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Week of Jan 25, 2010

The sudden halt to health care reform’s steady march forward came as a shock to many who saw an upset win by Republican Senator-elect Scott Brown in Massachusetts as all but impossible. But if many took delight in the election outcome’s impact on health reform legislation, Aetna Chairman Ronald A. Williams prefabricated it clear in a New York Times story last week that the country still needs meaningful health care reform – reform that addresses access as well as affordability. Everyone benefits by health reform that gets at the factors driving soaring health care costs and the loss of coverage for so many Americans. While Congress thinks carefully about its next steps, Aetna will continue to support meaningful health care reform and continue to offer responsible solutions to legislative leaders.

Federal

The election of Republican Scott Brown as the new senator from Massachusetts has derailed the Congressional health care reform train, less because Brown denies Democrats the 60th filibuster-proof vote, though that is certainly a major result, and more because it collapsed the Democratic political home of cards by highlighting the power of independent voters and the frustrated anti-incumbent mood of the electorate. Whether Democrats can regroup from this wake-up call will consume their leadership from now until the November off-year elections. How Democrats handle, and how Republicans respond to, health care reform in the short term and other key priorities – such as jobs, the economy, energy and security – over the rest of the session will underscore all Congressional decisions from now until the first Tuesday in November. In short, the 2010 elections started in serious with Brown’s victory.

Once Democrats get past the shock of losing Kennedy’s seat, they will have to grapple with health care reform, one way or the other. The primeval favorites, including passing the Senate bill “as is” in the House, have been dropped for now as Democrats recognize the political cost of ramming through something unpopular propelled by political muscle only. Passing a smaller, less invasive and mostly Democratic bill has only a slightly superior chance, as Republicans are not too likely to “crossover” quite yet. There is a growing interest in using reconciliation (the 51-vote tactic) down the road to pass a Democratic-only bill, once the Home and Senate Democratic leadership can concur to a single bill. And, there is the outside chance that Democrats will see the Massachusetts election as an imperative to craft a bipartisan bill with Republicans that can secure 70-plus votes in the Senate. Wednesday’s Say of the Union speech, followed by the celebration issues retreats later in the week, will go a long way toward determining which path will be pursued.

JANUARY 22, 2010

This Week in Health Care Reform

After months of public debate and private negotiations, health care reform discussions stalled following Tuesday’s Senate vote in Massachusetts. The Democratic Senate lost its 60th vote supermajority when Republican Scott Brown was elected to the United Says Senate in the Massachusetts special election.

Health Care Reform Negotiations Post-Massachusetts Special Election

Massachusetts Election of Senate Republican Recasts Debate: Following the election of Republican Scott Brown to the Massachusetts Senate seat Tuesday night, Democratic leaders have been scrambling to revive what could now be a dying bill. The loss of the Democrat’s 60th vote in the Senate opens up the legislation to a Republican filibuster – something the Democrats have managed to refrain thus far in the debate.

House and Senate Democrats met this week to discuss how to move forward with the reform legislation in light of this election and promised Wednesday that they would near ahead. There are a number of options that Democrats are considering, but at this point they have not charted their course.

On Wednesday, Speaker of the Home metropolis Pelosi (D-CA) attempted to rally Home Democrats around a strategy to near the Senate bill through the Home and onto President Barack Obama’s desk so as to refrain the need to again secure 60 Senate votes. However, the Speaker indicated on Thursday morning that she did not believe she has the needed 218 Home votes necessary to move forward. This option would have granted lawmakersto then propose additional modifications to the approved legislation through a process called “reconciliation,” which only requires 51 votes in the Senate.

Other remaining options:

1.
Home and Senate Democrats could also swiftly complete the merging of the two bills and vote on the combined package before Mr. Brown is sworn in.
2.
Democratic leaders could attempt to re-engage Sen. Olympia Snowe (R-ME), the only Republican who voted for the Senate Finance Committee’s bill passed in October. Democrats would need to grant her to amend the bill so that she could support its passage and give Democrats the needed 60th vote; or,
3. Home and Senate Democrats could essentially begin over in their respective chambers and propose scaled-back versions of the bill under “reconciliation” procedures or regular order. Reconciliation procedures would greatly limit the scope of the legislation to issues only related to raising or spending federal funds; therefore, many provisions, such as creating new insurance exchanges and an individual mandate, might be excluded.

President Obama seemed to indicate that he favors having Home and Senate lawmakers begin over again and produce a scaled-back bill. In addition, more moderate Senate Democrats – hesitant to near through such a massive partisan bill in light of the Massachusetts election – urged leaders to slow down.
Sen. Jim Webb (D-VA) has called on Senate leaders to suspend voting on health care reform until Mr. Brown is sworn into office. President Obama and Senate Majority Leader Harry Reid (D-NV) have iterated this same message. Further, Sen. Joe Lieberman (D-CT) called for a bipartisan effort as the ideal way to achieve health care reform legislation.

