Finance Committee Markup Begins

September 25, 2009

Senate

The America’s Healthy Futures Act of 2009 was released last week. Two days after 564 amendments to the mark were filed and shortly after Finance Committee deliberations commenced, Chairman Baucus (D-MT) released a new mark in an effort to appease key Committee members of their concerns regarding affordability. With a new mark in hand, the Committee commenced with lengthy opening statements by both parties.

Committee Democrats mentioned their desire for sweeping changes to make the system more affordable, slow rising costs and extend coverage to the uninsured. Conversely, Republicans argued for a more targeted, less costly approach, including medical malpractice reform, changes in the way health care benefits are treated by the federal tax code, allowing people to buy health insurance policies across state lines and redirecting nearly $400 billion in Medicare spending reductions to the program itself, rather than expanding health insurance coverage.

Chairman Baucus believes the mark will be sufficient to secure the 60 votes required to pass and mentioned that the bill could be out of Committee and on the Senate floor as early as next week. Meanwhile moderate Senators are seeking support for an amendment strategy to reshape the bill once out of Committee. The bill would still have to be melded with legislation approved in July by the Senate Health, Education, Labor and Pensions (HELP) Committee before it moves to the Senate floor.

It is also important to note that former Democratic Party chairman Paul Kirk will temporarily fill Sen. Edward Kennedy's (D-MA) seat, which could prove to be an important maneuver in shaping the outcome of the health reform effort.

The NAM has been weighing in on a variety of issues, including expressing our concerns about the proposed excise tax and the elimination of the exclusion for the Medicare Part D subsidy. We’ve also voiced support for the amendments to increase the premium discount percentages employers may use to reward employees for their participation in wellness and prevention programs and opposition to amendments that would threaten the integrity of ERISA. Most agree that while the current mark could be improved significantly, it is far better than anything currently under consideration.

House

House negotiations became contentious this week as Speaker Pelosi backed off from an agreement made in early August with the Blue Dog Democrats to gain their support and get the bill out of committee. Without input from the Blue Dogs, the bill is likely to move toward a stronger public option although a public option with a trigger is still under consideration. Moderate Democrats are still trying to negotiate with the Speaker to lower the surtax, which is of serious concern to smaller manufacturers.

The Energy and Commerce Committee held its final hearing on health reform Wednesday, sending recommendations to the rules committee for consideration in the final bill. The short meeting consisted mostly of amendments agreed to by both sides of the aisle. The NAM also weighed in on issues of importance to pharmaceutical manufacturers that could set a precedent for all manufacturers.