Health and Human Services Secretary Kathleen Sebelius has told lawmakers that she cannot guarantee greater transparency in health care reform negotiations in spite of President Obama's  repeated statements about providing greater transparency into the negotiations. 

"I am not a principal in the negotiations," Ms. Sebelius said in testimony before the Senate Finance Committee. "Nor is my staff."

Ms. Sebelius said administration officials provided "technical support" to Congress, but did not control the negotiations.

Her comments came about five hours after President Obama affirmed the need for openness in efforts by the administration and Congress to finish work on a health bill intended to expand coverage and rein in costs.

In the rush to pass legislation in December, Senate leaders and White House officials did much of their work behind closed doors, and Mr. Obama said Wednesday that the perception of secrecy may have undermined public trust.

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

The Puget Sound Business Journal reports that The state Health Care Authority (HCA) said it plans to ask private insurers to help it create a coverage option that anyone in the state could buy for about $100 a month.  The agency will issue a request for proposals to the insurers asking how much they would charge for a benefit package outlined by the agency.  Based on the bids, the agency would determine what premium insurers may charge for the package. Insurers who figure the premium would not cover their claims and administrative expenses could choose not to participate.

Washington State has an estimated 875,000 uninsured people that the HCA is hoping to open up coverage for.  Opponents of the proposal say that state regulations deny private insurers the right to offer comparable policies to the HCA plan and would destroy the individual insurance market.  Some lawmakers have introduced legislation to changes these regulations but legislative observers expect this legislation to run into stiff opposition from Democrats who control both the House and the Senate. 

For the full story, click here.

Health Leaders Media reports that one segment of health care reform may go ahead with or without a comprehensive reform package:

While Congress may not have approved healthcare reform legislation yet, one of the more well-discussed--and sometimes controversial--areas included in the reform bills was included in President Obama's proposed fiscal 2011 budget: comparative effectiveness research (CER).

However, a scan of the proposed budget will detect no references to "CER;" its new name is instead: "patient-centered health research."

In the Department of Health and Human Services (HHS) budget, no explanation is given for the name change. The fiscal 2011 budget request provides a total of $286 million--which included $273 million for research and $13 million for related program support--targeted in part for the Agency for Healthcare Research and Quality (AHRQ) to support new research projects.

A central tenant to President Obama's health care reform proposals has been comparative effectiveness research.  Comparative effectiveness research compares similar treatments in terms of both the relative medical benefits and risks of each option, and also the costs and the benefits of those options.  Comparative effectiveness is increasingly being viewed as a viable way to help drive down spiraling health care costs while continuing to provide quality care. Roughly $700 billion each year goes to health-care spending that can't be shown to lead to better health outcomes, according to the non-partisan Congressional Budget Office.

For the full story click here.  For the CBO report on comparative effectiveness research, click here.

Politico is reporting that House Speaker Nancy Pelosi is proposing a two track approach to health care reform:  less controversial incremental changes now with more sweeping changes tabled until a later date when the political climate improves.

"We believe that it's possible to have comprehensive health care reform as we go forward, but at the same time, it can be on another track where some things can just be passed outside of that legislation, and we'll be doing both," Pelosi said in an interview with POLITICO.

Though the Democrats' loss of Ted Kennedy's old Senate seat has complicated efforts to get the 60 votes they need for a sweeping health care bill, Pelosi insisted that comprehensive reform is still on the agenda.

"We have to get it done," the speaker said. "What the process is doesn't matter. The outcome is what is important, and what it means to working families in America."

For the complete story including video of the interview, click here.

The Congressional Budget Office (CBO) cites federal healthcare spending as "the single greatest threat" to the United States' budget stability in its new report, The Budget and Economic Outlook: Fiscal Years 2010 to 2020. Under current law, Medicare spending will reach $1,038 billion in 2020, with Medicaid spending coming in at $458 billion.  In 2009, higher unemployment drove up Medicaid spending by 9 percent ($18 billion). For the previous 10 years, the program's average annual growth rate had held at 7 percent. Medicare outlays also rose faster than average, jumping by 10 percent ($39 billion).

For an article summarizing the report, click here and for the CBO report, click here.

The election of Republican candidate Scott Brown to fill Ted Kennedy's senate seat last week was viewed by some as a referendum on health care reform.  The Kaiser Family Foundation did some polling on this election and found that the driving forces behind Brown's election to be much more nuanced: 

First, while health care policy did top the list of voting issues, the economy and general discontent with Washington also were significant factors for Brown voters. Second, and perhaps more importantly, Brown voters' top complaint about health reform was not about the substance of the legislation itself or its perceived impact on them or their families, but about a policymaking process that they seemed to think had gone badly wrong ... For Brown voters health reform became a reflection of, and in some ways a proxy for, deeper concerns about how Washington works today. 

For the full story, click here.

President Obama devoted relatively little time to health care reform in Wednesday night's state of the union address.    The topic of health care did not appear until thirty minutes into the address, a sign, according to The New York Times, "of how imperiled [the health care bill] had become:"

Mr. Obama's speech did nothing to resolve differences between the House and the Senate or to clarify the way forward. Just 20 weeks ago Mr. Obama stood in the same place and made an urgent plea to a joint session of Congress. "The time for bickering is over, the time for games has passed," he said on Sept. 9.  "Now is the time to deliver on health care," he said then.

But on Wednesday health care was wedged into a catalog of presidential priorities, which included jobs, the economy, education, bank regulation, energy independence, deficit reduction and the war in Afghanistan.  The change highlighted the risks for Mr. Obama in staking more of his political capital on legislation whose fate in Congress is uncertain -- a bill that divides the Democratic caucus, that is reviled by Republicans and that makes many independent voters nervous.

President Obama went on to state in his address that he had not clearly explained the benefits of health care reform to the public and blamed special interests, industry lobbyists and partisan politics for sidetracking healthcare reform.  He stood by the health care reform bills that and urged both parties to take another look at the bill after "temperatures cool"

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