Tuesday, December 8, 2009

Quick Update

Things are pretty hectic here on the ground, where real people who can't afford their health care or have some other health-related problem are calling us for help at an unprecedented rate, so I only have time for a quick update.

As you know, the Senate is considering the health reform proposal put forth by Senator Harry Reid, summarized in detail below. The two most difficult obstacles are (1) the public option; and (2) abortion.

An amendment that would preclude any woman receiving subsidies to use her own money to buy a plan that covers abortion services has been introduced. It's identical to the House version that was passed. However, the votes aren't there to pass it in the Senate. So there are a handful of Senators striving for a compromise. Democrat Sen. Nelson of Nebraska is needed to cut off debate and bring the bill to a vote and he says he won't vote to allow the bill to go forward unless it has something pretty close to this language included. That means Senator Reid needs at least one Republican to cut off debate and bring the bill to a vote (called cloture).

As for the public option, it seems to be all but dead in the Senate. Right now, a group of 10 Democrat Senators -- 5 moderate, 5 liberal -- are working on a compromise. The latest word I've heard is that they are talking about creating a national insurance plan to be offered by several health insurers at non-profit rates, administered by the Office of Personnel Management, EXACTLY the same as the federal employee plan. This is not considered a public option because the insurance would be offered by private health insurance companies, even though it would be overseen by a federal government agency. Works for me -- I've never lost a health insurance appeal to OPM, so if they're in charge, I'm comfortable with that. But this is not yet a done deal.

Liberals are pushing for more. Earlier today, there was talk of expanding BOTH Medicare and Medicaid -- people age 55 and over would be allowed to buy into Medicare, and Medicaid would be available to individuals up to 150 percent of the federal poverty level (as opposed to 133 percent in the Senate bill). The Medicaid piece of that took less than a day to die because Medicaid is partly funded by the states, and most states are cash strapped already. The Medicare expansion is opposed by the hospitals and other health care providers because Medicare reimbursement rates are lower than insurance reimbursement rates, so providers don't want to have to accept lower reimbursement rates for a whole lot more people.

As best I can tell, there are several variations on these themes being bandied about. My own (yuk) Senator Lieberman has said he's open to the look-alike federal employee plan, but Republican Olympia Snowe is saying no deal, according to Politico. That takes us back to Senator Nelson and abortion.

And the beat goes on. Updates to follow. Jennifer

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