Anticipating Action On Health Care

October 9, 2009

Anticipation describes this week’s activity on health care: Anticipation for the Congressional Budget Office (CBO) score, anticipation for a vote and anticipation for definitive House action. The anticipating and analyzing is causing much speculation about timing for the rest of the year, given the limited legislative days before the start of 2010.

Senate

With the release of the marked-up version of the Senate Finance bill and the unveiling of the CBO score late Wednesday, the Finance Committee is poised for a controversial vote next Tuesday. After a Finance Committee vote on the bill, it will be merged with the Health, Education, Labor and Pensions (HELP) bill and then will head to the Senate floor for a full vote later this month.

There is still disagreement as to what will be included in the final Senate package – issues as basic as whether not a public option will be included are still undecided in the Senate. Some Democrats are pushing Majority Leader Reid (D-NV) to make sure there is time to review the bill before a vote.

Thus, according to the CBO’s preliminary estimate, the score decreases the deficit by $81 billion over 10 years. Senator Baucus (D-MT) is touting that the Senate package is a smart “investment for American families, businesses and our economy” while Senator Grassley (R-IA) is noting the package “includes hundreds of billions of dollars in new taxes and fees.” The cost of the bill is also prompting Republicans to note that many of these taxes and fees will go directly to the middle class, thus breaking President Obama’s promise of not raising taxes on the middle class. The Joint Committee on Tax (JCT) this week clarified that it underestimated the fees drug companies, insurers and medical device makers would pay toward the overhaul. The industries would be assessed $29 billion more than first calculated.

House

House leadership is putting together a bill while many members of the House are making sure their voices are heard. Leadership has released a list of issues currently under consideration in the House. Of particular note is the reference to the single-payer issue: “Given the commitment to floor vote on single payer bill the recommendation is not to include in base bill the E&L amendment that establishes single payer as a state option.” It is still unknown when the House will move to a floor vote. The financing potion of the House legislation is also in flux.

Administration

Health and Human Services Secretary Sebelius echoed many of the same priorities for health reform that President Obama outlined during his speech to both chambers of Congress last month, including insurance reform; use of technology and payment reform to improve efficiency and quality; a focus on wellness versus sick care; and employer responsibility to provide or fund employee health insurance. The Secretary has not addressed how we should fund our health care system.