Health care reform: a status report

As Congress' August recess approaches, it is becoming clear that passage of a health care reform bill that expands coverage and restrains costs is not going to happen this summer, as many had expected. In both the House and the Senate, bills are stuck in committee, but Congressional leaders vow they'll be ready for a vote this fall.

In the House, the 1,000-page America's Affordable Health Choices Act (HR 3200) has been approved by the Ways and Means Committee and the Education and Labor Committee but has stalled with the Energy and Commerce Committee. The fiscally conservative Blue Dog Democrats have refused to pass the bill until cost concerns have been resolved. An analysis by the Congressional Budget Office recently concluded that the plan would cost $1 trillion and increase the federal budget deficit by $239 billion over the next decade. Lawmakers' latest idea of establishing an independent panel to make cuts to Medicare would only save about $2 billion, according to the CBO.

Key features of the House plan as it now stands include the following:

• a new government-run health insurance plan that would compete with private insurers,
• penalties for employers who do not provide health insurance for their employees (with a small business exemption) and for individuals who do not purchase it,
• subsidies for lower- and middle-class families to pay for health insurance premiums,
• a prohibition on denying coverage because of health status or pre-existing conditions,
• a health insurance exchange that would help individuals and small businesses comparison shop among private and public options,
• caps on annual out-of-pocket expenses,
• an expanded and improved Medicaid program,
• a prohibition on cost-sharing for preventive services,
• elimination of the Medicare Part D “donut hole,”
• Medicare reform, including repeal of the flawed sustainable growth rate (SGR) formula,
• a 5-percent increase in Medicare payments for designated services provided by primary care physicians,
• a 1-percent surtax on households earning more than $350,000,
• a 5.4-percent surtax on households earning more than $1,000,000.

In the Senate, the Affordable Health Choices Act, sponsored by Sen. Edward Kennedy, has been approved by the Health, Education, Labor and Pensions Committee. Its coverage provisions are similar to those in the House bill. Meanwhile, the Finance Committee, led by Sen. Max Baucus, is working on its own bill, with debate focused primarily on the funding of health care reform. The two versions will need to be combined into a single bill before going to the full Senate for a vote.

While there's progress in Washington, the public may be having some misgivings. The latest USA Today/Gallup poll found that more Americans disapprove (50 percent) than approve (44 percent) of the way the President is handling health care policy. New York Times columnist David Brooks speculated as to why: "People have a legitimate question: How is it we're going to cut my costs by creating a new trillion-dollar entitlement? ... How are we going to control costs without anybody sacrificing anything?"

Obama's prime-time news conference last Wednesday was intended to build support for health care reform, but syndicated columnist Mark Shields observed that the speech may have fallen short: "All I could think of was, Adlai Stevenson once said when he was introducing John Kennedy -- remember in classical times, whenever Cicero spoke, the people reacted and said, 'He spoke so well.' But when Demosthenes spoke, the people said, 'Let us march.' And after the Wednesday presentation, there was nobody saying, 'Let us march.'"

Posted at 01:36PM Jul 29, 2009 by Brandi White  |  Comments[1]