2009-09-10
On September 9, President Obama gave a speech to a special joint session of Congress outlining his plan for health reform and reigniting Democrats’ goal to pass comprehensive health reform this year.
In his speech, the President outlined three essential goals that are vital to reform efforts in this country, including: ensuring the current system remains secure and stable for those who already have insurance coverage and are happy with it; making insurance coverage affordable and accessible to those who need it; and reducing unnecessary costs and waste in the current system. Democrats in the House of Representatives and the Senate came away even more determined to pass legislation this year. Meanwhile, the official response from the Republican leaders is that they urge President Obama to scrap his ideas and start anew. Their list of objections to the President’s plan include: the public option, which they say would drive out private insurers and the Democrats’ insistence on a mandate that all Americans buy health insurance, either through work, on their own, or with a public subsidy.
Status of Health Reform Legislation
There are three committees in the House of Representatives that have been working on a bill, H.R. 3200. Two of the committees have passed versions of the bill, the third is close to finishing, but likely is waiting for action by the Senate. In the Senate, two committees are working on legislation. One has passed a bill along party lines. The second committee, the Finance Committee, chaired by Senator Max Baucus (D-MT), has been working for months to get bipartisan support for a bill, but it is not clear he will achieve this even though his bill is more moderate than the other Senate bill and the House versions. Consequently, Senator Baucus has indicated that he will mark up a draft bill the week of September 21 and will move ahead with or without votes from both sides.
Next Steps
What will happen next is that the three House bills will be melded into one bill and voted on by the House of Representatives, and the Senate bills will be combined and passed by the full Senate. Then, a conference between the House and Senate will take place to iron out differences and send a bill to the President.
Outlook
At present, ASH believes that we can expect a health reform bill sometime around Thanksgiving or early December. We believe there will be a bill because of several reasons. First, President Obama is absolutely committed to this, and his speech to the Congress on Wednesday night reignited efforts to pass a bill this year. Second, the Democrats who support health reform are in the majority and, while they would like to have a bipartisan bill, they can pass something without Republican support. Finally, there is actually a lot of agreement on legislation despite the media reports of only differences.
What do policy makers agree on?
There is agreement that we can do more to make insurance affordable and accessible to more Americans, particularly those in the private insurance market – people who do not get their insurance from employers, Medicare or Medicaid. There is also agreement that more needs to be done to reduce costs and waste in the current system. There is also agreement that we need more improvements to our health system so there is greater attention to primary care, better ways to coordinate care, and ways to improve quality. The media has focused on the disagreements, including the proper role for government and the costs of the bill.
Throughout the health reform debate in Washington, ASH has been advocating the following:
- Congress should maintain policies that ensure patients have direct access to specialists, including hematologists.
- Legislation must recognize the value of cognitive services and improve Medicare payment for these services.
- Legislation should not establish policies that increase payment to primary-care services by reducing payment for specialty services.
- Congress should eliminate the Medicare Sustainable Growth Rate (SGR) formula, the current system for adjusting physician payments, and provide physicians with an adequate annual update in fees.
Of these four issues, the Congress and the Administration have recognized the importance of the last item – fixing the SGR. While it is likely to be included in legislation because of the high cost, the legislation may only include a temporary fix. The other items are less clear. There is tremendous emphasis on primary care and this may come at the expense of specialists.
Below are links to additional information concerning health reform:
back to top
