the maintenance of effort in Medicaid. And you have the American public that is split on the bill.
JACKIE JUDD: And the court cases.
MARY AGNES CAREY: And the court cases, exactly. And so the administration has to kind of fight a war on all fronts, if you will, as they implement the health law. But I think looking back at how difficult it was for them to pass it, many people knew this would be the next chapter and they are certainly attacking it head on. Whether or not they will be successful, we will have to wait and see.
JACKIE JUDD: Okay, thank you so much, Mary Agnes Carey of Kaiser Health News.
MARY AGNES CAREY: Thank you.