Health Care Reform Negotiations Prior to Massachusetts Special Election

Senators Urge Guarantee of Government Savings: In a letter sent last Thursday to Sen. Reid, five Democratic Senators asked for the inclusion of a “fail-safe mechanism” in the final bill. This mechanism would give Congress “the tools to keep costs under control should the current savings estimates change to materialize. “

Both the Senate and Home versions of the bill rely heavily on reductions in government spending, particularly around Medicare, to help pay for reform. Republicans and some nonpartisan analysts believe the government will not follow through on these spending reductions, which will lead to soaring costs.

President Obama Pushes for Less Protection for Biologic Drugs: Last Thursday President Obama pushed for a change in the health care reform legislation that would reduce the number of years that biologic drugs were patent fortified from generic competition, previously set at 12 years. White Home officials and Rep. Henry Waxman (D-CA) were negotiating for 10 years endorsement or less.

Members of the news media speculated that the move to reduce biologic drug protections could be a leverage point for President Obama to pressure the drug industry to increase contributions to pay for health care reform. In fact, the Wall Street Journal reported that Congressional Democrats had already asked drug companies to contribute an additional $10 billion or more, over and above the $80 billion which the industry concurred to primeval on in the reform negotiations.

President Obama Strikes Deal with Unions: Last week Democratic negotiators struck a deal with union officials and conceded to union demands to scale back a tax on high-end insurance plans. The deal would exempt union workers from having to pay the tax until 2018, five years after the tax would apply to other workers. While the deal would help acquire union support for the bill, it would also reduce the amount of tax revenue generated by about 40 percent, to $90 billion. As such, Democratic leaders would need to find other sources of revenue to make up the difference.

Public Opinion

Exit Poll Indicates Health Care Reform as Hot Button Issue: As the ballot polls shut on Tuesday night’s Massachusetts Senate election, an exit poll conducted by Frabrizio, McLaughlin & Associates indicated that 52 percent of voters stated that they oppose the federal health care reform measure and 42 percent stated they cast their ballot to help stop President Obama from passing this legislation. In addition, 48 percent stated that health care was the single issue driving their vote.

Polls Show Discontent: The latest Wall Street Journal/NBC News poll indicated that nearly half of Americans believe the health care reform bill in Congress is a bad intent (46 percent). This figure is up dramatically from April when only 26 percent believed the plan was a bad idea. Further, just 33 percent state the plan is a good idea. Almost half of those surveyed (48 percent) believe that passing the current legislation would be a “step backward. “

In addition, a new Quinnipiac University poll showed that public support for health care reform continues to decline. Thirty-four percent mostly approve, while 54 percent mostly disapprove. At the end of December, 53 percent of Americans mostly approved, while 36 mostly disapproved.

Looking Ahead

Currently, the path to health care reform is unclear. Democrats seek a way to secure the necessary votes to pass the legislation, and some now question the value of actuation such a massive bill. President Obama had hoped to see a final bill prior to his Say of the Union address, which has been scheduled for Jan 27; however, it appears this goal is likely out of reach.

the week of Jan 25, 2010

The crash of the health reform keeps marching forward was a shock to many that for a surprise victory by Republican Senator elected Scott Brown, Massachusetts has not seen everything but. But so much fun, the electoral result of the impact on the reform bill of health, took Aetna President Ronald A. Williams clear in a New York Times last week that the country needs more significant health care reform – reform that addresses access and affordability. Everyone benefits from the reform of health care who receives the factors increasing the costs of health care and loss of insurance coverage for many Americans. While Congress is seriously considering its next steps Aetna continue to support the reform of health care continue to wage meaningful and responsible solutions to legislative leaders.

The choice of the Republican Scott Brown as the new senator from Massachusetts, train health care reform, Congress derailed because fewer Democrats deny Brown’s 60th Filibuster proof vote, even though this is certainly an important result, in addition, because the home collapsed in a democratic political maps, by the power of independent voters, and mood anti-incumbent frustration among voters. What can Democrats wake of this group, his leadership will use from now until the elections of November this year. How Democrats and manage how the Republicans on health reform, which react in the short term and other key priorities – such as employment, economy, energy and security – the remainder of the meeting All decisions of the Congress to focus now and the first Tuesday of November. In short, the elections of 2010 really began with the victory of Brown.

