As the Senate begins debate on its health reform bill, Kaiser Health News dug through the 2,074-page bill and found several special interest provisions that have thus far flown under the radar. Congress has a long history of adding items that may not be able to get passed on their own to larger comprehensive bills that are more likely to be approved by both houses and the Senate health care reform bill is no exception. Some of the special interest additions to the bill include the following:
Nursing Mothers Get A Break
Employers would be required to provide an unpaid "reasonable break time for nursing mothers" in the first year after giving birth. Women would be provided a private place, other than a bathroom, to use a breast pump. The provision exempts companies with fewer than 50 workers if the requirement would impose "an undue hardship," a determination left to the employer to make. To encourage businesses, the legislation would give them a tax credit toward the costs of providing a suitable space for women...
Learning To Be An Adult
Being a teenager is tough. The Senate wants to help with a provision allocating $400 million from 2010 to 2015 to help teens make the transition to adulthood. The money goes to states primarily to set up sex education programs. But the money can also be used for "adult preparation" programs that promote "positive self esteem, relationship dynamics, friendships, dating, romantic involvement, marriage and family interaction...."
Retiree Health Benefits
The Senate bill includes a provision designed to ease out-of-pocket costs for retirees who are under 65 but who still get health insurance from their former employer. The bill would create a temporary "reinsurance" program under which the government would pick up 80 percent of some high-cost insurance claims filed by retirees...
Promoting Use Of Bone Density Scans
Rapid increases in Medicare payments for imaging services led lawmakers to reduce payments for some services, including those that test bone density.... [but] raising the payment for bone density scans is a priority for two senators whom Reid hopes to win over in his bid to get 60 votes for his health care plan: Blanche Lincoln, a moderate Democrat from Arkansas, and Olympia Snowe, a moderate Republican from Maine.
Setting ER Prices
Hospitals would have to limit how much they charge low-income uninsured emergency patients to the lowest amount they receive from insured patients for the same services. The provision in the Senate bill comes more than six years after consumer groups in California and Texas began highlighting how hospitals were charging uninsured patients several times more for the same services as insured patients.
Singing The Blues
Non-profit Blue Cross and Blue Shield health plans would have to spend at least 85 cents of every premium dollar on health services or forfeit their special federal tax deductions. The Congressional Budget Office estimates this provision in the Senate bill would cost the Blues' plans about $400 million over the next decade....Historically, Blue Cross and Blue Shield plans received a tax-preferred status because they were created to provide a more significant "community benefit" than other insurance companies...
Transparency in Drug Pricing
Pharmaceutical benefit managers are a critical part of the nation's health care system. Administering drug plans for more than 210 million insured Americans, they negotiate discounts on prescription drugs with retail pharmacies and wholesalers and also get rebates from drug makers. At the urging of Sen. Maria Cantwell, D-Wash., the Senate Finance Committee inserted language into its health bill that would force the benefit managers, known as PBMs, to disclose details of those negotiations - including how much of the savings were passed on to consumers.
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