Republican plans to overhaul Congress could have a profound impact on healthcare reform efforts next year.
In the House, the incoming GOP leadership is considering placing healthcare under the jurisdiction of a single committee.
Meanwhile, a Senate GOP transition team said last week that healthcare reform would be among its legislative priorities.
Currently, the House Ways and Means Committee has domain over most of the Medicare program, while the Energy and Commerce Committee oversees the Medicaid program and some Medicare Part B issues as well as public health concerns.
The new leadership has promised to shake up the current structure by consolidating committees and changing their jurisdictions. Under the plan that seems to be the most likely to be implemented, the Ways and Means Committee would be stripped of its healthcare duties, which would be consolidated under the Energy and Commerce Committee. That panel would be renamed the Commerce and Health Committee.
If such a plan is implemented, it would have a significant impact on what type of reform is considered by the House next year.
The Energy and Commerce Committee has had experience with healthcare reform. But many of the most knowledgeable House members on healthcare, including Reps. Fortney "Pete" Stark (D-Calif.), Bill Thomas (R-Calif.), Nancy Johnson (R-Conn.) and Benjamin Cardin (D-Md.), would no longer be involved.
The front-runner to lead the new Commerce and Health Committee is Rep. Thomas Bliley (R-Va.). Mr. Bliley was a staunch opponent of the Clinton reform plan and endorsed a more modest plan introduced by retiring House Minority Leader Robert Michel (R-Ill.).
The Energy and Commerce Committee is generally more conservative than Ways and Means. For example, it was the only committee of those with jurisdiction over reform that was unable to pass any legislation, largely because Chairman John Dingell (D-Mich.) failed to garner much support from the committee's many conservative Democrats.
On the Senate side, the new Republican leadership pledged that healthcare reform would be one of its priorities.
Sen. Don Nickles (R-Okla.), one of the three transition team leaders, said that he expected the Republican plan to focus on insurance reforms, medical malpractice reform, paperwork reduction and changing the tax code to insure that health insurance is tax deductible for the self-insured.
"You will see healthcare reform before the end of (the next) Congress,"
Mr. Nickles predicted.
According to several Republican aides, the new GOP leadership believes that passage of some form of healthcare reform would be a plus for Republican candidates in the next election.
Public interest in healthcare reform was demonstrated in a poll taken election night by the Kaiser Family Foundation and the Harvard School of Public Health.
According to their study released last week, healthcare was the most important issue in deciding whom voters chose, with 33% of voters saying it was their most important issue. That was followed by crime (29%) and taxes (23%). The poll also found, however, that neither Republicans nor Democrats were helped significantly by the issue.
Healthcare (40% of voters surveyed) also topped the list of issues voters expected the next Congress to tackle followed by crime (31%) and lowering taxes (17%).
"The message to the (next Congress) is that by passing a modest, incremental bill they can get a lot of credit," said Robert Blendon, chairman of the Department of Health Policy and Management at the Harvard School of Public Health.