Just when everyone thought health care reform was dead….it’s baaaack!!! The last week of February showed the American people that President Barack Obama and Congressional leaders are committed to advancing and enacting meaningful health care reform.

The Latest!
On Monday, February 22, President Obama unveiled an estimated $950 billion health care proposal designed to reinvigorate the health care reform debate.  The President’s proposal used the Senate-passed Patient Protection and Affordable Care Act (H.R. 3590) as a template and is an attempt to bring together Senate and House measures that passed last year and served as a blueprint for the summit that was held with House and Senate leadership.

Although some of the details of his proposal are vague, there are notable similarities and changes that ANA would like to highlight for you:

Similarities:

The President’s proposals would:

• Provide health insurance for 31 million Americans who are currently without insurance.
• Put an end to insurance industry practices such as denying coverage for pre-existing conditions.
• Establish state-based exchanges for the uninsured to purchase insurance (similar to Senate plan— the House version created a national exchange system).
• Directly call for an increase in the number of nurses in the U.S. It aims to address the critical problems facing nursing today: workforce shortage and retention (but does not offer detailed proposals).

Changes in Proposal from Senate bill (H.R. 3590):

The President’s proposal:

• Eliminates the special Medicaid deal for Nebraska, which Republicans dubbed the “Cornhusker Kickback.” This was widely seen as the most criticized element of H.R. 3590. The proposal also provides additional funding to all 50 states for the expansion of Medicaid.
• Scales back the tax on “Cadillac” insurance plans and delays the tax for all plans until 2018. It further raises the threshold at which the tax would kick in to $27,500 for an annual family plan, up from $23,000.  
• Closes the “donut hole” for Medicare prescription drug beneficiaries by 2020. This new provisions goes further than the Senate bill, which would have only narrowed it to 50%.
• Incorporating additional suggestions from Republicans, the proposal seeks to boost measures to crack down on waste, fraud and abuse in Medicare and Medicaid.
• Boosts tax subsidies for low- and moderate-income individuals to purchase insurance and bigger penalties on larger employers that do not provide health insurance.
• Creates a new Health Insurance Rate Authority to provide assistance and oversight to states in controlling exorbitant rate hikes by the nation’s health insurance companies. It would also give Kathleen Sebelius (Secretary of Health and Human Services), new powers to review premium hikes by private insurance companies – and in some cases, block those deemed excessive.

On Wednesday, February 24, House lawmakers voted overwhelming 406-19 to pass H.R. 4626 “Health Insurance Industry Fair Competition Act.” The legislation will now move to the Senate for consideration. H.R. 4626 is seen as a building block for the larger health care bill. The legislation will curb the broad immunity from anti-trust laws currently enjoyed by the insurance industry under the McCarran-Ferguson Act and will provide health insurance companies with competitive incentives that will promote better affordability, improved quality, increased innovation, and greater consumer choice.

On Thursday, February 25, the long awaited White House Summit was held at Blair House in Washington, DC. President Obama convened the meeting with House and Senate leaders, from both political parties, in an attempt to find common ground in advancing health care reform. While no definitive action was decided during the meeting, there is late word that President Obama is set to outline his plans moving forward with health care reform in the very near future?

Flashback!
Status of Health Care Reform in the U.S. House of Representatives:
There are three House committees that have jurisdiction over Health Care reform: the Energy and Commerce, Ways and Means and Education and Labor Committees.  All three Committees came together to create and release a discussion draft in early June.  Each of the three committees immediately held independent hearings on the draft (ANA testified before two of the three –Energy and Commerce and Ways and Means).  Following these hearings, formal Legislation, “America’s Affordable Health Choices Act of 2009” (H.R. 3200) was introduced on July 14^th. 

In July, each of the three committees considered portions of H.R. 3200 that fell within their jurisdiction, made amendments (aka “marked-up”), and successfully voted, largely along party lines, to move the bill out of committee.  Over the course of several months, the pieces of the bill that each committee considered and amended were reintegrated back into one comprehensive piece of legislation.  The bill was given a new number (H.R.3692) and was released on October 29^th

On November 7^th, the House of Representatives passed H.R. 3692 by a vote of 220-215.  The bill passed with 39 Democrats voting in opposition and one Republican, Rep. Anh “Joseph” Cao of Louisiana, voting in favor.  Click here to see how your Member voted.   

What’s next: See “Final Steps.”

Status of Health Care Reform in the Senate:
There are two Senate committees that have jurisdiction over health care reform: the Health, Education, Labor, and Pensions (HELP) Committee, and the Finance Committee.  The HELP Committee released language for its draft, the “Affordable Health Choices Act” (S. 1679) on June 9^th, and considered amendments to the bill over the course of 11 days in June.  After approving 36 Democratic amendments and 161 Republican amendments, the bill was approved by the committee with a party-line vote on July 15^th.

The Finance Committee released its health care reform proposal “America’s Healthy Future Act” (S.1796) on September 16, and began consideration of 564 amendments on September 22^nd.  The committee completed consideration of amendments on October 2^nd, and the bill was approved with the support of all committee Democrats and one Republican – Senator Olympia Snowe of Maine—on October 13^th.

On November 18^th, Senate Majority Leader Reid released the combined version of the Senate bills – H.R. 3590, the “Patient Protection and Affordable Care Act.”  On November 20^th, the Senate voted on a party line (with the two Independents voting in favor) to proceed with debate on the health care reform bill.

On December 24^th after months of negotiations, debate and filibuster threats the Senate passed H.R. 3590, the Patient Protection and Affordable Care Act on a party line vote of 60-39 (Senator Jim Bunning (R-KY) did not vote).  Click here to see how your Senator voted.

What’s next:   See “Final Steps.”

Final Steps:  :  While House and Senate leadership, along with guidance from the President, set out to reconcile the two bills in informal conference committee, the recent special election victory by Republican Scott Brown (R-MA) to fill the late Senator Ted Kennedy’s Senate seat has put the future of health care reform in doubt. As of now there are still many options available but no clear way forward. The President, along with the House and Senate leadership, are continuing to try to find a way forward on this important issue.

Tags: antitrust, February 2010, H.R. 3590, H.R. 4626, health care reform, Health Insurance Industry Fair Competition Act, McCarran-Ferguson Act, Patient Protection and Affordable Care Act, President Barack Obama, President’s proposal

This entry was posted on Friday, March 5th, 2010 at 3:55 PM and is filed under Archived. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.