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Congress, Administration Respond to Health Care Crisis
by Neil Bomberg
This is the second article in a three-part series focusing on health care reform. This part focuses on the federal response to the health care crisis.
When it comes to health care reform, what cities and towns want and what is possible is largely dependent on what the Administration and Congress are able to deliver. The Administration has set out a number of guiding principles that it believes any health care reform legislation must include. These are to reduce the long-term growth of health care costs; to protect families from bankruptcy or debt because of health care costs; to focus on prevention and wellness and to ensure health care coverage for all Americans.
In response, Congress has set itself a very tight schedule, with both the House and Senate committing to moving versions of health care reform by the end of July, crafting a single bill through the “conference” process by the end of September, passing legislation by early October and having the bill on the President’s desk for signature by October 15. The Senate and House are both moving in a direction that suggests they are seriously attempting to adhere to this self-imposed schedule.
In the Senate, the Health, Education, Labor and Pensions (HELP) Committee has begun deliberating over a draft bill called the “Affordable Health Choices Act.” The key elements in this bill include: health care for all Americans; a public health option — one of the most controversial aspects of the bill; a strong employer-based health care system; minimum standards for health insurance plans; and emphasis on wellness and prevention.
The Senate Finance Committee, the other committee with jurisdiction over this process, has yet to introduce its bill, and may not do so until after July 4. Like the HELP Committee, the bill will include health care for all Americans with an emphasis on prevention and wellness, and a strong employer-based health insurance system, but it does not include, at this point, a public health plan option.
Other important elements of the Senate Finance Committee bill are likely to be national or state health insurance exchanges where individuals and businesses will go to purchase insurance; performance-based payments; improved health care infrastructure; and strategies for addressing fraud, waste and abuse.
The Finance Committee, under the leadership of Sen. Max Baucus (D-Mont.), has been trying to craft a consensus bill, one that Republicans on the committee could support. The difficulty that Sen. Baucus faces is that all but one of the committee’s Republicans have said no to any bill with a public plan option, something cities and the American public support very strongly.
Once both committees have completed their initial work, the Senate will begin considering the proposals and will attempt to merge them into a single document that can be adopted by the end of July.
The House is taking a different approach. Rather than drafting separate bills, the Committees on Education and Labor, Ways and Means, and Energy and Commerce, all of which have jurisdiction over health care, crafted a single bill that each committee will review. In the end only one version of the bill will be brought to the floor in late July for a vote.
Highlights of the House bill include: health care for all Americans with an emphasis on wellness and prevention; maintenance of the current employer-based health care system; a public plan option; a national exchange for the purchase of health insurance by individuals and companies; and a mandate that all Americans have health insurance.
The third part of the series, featured in an upcoming issue of Nation's Cities Weekly, will focus on the prognosis for passage of health care reform.
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