February 2010 Archives

Coverage of the aftermath of the Health Care Summit is extensive, with most media outlets reporting that Democrats plan to move forward with the Obama plan with or without the help of Republicans but that it remains uncertain whether the necessary votes will materialize:

Obama, Democrats Ponder Next Health Care Moves; Reuters - February 26, 2010        

Now the White House and congressional Democrats are in the difficult position of deciding whether to force a reform of the $2.5 trillion U.S. health care system through Congress with a simple majority vote - a maneuver Republicans have condemned.

Obama Bipartisan Health Summit Clears Path to Party-Line Vote; The Bloomberg Report - February 26, 2010

President Obama began yesterday's health care summit saying he wanted to find bipartisan ways to fix the health care system. By the end of the health care summit, President Obama will pursue a partisan plan costing about $950 billion over 10 years and covering 31 million uninsured Americans.

After Summit Flop, Democrats Prepare to Go It Alone on Obamacare; The Washington Examiner - February 26, 2010

With no signs of compromise from either side in President Obama's health summit, Democrats prepared a final partisan push for their massive health care plan.

The Aftermath of the Health Care Summit:  Confusion, Conflict; Politico - February 26, 2010

Post summit means a democratic party looking to emerge with a clear sense of the path forward instead finding itself in the same old place - fighting the clock to finish health care, with an uncertain timeline, a complex legislative path and no idea if its leaders can muster the votes.

The sweeping health-care package unveiled this week by the White House appears to face big hurdles in the House, with abortion and unease among moderates potential stumbling blocks to winning passage of the legislation.

In the Senate, at least one Democrat opposes a new provision in the package that would allow the federal government to regulate insurance-premium increases.

Slate's Timothy Noah has put together a fantastic cheat sheet that defines many of the terms and concepts as well as " impenetrable jargon; familiar words and phrases used in unfamiliar ways; and obviously coded messages that you may have some difficulty deciphering" that are part of the heath care debate.

Enjoy:  Health Summit Cheat Sheet. 

Coverage of the Health Care Summit abounds: 

Still Stalemated After Summit; Politico - Feb 25, 2010-02-25

President Barack Obama called on Democrats and Republicans to find a health care compromise in the next few weeks that has eluded them for a year -- but made it clear that he's prepared to short-circuit Senate rules to get reform passed if they fail.

"The question that I'm going to ask myself, and I'm going to ask of all of you, is, is there enough serious effort that in a month's time, or in a few weeks time, or six weeks time, we could actually resolve something," Obama said to close the seven-hour health care summit. "And if we can't then I think we've got to go ahead and make some decisions."

Republicans said the same thing in their closing comments that they said at 10 a.m. - start over. Obama won't.   So the parties walked out of Blair House almost exactly the way they walked in - completely at odds over the best way to fix the health insurance system. There were modest efforts around the edges to find common ground - on reining in waste and fraud and keeping the deficit in check - but no broad agreements on the shape of reform.

Little Sign of Common Ground at Health-Care Summit; The Washington Post -Feb 25, 2010

President Obama held more than six hours of talks Thursday with a bipartisan group of lawmakers on ways to salvage health-care reform legislation now stalled in Congress but ran into stiff opposition from GOP members who rejected key provisions and insisted that the effort start again from scratch.

Republicans are planning to counter President Obama's health care proposal with one of their own.  According to the Washington Post,

Republicans are preparing to use Thursday's White House health-care summit to sell their own ideas for using the private marketplace to expand coverage and reduce costs, but they remain wary of fumbling away what they believe is an advantage on the issue heading into this year's critical midterm elections.

GOP leaders are acutely aware of the stakes involved in the extraordinary bipartisan gathering. An effective performance could give their party a vital image boost as November approaches. But if the party's delegation stumbles or oversteps, President Obama and congressional Democrats could see the session provide new life to the stalled health-care legislation they have been laboring over for a year.

Politico has published a copy of the agenda for Thursday's White House Health Care Summit, noting that

... the White House health reform summit has been designed to preserve President Obama's home court advantage. The president, Vice President Biden and Health and Human Services Secretary Kathleen Sebelius will get the first word on every topic during Thursday's meeting.

For the full story in Politico, click here. 

Despite a stepped-up lobbying effort over the past months, leading physicians' groups appear resigned and exasperated with the idea that Congress will not take permanent action to fix the sustainable growth rate formula before 21% reimbursement cuts for Medicare take effect March 1.

