Week in Health Insurance Reform EasyToInsureME

December 16, 2009

This Week in Health Reform—Legislative Overview

Senate
The Senate this week continued debate on its health care reform legislation, H.R. 3590, “The Patient Protection and Affordable Care Act”. The two most controversial issues continue to be the public option and abortion, with both issues being discussed at length last week. On December 9, Senate Democrats blocked an amendment, 54-45, by Ben Nelson (D-NE) and Orrin Hatch (R-UT) that would tighten restrictions for funding of abortions. The amendment’s language mirrored what was in the House legislation that passed last month to the opposition of many Progressive Democrats. Majority Leader Reid (D-NV), voted down the amendment stating that the language in the existing Senate bill already adequately states that insurance plans (public or private) in the new exchange would be restricted from using taxpayer money for abortions.

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Democrats Ben Nelson (NE), Bob Casey (PA), Kent Conrad (ND) and Byron Dorgan (ND), Ted Kaufman (DE) and Mark Pryor (AR) all supported the amendment. An outspoken opponent on abortion, it is unclear whether or not Nelson will support a final bill without the amendment. If he does not, then Reid has the additional task of ensuring that at least one Republican Senator votes in favor of his bill to secure the 60 votes needed to block a filibuster.

In order to break the bottleneck in the Senate over the public option last week, a group of ten moderate and liberal Democrats negotiated a compromise agreement that they said would appease both moderate and liberal Democrats – and perhaps interest some moderate Republicans. The re-formatted public option would create a national insurance plan, run by nonprofit private insurance companies, and supervised by the Office of Personnel Management. The program is said to be modeled after the Federal Employee Health Benefits Program (FEHBP), which currently covers more than eight million federal employees, including members of Congress. To appease the liberal base of the Democratic Party, the compromise also reportedly created an expansion of Medicare to individuals between the ages of 55 to 64.

Senator Joe Lieberman (I-CT), an Independent who often caucuses with the Democrats, has been an outspoken opponent of the Medicare expansion provision and publicly stated that he would not vote for any bill that includes it. While Senators still remain quiet on the details of the legislation, stating that they are waiting to receive a cost analysis from the Congressional Budget Office (CBO) before discussing it publicly, it looks like the Medicare expansion provision has been removed from the pending legislation.

Reid is still aiming to have a vote on the Senate’s portion of the health care reform bill ahead of the Christmas holiday.

House
Last week Speaker Nancy Pelosi (D-CA) publicly stated that she would not discard the option of keeping House members in Washington for part of Christmas week – if it means that they make progress in passing health care reform legislation. Pelosi reiterated both her support for President Obama’s top domestic priority – health care reform – and her enthusiasm for seeing the Senate’s version of the bill.

Overview: NFIB Opposes Senate Health Care Reform Bill
On December 8, the National Federation of Independent Businesses (NFIB), an association that represents small and independent businesses, publicly stated its opposition to the Senate’s “Patient Protection and Affordable Care Act” (H.R. 3590).

See below for excerpts from the letter:

* The letter states that “the most recent Congressional Budget Office (CBO) study detailing the effect that H.R. 3590 will have on insurance premiums reinforces that, despite claims by its supporters, the bill will not deliver the widely-promised help to the small business community. Instead, CBO findings report that the bill will increase non-group premiums by 10 to 13 percent and result in, at best, a two percent decrease for small group coverage by 2016. These findings tell small business all it needs to know – that the current bill does not do enough to reduce costs for small business owners and their employees.”

* “Despite the inclusion of insurance market reforms in the small-group and individual marketplaces, the savings that may materialize are too small for too few and the increases in premium costs are too great for too many. Those costs, along with greater government involvement, higher taxes and new mandates that are disproportionately targeted at small business and are being used to finance H.R. 3590, create a reality that is worse than the status quo for small business.”
* “...the excessively tight age rating (3:1) in H.R. 3590 will increase more costs than it will decrease, and make coverage unaffordable for the very populations that are most beneficial to the insurance pool – the young and the healthy. Independent actuaries have analyzed the negative impact of such tight bands and have indicated that there will be devastating effects to the long-term viability of a pool without action to correct this rating imbalance.”