When Democrats go beyond the shock of losing the seat of Kennedy, they need to reform health care, one way or another struggle. The primeval favorites, including the adoption of the bill the Senate “as is” in the Home have now fallen to the ground is considered the Democrats the political costs of hype around something unpopular policies driven by the muscle only. Passed a bill smaller, less invasive and generally democratic has a tiny superior chance that the Republicans are not too likely “crossover” not yet. There is a growing interest in the use of reconciliation (the 51-vote tactics) on the path of democracy a bill passed only once, the Home and Senate Democratic leadership to concur on a single bill. And chances are that the Democrats of Massachusetts outside of the imperative of choice as a bipartisan bill with the Republicans, who can get over 70 votes in the Senate see the craft. Wednesday Say of the Union speech will be followed by the Celebration exercises questions during the week is a long way to determine which direction to go.

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22nd Jan 2010

This week, enter the health care reform

After months of public debate and private negotiations, debates on reform Health stopped Tuesday after the Senate vote in Massachusetts. The Democratic Senate has lost its 60th in a qualified-majority voting Republican Scott Brown was the United Says Senate in Massachusetts special ballot.

Negotiations on health reform post-election special Mass.

Massachusetts Senate Republicans recast the electoral debate: After the election of Republican Scott Brown the Senate seat from Massachusetts on Tuesday night, Democratic leaders were swift to revive what they are this day a bill die. The loss of 60 Vote Senate Democrats opened the Republican legislation to impediment -. something that Democrats have managed so far avoided the debate

Home and Senate Democrats met this week to discuss how to move forward with reform legislation in light of this election, and promised Wednesday that they promote. There are a number of options, Democrats are considering, but at this point they do not plot its course.

tried Wednesday Home Speaker metropolis Pelosi (D-CA) Home Democrats to rally around a strategy to near the bill in the Home and the office of president Barack Obama on the need for new, 60 votes in the Senate to avoid. However, the speaker Thursday morning they believed not to have the necessary 218 votes needed home, go ahead. This option would grant proposals lawmakersto then called for other changes to the legislation approved by a process are “reconciliation” only 51 votes in the Senate

The remaining options.

1.
Home and Senate Democrats could be sworn in primeval completion of the merger of the two bills and vote on the combined package Mr Brown on the second

Democratic leaders might try to resume Senator Olympia Snowe (R-ME), the only Republican who voted for the Senate Finance Committee passed the bill in October. Democrats would grant it to amend the bill so as to place their support and the Democrats of the 60th Voice necessary or
3 Home and Senate Democrats could begin significantly in their respective rooms and new versions of the proposed lightweight law of “reconciliation” process, or a regular order. Arbitration would be restricted field of law issues that increase spending or federal funds in the frame, so many provisions, such as creating new markets for insurance and an individual mandate, could be excluded.

Back Obama seems to recommend that he favors starting with legislators in the Home and Senate once again and produce a stripped account. In addition, moderate Democrats in the Senate – called on leaders to slow /> <br Sen – slow growth by such a massive partisan bill in light of the Massachusetts election. Jim Webb (D-VA) called on Senate leaders to suspend the vote on health reform until Mr. Brown is sworn. Obama and Senate Majority Leader Harry Reid (D-NV) have reiterated the same message. Also known as Senator Joe Lieberman (D-CT) for a bipartisan effort that the ideal way to achieve law reform health care.

health reform negotiations Massachusetts Special Election

senators urge the Government to guarantee savings: In a letter sent last Thursday to Senator Reid, five Democratic senators for inclusion of a “fail-safe mechanism” called for in the final declaration. This mechanism would be Congress ‘tools to keep costs under control, it is not the current budget savings. Materialize “

The two versions of Senate Bill s’ lean heavily on cuts in public spending, especially in Medicare financing reform. Republicans and some analysts state the government is not in favor of the spending cuts that will lead to higher costs forced

Obama in less endorsement for biologics. Last Thursday, Obama is actuation for a change in the law on health reform as the number of years, biological drugs are patent generic competition that would reduce previously fortified set at 12 years. The White Home and Rep. Henry Waxman (D-CA) have negotiated for 10 years of endorsement or less.

Members of the media speculated that the change would reduce or increase the endorsement for biological medicines, an approach that Obama presidency point pressure of the pharmaceutical industry, contributions to pay for health care reform. In fact, reports the Wall Street Journal that the Democrats in Congress had asked the pharmaceutical companies to take an extra billion dollars or more that industry has concurred to primeval negotiations on reform.

