Update on Health Care Reform Legislation
While news of health care reform has taken a backseat lately to fallout from the Dec. 25 terrorist attempt and the Haiti earthquake, Congressional leaders are continuing efforts to merge versions of the House and Senate health care bills passed last year.
One notable cut took place Saturday, when Nebraska Democratic Senator Ben Nelson agreed to drop the federal subsidy for Nebraska’s Medicaid program. Dubbed the “Cornhusker Kickback”, the subsidy gave special treatment to Nebraska’s Medicaid program in order to induce Nelson to cast the all-important 60th vote needed to defeat a Republic filibuster and pass the Senate health care bill. Given that the CBO estimated that the “Kickback” would cost taxpayers an additional $100 million over ten years, the compromise was not a popular one. Nelson agreed to drop the subsidy, reasoning that it had become a “sticking point” in the negotiations.
Despite winning Nelson’s vote, the Senate may have more problems ahead. Polls show that Massachusetts Attorney General Martha Coakley, the Democratic candidate running for the late Ten Kennedy’s (D-Mass) Senate seat, is slightly behind her Republican opponent, Republican State Senator Scott Brown. If Brown wins and Kennedy’s seat goes to a GOP member, the Senate may again lack the 60 votes needed to pass the health reform bill when it comes out of committee.
After the jump - House/Senate compromises continue
In the interim, House Speaker Nancy Pelosi has told her House colleagues that they will have something they can “sink their teeth into” this week. One contested issue has been how to structure the “insurance exchange”, where private health plans would compete for customers.
House lawmakers have called for a national exchange (i.e., where private health plans would have a network of providers with doctors/hospitals in every state and compete with a nation-wide, government-run public insurance plan), while the Senate has called for state-based exchanges (where plans would be restricted to individual states and regions, allowing individual states to opt-out of a nationwide plan). Plans offered on the exchange would be issued by private insurers who must meet government requirements such as offering minimum benefits packages, levels of allowed cost-sharing through co-payments and deductibles, etc.
Other hot button issues include abortion coverage, the availability of health care to immigrants, and whether health insurance companies should be stripped of their anti-trust exemption. Currently, health insurance and medical malpractice insurance companies are excluded from the scope of federal laws prohibiting price fixing, bid rigging, and market allocation. Instead, regulation of insurance companies has been left to the individual states.
The Health Care Lawyer Blog will continue to keep readers updated as developments unfold.
