Question: What do the baseball strike and healthcare reform have in common?
Answer: There was very little progress on either one last week.
With Congress on vacation and members and staff obviously tired of healthcare reform, providers and other interest groups worked behind the scenes to craft a strategy to salvage some vestige of reform this year.
However, the groups acknowledged that with the level of apprehension over reform growing among the American people, Congress may come back from its recess even less enthusiastic about passing any reform measure.
"If (members of Congress) hear from their constituents that they are afraid and worried, even incremental reform may be too much," said one lobbyist who asked not to be identified.
Provider groups are moving their messages away from grand themes such as universal coverage. Instead, they're considering what measures can be passed to begin to lower the number of uninsured and control costs without getting in the way of changes already taking place in the private sector.
They're also concerned that an incremental plan such as the one introduced last month by the bipartisan "mainstream" coalition will include significant reductions in Medicare without enough movement toward universal coverage.
"Now that it appears things are moving off universal coverage back to incremental reforms, we have to make sure that Congress doesn't finance that on the backs of providers," said Mike Rock, senior associate director of the American Hospital Association's congressional relations division. "We're telling Congress, `Don't just cut Medicare and call it healthcare reform."'
Providers aren't the only ones with concerns over incremental reform. Nearly 40 business groups, including the U.S. Chamber of Commerce and the National Association of Manufacturers, last week blasted the mainstream reform plan, which they said would increase insurance costs and create incentives for employers to drop their insurance plans. Because the mainstream plan includes generous low-income subsidies, the business groups said employers would drop their own coverage and move their workers into public programs to make them eligible for federal insurance subsidies.
"The bottom line is that a bad bill is far worse than no bill," the groups wrote in an open letter to policymakers.
The Chamber of Commerce also voiced a concern held by many groups that Congress is trying to do too much in too little time.
"This is legislative process by musical chairs," said Jeffrey Joseph, the chamber's vice president for domestic policy. "Are we to tamper with one-sev- enth of the U.S. economy in a game of who is left standing when the music stops?"
The criticism by business will not make the work of the mainstream group any easier. Aides to members of the group have been meeting regularly with aides to Senate Majority Leader George Mitchell (D-Maine). While the aides would say little about attempts to merge the mainstream plan and the Mitchell bill, several lobbyists close to the negotiations say staff members have made little progress.