Obama strikes deal with unions: Last week Democratic negotiators reached an agreement with the union and admitted to the Union demands the withdrawal of a tax on insurance premium . The deal would pay the union members to the tax until 2018, five years after the tax would apply to other exempt employees. Even though the firm to help win union support for the bill, it would generate also reduce the amount of tax revenue by about 40 percent of dollars. As such, the Democratic leadership will have to find other sources of income, the difference

Public Notice Exit reform health care poll like a hot iron. Since the polls to vote Tuesday night, Massachusetts Senate election, an exit poll Fabrizio, McLaughlin & Associates survey found that 52 percent of voters stated they oppose the measure of health Federal health care reform, saying 42 percent, they voted to support President Obama, this bill. In addition, 48 percent stated that health was the only issue driving their vote />
<br polls show dissatisfaction. later, the Wall Street Journal / NBC News poll found that almost half of Americans believe that the proposed health care reform in Congress is a bad intent (46 percent). This number is considerably compared to April, while only 26 percent thought the plan was a bad idea. In addition, only 33 percent state the plan is a good idea. Almost half of respondents (48 percent) think it would be the existence of the current legislation a "step backwards".

Was also a new Quinnipiac University poll that public support for reform of health care continues to decline. Thirty-four per cent more approve, while 54 percent opposed the most. At the end of December, 53 percent of Americans generally approve, while 36 to Most rejected.

view is present, the road to health reform is unclear. Democrats looking for a way to secure the votes needed to pass laws and some are actuation the value of the question, for example, an important bill. Obama had hoped the final bill before his Say of the Union, which is scheduled for Jan 27 to see but it seems that this goal is probably out of reach

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This Week in Health Reform

Republican Scott Brown’s victory over Massachusetts Attorney General Martha Coakley (D) in the Jan 19 special election to fill the seat of the late Senator Edward Kennedy (D) might establish to be a game-changer for the health care reform debate. The loss of the 60th Democratic vote now robs Senate Democrats of a filibuster-proof majority. Last week, Democrats were rushing to wrap up a House/Senate agreement on the bill, likely due to reports that Coakley’s lead had diminished.

Congressional leaders are still aiming to have the controversial points in the health care reform bill settled as soon as possible, so they can send the compromised bill to the Congressional Budget Office (CBO) for scoring. The CBO will then need 12 days to examine the legislation.

In addition to Senate Majority Leader Harry Reid (D-NV) and Speaker of the House, metropolis Pelosi (D-CA), lawmakers participating in the White Home meetings include: Home Majority Leader Steny Hoyer (D-MD), Home Majority Whip saint Clyburn (D-SC), Home Energy and Commerce Committee Chairman Henry Waxman (D-CA), Home Ways and Means Committee Chairman Charlie Rangel (D-NY), Home Education and Labor Committee Chairman George Miller (D-CA), Assistant Senate Majority Leader Richard Durbin (D-IL), Senate Finance Committee Chairman Max Baucus (D-MT), Senate HELP Committee Chairman Tom Harkin (D-IA), and Senate Banking Committee Chairman Christopher Dodd (D-CT).

A main point of contention between the two houses of Congress pertained to the
40 percent excise tax on high-cost health insurance plans passed by the Senate. Since many fag union members would be affected by the tax on high-cost health insurance plans, the Home of Representatives was not supportive of this supplying in the Senate bill. Union leaders have also been included in key negotiations on this provision, and on Jan 14, signaled that they are ready to support the merged legislation with the compromised provision.

The main revenue source for the Senate’s health care reform bill (H.R. 3590) would be from an excise tax – beginning in 2013 – on employer-provided, high-cost health insurance plans costing more than ,500 for individuals and ,000 for a family. The reported compromise on the legislation now makes the tax kick-in on policies costing ,900 for individuals and ,000 for families. The tax threshold would still rise at inflation plus one percentage point, as is currently written in the Senate bill. Additionally, dental and vision benefits would be removed from the calculation of threshold costs, and plans offered by say and local governments, as well as plans covered by collective bargaining agreements, would be exempted from the excise tax until 2018. This would grant current agreements to expire and grant for negotiation of new contracts.

In an effort to make up the demand of revenue from the modification of the excise tax provision, leadership will have to come up with new funding to finance the merged bill. Some reports have mentioned that the pharmaceutical industry has concurred to wage more money than the billion they have already negotiated with the White House. Medical device companies could also grappling additional fees. Portions of the main revenue source in the Home bill – a Medicare payroll tax on wealthy U.S. residents – could be added as well.

On Jan 14, Richard Trumpka, president of the AFL-CIO, said, “Union leaders approached negotiations with the White Home and congressional leaders with one overriding goal in mind – getting a bill signed into law.” Gerald McEntee, president of the American Federation of State, County and Municipal Employees (AFSCME), said, “We do like the way it’s shaping up, but it’s still not finished. We’ve got to see a final product.”

There also has been significant discussion – but no resolution so far – about the question of whether to establish a single national health insurance exchange or grant apiece say to operate its own exchange. Blue Cross and Blue Shield of Texas continues to support a state-based approach to exchanges.