Following last week’s health care summit and release of
his health care reform proposal, the President today urged Congress to end the
debate and bring health reform across the finish line. In his remarks, the
President painted a vivid picture of what it means to not pass health
reform, including more uninsured families, additional people denied coverage
because they are sick, and skyrocketing premiums. Yesterday, we reported on
what doing nothing would mean to families.
The Proposal
The President did not release a revised health care
proposal but said he will incorporate at least two Republican ideas brought
forward at the health care summit. This includes sending in “secret shoppers”
to Medicare and Medicaid providers to combat fraud and abuse (an idea offered
by Sen. Coburn) and providing a funding appropriation of $50 million in state
demonstration grants to find alternatives to resolving medical malpractice
disputes (similar proposals have been included in Republican bills).
On Tuesday, the President also sent a letter to
congressional leaders outlining two other ideas that he is willing to consider
for inclusion. One idea was suggested by Sen. Barrasso to allow the Health
Savings Accounts (HSAs) in the Exchange.
The other idea (which was initially raised by Sen.
Grassley at the summit) would address what the President acknowledged are
“inadequate” reimbursement rates in Medicaid. Improving doctor reimbursement
would help increase access to care for the millions of new families entering
Medicaid under health reform. As you may recall, the House bill already
includes a phased-in increase in Medicaid reimbursement rates (tied to those offered in Medicare) for primary care services, with the federal government
picking up the tab for most of the increased costs. It is not evident whether
this or a similar provision will ultimately make it into a bill but the
President’s recognition of the issue is a positive sign.
We expect legislative language soon and will provide more
details then.
Timing/Process
President Obama said the time for discussion is over and that he wants an “up or down” vote scheduled within the next couple of weeks. Media
reports suggest that Democratic leaders are indeed leaning toward going the
reconciliation route. In the world of congressional rules, this means that the
House would first pass the Senate health bill for the President’s signature,
followed by both chambers passing, through a simple majority vote, a second
bill containing the various “fixes.” Reports have continued to cite a middle to end of March timeline.