Partisan squabbles and last-minute work on key coverage provisions have slowed progress on a Senate Health, Education, Labor and Pensions Committee healthcare reform bill, the Affordable Health Choices Act.
... but little other progress
HELP panel is beset by partisan squabbling
Republicans, concerned about the implications of barreling through on a massive piece of unfinished legislation, argued repeatedly that the bill would create more bureaucracy and drive up healthcare costs, not produce savings. This is fiscally irresponsible, said HELP member Sen. Judd Gregg (R-N.H.), who said the bill, once fully assessed, would add more than $2 trillion to the nations deficit and cause more than 30 million people to lose coverage.
To date, the HELP Committee has yet to work on some of the major provisions of the bill, with partisan debates over prevention, workforce and comparative-effectiveness issues monopolizing negotiations over the past few weeks. The committee broke for the July recess without completing some of the key provisions of its wide-sweeping healthcare reform bill. Issues on coverage that had been left blank in the legislation are still being discussed, including a government-run public option and an employer mandate.
Yet Sen. Christopher Dodd (D-Conn.), who has steered negotiations, has made it clear that he wants a strong bill, if not necessarily a bipartisan one, said Alexander Vachon, a Washington-area consultant. He said that could ultimately sideline the bill in favor of the work being done on the Senate Finance Committee (See story, above). If (the committee) is able to get a bipartisan offset, then that is what Congress is going to be able to pass, Vachon said.
That view is echoed by the American Hospital Association. Many in the healthcare field see the Senate Finance Committees work as the one to watch. The committee has jurisdiction over the Medicare and Medicaid programs and can make changes to the tax code, and is working for a bipartisan package, said Alicia Mitchell, spokeswoman for the AHA.
Some provider groups disagree. The Finance Committee may specialize in Medicare, for example, but Dodds panel has exclusive jurisdiction over other key provisions, such as workforce, insurance market reforms, and prevention and wellness, said Bob Doherty, senior vice president of governmental affairs and public policy with the American College of Physicians.
The HELP bill contains a number of proposals, including several that would boost the ranks of primary-care physicians.
In proposing state-run gateways, or health insurance marketplaces that would allow individuals and families a wide array of health plan options, Kennedys legislation would have considerable input in what private plans would offer, Doherty said.
Sen. Michael Enzi (R-Wyo.), the HELP panels senior Republican and also a member of the Finance Committee, said he was dubious about a public plan option yet to emerge in committee. I dont think the majority knows what public option will be chosen at this point, Enzi said.
Lori Heim, president-elect of the American Academy of Family Physicians and a family physician at 102-bed Scotland Memorial Hospital, Laurinburg, N.C., said the AAFP supports a public plan.
We just ask that it not be Medicaid and that it not require doctor participationand that it be truly competitive with other insurance plans, she said.
Karen Greenrose, president and CEO of the American Association of Preferred Provider Organizations, sees a public plan as a recipe for disaster. Any government plan is all about rationing care, she said.
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