While all but surrendering hope for a permanent solution to end the annual "doc fix" on Capitol Hill, physicians now wonder if an 11th hour temporary fix is doable.

"I don't see the vehicle that Congress can use to come up with that short-term fix," says Lori Heim, MD, president of the American Academy of Family Physicians.

For the full story from Health Leaders Media, click here.

Stressing the urgent need for action this week on Medicare physician payment reform, AMA President J. James Rohack, M.D. writes in a letter today to every member of the U.S. Congress that in one week "a 21 percent payment cut takes effect, yet the pathway for addressing the underlying problem remains a mystery."

"Kicking the can down the road with yet another short-term action magnifies the problem and makes it very difficult for physicians to continue caring for seniors and military families," writes Dr. Rohack as he recognizes the fiscal challenges facing our nation, while pointing out that short-term action increases the cost of reform and the size of the cut.

"We cannot support congressional efforts that will further undermine the stability of the Medicare program and access to care for our nation's elderly, disabled and military families," writes Dr. Rohack as he calls on Congress to "stop this growing threat to the Medicare and TRICARE programs."

For the full text of the AMA letter, click here. 

At a news conference, Health and Human Services Secretary Kathleen Sebelius cited half a dozen examples, from Maine to Washington state, in which insurers have sought large premium increases on people who buy coverage individually. In every case but one, state insurance regulators rejected all or part of the requested increases.

"It shines a light on the urgency for health reform," she said.

The administration's attempt to focus attention on insurance comes during a moment of deep uncertainty over the fate of Congress's intense debate about the health-care system. The House and the Senate have passed Democratic health-care legislation, but those efforts have stalled.

Ten days ago, Sebelius wrote a pointed letter to one insurer, Anthem Blue Cross of California. She demanded to know why the company had alerted 800,000 policyholders that their premiums would rise by as much as 39 percent. Anthem postponed the increase by two months.

For the full story in The Washington Post, click here. 

Related Coverage:

HHS Warns of Double-Digit Spike in Health Premiums; AP/Google News - Feb. 18, 2010

Bleak Economy Pushing Insurance Companies to Raise Rates; The New York Times - February 18, 2010

The Lesson of Anthem Blue Cross; The New York Times - Op-Ed - February 18, 2010

Fight Over Health Care Premiums Heats Up; The Wall Street Journal - February 19, 2010

President Obama on Monday issued his own blueprint for a health care overhaul, challenged Republicans to come forward with their ideas and laid the groundwork for an aggressive parliamentary maneuver to pass the legislation using only Democratic votes if this week brings no progress toward a bipartisan solution.

In laying out for the first time the details of what he wants in the legislation, Mr. Obama set in motion a new round of maneuvering intended to bring a bitterly divisive yearlong clash to a conclusion. With the two parties scheduled to meet Thursday for a televised session on the health care overhaul, Mr. Obama appeared intent on forcing the Republicans into a choice: either put a specific alternative on the table, giving Democrats a chance to draw pointed contrasts between the parties' approaches, or be cast as obstructionist and not serious about addressing an issue of great concern to voters.

For the full story in The New York Times, click here. 

Related coverage:

Obama Stays on Offense With Health-Care Proposal; The Washington Post - Feb. 22, 2010

Obama's Health Bill Plan Largely Follows Senate Version, The New York Times

New Health Care Plan, But With the Same Old Problems, Politico

Outlook No Brighter for Obama's New Health Plan, AP

Obama Renews Health Push, The Wall Street Journal

Obama Unveils a $950B Restart on Health, USA Today

According to the NY Times...

President Obama will put forward comprehensive health care legislation intended to bridge differences between Senate and House Democrats ahead of a summit meeting with Republicans next week, senior administration officials and Congressional aides said Thursday. Democratic officials said the president's proposal was being written so that it could be attached to a budget bill as a way of averting a Republican filibuster in the Senate. The procedure, known as budget reconciliation, would let Democrats advance the bill with a simple majority rather than a 60-vote supermajority.

In a brutal assessment of the Democratically authored healthcare reform bills pending in Congress and the party's approach to healthcare, more than half of the respondents to a new Zogby International-University of Texas Health Science Center poll said that lawmakers should start from scratch.

Of the more than 2,500 people surveyed from Jan. 29 to Feb. 1, 57 percent agreed with a statement that Congress should start over -- which is exactly what Republicans are demanding and what President Barack Obama insists he will not do.

