February 11: Health Care Reform News
Top stories
Pelosi Makes Her Case: A Majority Is 51 Votes
Roll Call
Feb. 10, 2010
House Speaker Nancy Pelosi (D-Calif.) is pinning the blame on Republicans for a lack of bipartisanship in Congress and plans to bypass them if they continue to oppose efforts to enact near-universal health care.
Pelosi Aide Outlines Healthcare Endgame (Subscription required; full text below)
National Journal
Feb. 9, 2010
House Speaker Pelosi's top healthcare adviser today outlined a plan that would allow both chambers to make changes to the Senate healthcare overhaul before the overhaul becomes law.
Insurance
Sticker Shock: Unpacking the Anthem Increase
The New Republic
Feb. 9, 2010
The Anthem Blue Cross rate increase of nearly 40 percent in California is not, to be clear, just another story of medical care getting more expensive because of technology, over-treatment, monopoly pricing, or any of the other familiar drivers of system-wide costs. ... Policy wonks call this the adverse selection death spiral. And the key thing to remember is that it happens all the time, even when the economy is strong.
Other Insurers Raising Health Care Rates Too
The San Francisco Chronicle
Feb. 11, 2010
Anthem Blue Cross has come under fire after it told thousands of individual policyholders their premiums would increase on March 1 by as much as 39% and, in some cases, more. But consumers say other carriers, including Health Net and Aetna, are also raising rates.
Transparency/Safety
The Trouble With Comparative Effectiveness
The Wall Street Journal
Feb. 11, 2010
An examination of one of the best-known examples of a comparative-effectiveness analysis shows how complicated such a seemingly straightforward idea can get.
State news
Virginia Advances Legislation Against Insurance Requirement
The New York Times – Prescriptions blog
Feb. 10, 2010
Virginia took another step on Tuesday toward becoming the first state to enact legislation to exempt its residents from a central feature of President Obama’s health care plan: a requirement that everyone buy health insurance or pay a penalty.
Patrick Wants Health Cost Veto
The Boston Globe
Feb. 11, 2010
Governor Deval Patrick is seeking sweeping authority to review and reject rates charged by hospitals, physician groups, medical imaging centers, and insurers, in a broad new effort to make health care more affordable, particularly for smaller companies and their workers.
MN: A Target for Shady Health Plans: The Uninsured
The Minneapolis Star-Tribune
Feb. 11, 2010
As the problem of deceptive marketing swells, Minnesota is suing firms that sell discount cards.
Texas Health Care Providers Could See Medicaid Fees Reduced
The Dallas Morning News
Feb. 11, 2010
Doctors, dentists and hospitals would see their Medicaid fees trimmed by at least 1 percent under possible budget reductions offered Wednesday by state Health and Human Services Commissioner Tom Suehs.
New Jersey Is Added to Trial Program to Streamline Health Insurance Paperwork
The New York Times
Feb. 10, 2010
Five of New Jersey’s largest private insurers plan to offer doctors and hospitals the ability to use a single Web portal to check a patient’s coverage and track claims, regardless of which of those five health plans they are enrolled in.
Medicare/Medicaid
Medicare Pay Cuts to Doctors: The Latest Patch
The Wall Street Journal – Health Blog
Feb. 10, 2010
Medicare payments to doctors are set to be cut by 21% on March 1, but the jobs bill Senate Majority Leader Harry Reid is putting together includes a "short-term patch" that would temporarily block the cuts.
Reform efforts
New England Journal of Medicine
Feb. 10, 2010
Several new articles on health reform were recently published in the NEJM, including:
Forging Ahead — Embracing the “Reconciliation” Option for Reform, Henry J. Aaron, Ph.D.
Throwing Down the Gauntlet — Televised, Bipartisan Health Care Discussions, John K. Iglehart
Can the States Nullify Health Care Reform?, Timothy S. Jost, J.D.
The Constitutionality of the Individual Mandate for Health Insurance, Jack M. Balkin, J.D., Ph.D.
Slate
Feb. 9, 2010
What game theory can teach us about the fate of health care reform.
Can Judd Gregg Help White House Save Health Bill?
Politico
Feb. 11, 2010
Is Judd Gregg a tease or a real potential partner for President Barack Obama in trying to salvage some health care reform in this Congress?
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Pelosi Aide Outlines Healthcare Endgame
National Journal
Feb. 9, 2010
House Speaker Pelosi's top healthcare adviser today outlined a plan that would allow both chambers to make changes to the Senate healthcare overhaul before the overhaul becomes law.
Wendell Primus said the plan is to have President Obama sign the Senate bill before signing the legislation making the changes, even though Congress will approve them in reverse to satisfy skeptical House members who refuse to pass the Senate bill before changes are made.
"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," Wendell Primus told health policy experts gathered at 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. House members have insisted both chambers approve the changes, which likely will go through the reconciliation process to require 51 votes rather than the 60-vote supermajority in the Senate, before they pass the Senate bill.
Primus also mentioned bill drafters would need to use certain language to ensure the plan works, although he did not elaborate.
"There's a certain skill, there's a trick, but I think we'll get it done," he said.
Negotiators first must agree on changes.
The Senate parliamentarian still needs to weigh in, he added.
Despite all these complications, Primus said, lawmakers will be "very close to being done" with an overhaul by Easter recess.
He said the prenegotiated package would be based on agreements reached before Democrats lost their 60-seat supermajority in the Senate last month after the special election in Massachusetts won by GOP Sen. Scott Brown.
"It is quite conceivable that we could have a prenegotiated package much like a conference report, if you will," he added.
Those agreements include changes to the Senate's excise tax on high-cost plans so it hits fewer people; increased federal subsidies; a plan to close the coverage gap in Medicare prescription drug coverage; and elimination of a deal that Senate Majority Leader Reid made with Sen. Ben Nelson, D-Neb., to gain his vote.
Reid inserted a provision in the Senate overhaul bill that requires the federal government to cover Nebraska's entire costs for a Medicaid expansion.
Sweetheart deals such as Nelson's and additional deals between the White House and industries soured the American public on the bill, Primus said.
Obama attempted this week to revive the overhaul by announcing a bipartisan healthcare summit at the White House later this month. House Republican leaders sent a letter Monday to White House Chief of Staff Emanuel asking that governors and state legislators be invited as well, given at least 36 state legislators have introduced legislation allowing them to opt out of a federal overhaul.
"One of the fundamental problems with the approach the Obama administration has taken to health care is that it seems rooted in a Washington-knows-best mentality." House Minority Leader Boehner said. "Excluding the voices of America's governors and state legislators from the proposed 'summit' would compound this error."
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