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This Week in Health Reform: December 14-18, 2009

Dec 22, 2009

Health Care Reform Update

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DECEMBER 18, 2009

This Week in Health Reform                      

In an ongoing effort to reach a consensus, Democratic senators this week removed any form of a public option from the emerging Senate bill. Lawmakers continued debate for the third week in a row, including the last two weekends, with the hope of finishing by Christmas.

With the Senate vote likely to occur in the next few days, we encourage you to engage your Senators now. To make your voice heard in this debate visit the Health Action Network and tell your Senator we need and support reform, but the current proposal is not the reform we need.

Senate Negotiations

Senate Continues Debate on Health Care Reform Bill: Senate Democrats moved to eliminate the proposed Medicare buy-in for those between the ages of 55 and 64 - a central component of the compromise announced last week as an alternative to a public option. While official Congressional Budget Office (CBO) cost estimates have yet to be released, the Medicare expansion drew significant criticism across the health care industry.

Sen. Joe Lieberman (I-CT), whose vote is considered crucial to the passage of this legislation, voiced concerns over Medicare expansion and denounced the measure over the weekend, leading to its removal from the bill.  Media reports have indicated that, since the removal of this measure, Sen. Lieberman has warmed up to the legislation. His potential support gets Senate Majority Leader Harry Reid (D-NV) closer to the 60 votes needed to pass the legislation. Yet, the removal of the Medicare expansion signaled that several leading liberal lawmakers appear to have abandoned hope for a public option in order to pass the legislation.

And, despite a one-on-one meeting Tuesday with President Barack Obama to review other proposals by Democratic Senate leaders, Sen. Ben Nelson (D-NE) indicates that he still has concerns about other measures in the bill including: using federal funding for abortions, proposed tax increases and cuts in Medicare. Sen. Nelson is the only known holdout among 60 senators whose votes are needed to move the bill, however there are several other Members who continue to voice concerns over the legislation, and who may have conflicting concerns.

In a meeting at the White House on Tuesday, President Obama encouraged Senate Democrats to overcome lingering disputes and push the bill through before Christmas. He declared that they were "on the precipice" of enacting historic legislation. However, former Democratic Party chairman Howard Dean stated that the Senate bill should be scrapped if it fails to include a public option.

In addition, on Tuesday evening Senate lawmakers voted down (51-48) a controversial amendment offered by Sen. Byron L. Dorgan (D-ND) that would allow for the importation of prescription drugs from other countries. Both White House officials and the pharmaceutical industry had lobbied against the passage of the amendment, citing potential safety hazards.

Republicans Stall Debate: News media report that Senate Republicans vowed to use tactics to delay voting on the reform proposal. On Wednesday, Republican Sen. Tom Coburn of Oklahoma demanded that an amendment to create a single-payer system proposed by Sen. Bernie Sanders, (I-VT) be read in full. The reading of the 700-page amendment lasted for almost three hours before the Parliamentarian made a controversial ruling allowing Sen. Sanders to withdraw it.

Senate Democratic Leaders Vow to Close Medicare Doughnut Hole: Senate Democratic leaders this week joined their House counterparts in vowing to close the Medicare Part D prescription drug coverage gap , or "doughnut hole," if President Obama's health care reform effort passes. Lawmakers indicate they expect the pharmaceutical industry to add at  least $20 billion more to the $80 billion the companies originally pledged to help close the "doughnut hole." Drug makers have already offered a 50 percent discount on brand name drugs that fall in the coverage gap, and this offer has been incorporated into the legislation. News media reports that several Senators expect the industry to agree to the increase given their recent vote against drug importation.

Other Activities

New Government Report Says Health Care Costs Will Increase Under Reform Plan: Government actuaries at the Health and Human Services Department released a report on Friday estimating that under the current Senate reform bill, total health care costs in the U.S. would be $234 billion higher than if the bill failed. The report also indicated that the proposed Medicare costs savings could lead to cuts in services and may be unrealistic. Further, the long-term care insurance plan included in the bill would be unsustainable. In reaction, Sen. Chris Dodd (D-CT) pointed to an earlier report by the Congressional Budget Office which previously assessed the long-term care insurance plan to be solvent for 75 years.

Public Opinion

Americans Oppose Reform Plan: As details of the Senate's compromise reform plan emerge through the ongoing debate, the public has become increasingly skeptical about the proposals being discussed in Congress. A new Washington Post/ABC News poll finds that more than half of those polled are generally fearful that reform will bring higher costs while worsening the quality of their care. Fifty-five percent say the overall cost of care will go up sharply, and only 37 percent say the quality of their care will increase with reform.

Looking Ahead



Sen. Reid is working towards a procedural vote this weekend with a final vote targeted for December 23rd; however, given recent delays this timing looks less likely, and Sen. Reid has threatened to keep the Senate in session on Christmas Eve or even Christmas Day.


Editor's Note: In light of the holidays we will not be distributing a health reform update the week of Dec. 28.

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Health Care Reform Update

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