Health Care Reform: On The Brink?

Congressional leaders hope to reach a deal on the broad outlines of a final health care bill by late today. The bill would go to the Congressional Budget Office for a cost analysis, which must be completed before Congress can act. While the CBO is doing its calculations, lawmakers plan to resolve issues that don’t affect cost, like immigration and abortion.

The White House and Congressional leaders have reached a tentative deal on a proposed excise tax on high-cost, employer-sponsored insurance plans. Immediate details of the tentative agreement were not provided, but it is expected to include an increase in the thresholds at which policies are hit by the tax.

House Democratic leaders are pushing for more generous subsidies to help make health insurance affordable to a greater number of middle-class households, as well as other concessions. Future blog posts will address those plans as they develop.

Nineteen Senate Democrats on Wednesday released a letter calling for a provision in final health reform legislation to repeal the insurance industry's longstanding exemption from antitrust laws. The letter comes shortly after a report that several large insurers quietly contributed millions of dollars to help fund an advertising campaign against health reform legislation. The House's health reform bill (HR 3962) includes a provision to eliminate the antitrust exemption, but the Senate bill (HR 3590) does not.

The fight over whether states or the federal government should run proposed health insurance marketplaces is heating up. The House would establish a national exchange run by the federal government. They would set a uniform program that would help protect consumers. The Senate wants each state to create and run its own exchange. They feel states have more experience overseeing insurance plans and know their residents’ needs better. Besides the details of the fed vs state approaches, there are major political overtones at the backbone of the debate. Liberal Democrats are angry that the public option is all but certain to be omitted from the final package, and they want the federal government to have as much power over insurers as possible.

David Darrigan, DO