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May 2009

Health Reform News from Capitol Hill

With new Secretary of Health Kathleen Sibelius finally confirmed, an established Department of Health and Human Services Office of Health Reform up and running, an eager Congress, and even the health care industry offering to work with the administration to reduce health care costs, momentum for federal health reform continues to build. On Wednesday, May 13, 2009, after the House Democratic leaders stated that they intend to pass a health reform bill by August Recess, President Obama echoed his support and optimism, saying ‘the stars are aligned.’[1]

While there have been many comparisons of the process of accomplishing health reform this year with the efforts of 1993-1994, one thing is clear:  regardless of the outcome, this go-around has been a remarkably transparent process, engaging stakeholders in multiple ways.  For those interested in following the action, there are multiple opportunities.

Both the Senate Finance and Health, Education, Labor and Pensions (HELP) Committees have held several hearings related to health reform, all of which are available on-line.  Of note, on April 28, 2009 the Senate HELP Committee held a hearing on “Learning from the States: Individual State Experiences with Health Care Reform and Coverage Initiatives in the Context of National Reform.”  Testimony was provided by a panel that highlighted state experiences with reform and lessons learned. The panel included experts from Massachusetts, Vermont, California and Utah.

The Senate Finance Committee also has held hearings on financing health reform, expanding coverage, and reforming the delivery system. The Committee has issued a series of three discussion papers focused on health reform. On April 29, the committee issued the first paper, Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs, which examines options to improve the quality and integrity of Medicare payment systems, long-term care payment reforms, health care infrastructure investments, improvements in the Medicare Advantage program,  and options to reduce fraud, waste, and abuse in public programs. In its second paper, Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans, the committee explores insurance market reforms, how to make coverage affordable,  the public insurance option, the role of public programs, shared responsibility, options to improve access to preventive services and encourage healthy lifestyles, long term care services and supports, and health disparities. The final paper, Financing Comprehensive Health Care Reform: Proposed Health System Savings and Revenue Options, just released on May 19, examines how to achieve health system savings, options to modify the exclusion for employer-provided health coverage, health care related revenue raisers, lifestyle related revenue raisers, and the administration’s revenue raising proposals.  

Conservative Republicans introduced the Patients’ Choice Act on May 20 as an alternative to plans outlined by the Democrats.  According to the Congressman Paul Ryan, one of the four sponsors of the bill, “‘The Patients’ Choice Act’ promotes innovative, State-based solutions, along with fundamental reforms in the tax code, to give every American, regardless of employment status, age, or health condition, the ability and the resources to purchase health insurance. The comprehensive legislation includes concrete prevention and transparency initiatives, long overdue reforms to Medicare and Medicaid, investments in wellness programs and health IT, and more.”[2] The bill would eliminate the tax subsidy for employer-provided health insurance and replace it with a different tax subsidy for individual purchase of health insurance.[3]


[1] Bettelheim, A. “Democrats Pledge House Vote on Health Care Before August Recess,” CQ Today, May 13, 2009.