Moreover, 56.4 percent of people indicated they would prefer Congress to tackle healthcare reform on a step-by-step basis, not take the comprehensive approach as embodied in the legislation that passed the House and Senate last year but has stalled for the past month.

The poll underscores both public frustration with Congress and disenchantment with health care reform efforts to date.   Americans, however, don't want to scrap the idea of health reform entirely and generally favor some kind of reform.    

Despite their misgivings about the bills overall, the poll showed  the public is strongly in favor of some of their key components, such as forbidding insurance companies to deny coverage based on pre-existing conditions, establishing a health insurance exchange marketplace, prohibiting women from being charged higher premiums and requiring most employers to provide health benefits.

These same respondents, however, demonstrated resistance to making tradeoffs in exchange for these benefits by stating their opposition to paying more taxes, instituting cuts in Medicare spending or being required by law to obtain health coverage.

For the full story in The Hill, click here. 

Several senators have banded together to urge Senate Majority Leader Harry Reid to bring the on again, off again public option to a vote.  As of Thursday, February 18 at  12:30pm EST, 17 senators had signed a letter to Reid that read in part:

We respectfully ask that you bring for a vote before the full Senate a public health insurance option under budget reconciliation rules.

There are four fundamental reasons why we support this approach - its potential for billions of dollars in cost savings; the growing need to increase competition and lower costs for the consumer; the history of using reconciliation for significant pieces of health care legislation; and the continued public support for a public option.

Senator Diane Feinstein (D-California) signed on late Wednesday, and her support may have led to other Senators to the cause.  In putting her name among the signatories Feinstein expands the pool of senators pushing for a public plan beyond the progressive wing and those lawmakers facing primary challenges in the 2010 midterm elections.

The California Democrat has been a supporter of the proposal from the start, though not a particularly vocal one. The recent news that the largest insurer in her home state, Anthem Blue Cross, was raising premiums on its customers by as much as 39 percent played a role in her decision.

"I can think of no better example of why we need health insurance reform," she said of the rate-hike news, "and this kind of behavior is a stark reminder of why any reform plan should establish a rate authority to keep insurance rates affordable."

The list of Senators who have signed the letter includes Jeff Merkley (D-Ore.), Sherrod Brown (D-Ohio), Michael Bennet (D-Col.), Kirsten Gillibrand (D-N.Y.), Bernie Sanders (I-VT), Al Franken (D-Minn.), Pat Leahy (D-VT), Roland Burris (D-Ill.), John Kerry (D-Mass.), Sheldon Whitehouse (D-RI), Diane Fienstein (D-Cal.), Sen. Frank Lautenberg (D-N.J.), Barbara Mikulski (D-Md.), Amy Klobuchar (D-Minn.), Jack Reed (D-R.I.), Tom Udall (D-N.M.) and Ben Cardin (D-Md.).

For the full story in The Huffington Post, click here. 

Related coverage:

Senators Urge Reid to Revisit Public Option; Politico - Feb. 17, 2010

Congressional Democrats persuaded hospitals and other health care providers to accept cuts in government payment as part of both the Senate and House health care reform packages.  Industry groups as well as consumer groups like the AARP supported the cuts as part of a way to finance health care reform and provide greater access.  Now these groups are worried that the payment cuts will instead be used to reduce the growing federal deficit. 

"They'll be eating spinach and no cake," said Paul Heldman, senior health policy analyst with Potomac Research Group, a Washington research firm that focuses on policy and technical analysis.

The health care legislation isn't dead yet, of course; supporters are hoping Obama's Feb. 25 summit will give the effort new life. And they argue that the bill itself would help reduce the deficit over the long haul by lowering the growth of health care costs - an argument roundly rejected by many Republican critics.

NPR's Julie Rovner reported on Monday's Morning Edition that the idea of a health insurance mandate was in fact a Republican idea, despite current widespread opposition to the idea from most Republicans.  Both House and Senate health reform efforts have included a requirement that all Americans carry health insurance. 

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"Congress has never crossed the line between regulating what people choose to do and ordering them to do it," said Sen. Orrin Hatch (R-UT). "The difference between regulating and requiring is liberty."But Hatch's opposition is ironic, or some would say, politically motivated. The last time Congress debated a health overhaul, when Bill Clinton was president, Hatch and several other senators who now oppose the so-called individual mandate actually supported a bill that would have required it.