Sebelius, DeParle discuss health care reform with congressional lawmakers

Kansas Gov. Kathleen Sebelius (D), President Obama's nominee for HHS secretary, and Nancy-Ann DeParle, the director of the White House Office for Health Reform, each met with congressional lawmakers on Tuesday to discuss plans for health care overhaul, CQ Today reports. Sebelius said she met with nearly 40 senators who expressed "a lot of interest in health reform."

DeParle at a meeting of House Democrats said that health care reform is a top priority for the Obama administration and the White House is looking to work with Congress on efforts, Rep. Allyson Schwartz (D-Pa.) said after the meeting. According to Schwartz, House Speaker Nancy Pelosi (D-Calif.) told Democrats at the meeting that the budget resolution is an important "first step" in health care reform; however, Pelosi declined to address whether to use the budget reconciliation process to enact an overhaul. "Using reconciliation would give Democrats a much better chance to pass a health overhaul that includes a provision important to liberals and labor groups: creation of a government-run health plan that would compete with private insurers," an idea most Republicans opposed, CQ Today reports.

Budget reconciliation likely would receive no Republican support and any policy created under it would expire after 10 years unless Congress in the future votes for an extension, according to CQ Today. Senate Health, Education, Labor and Pensions Committee ranking member Mike Enzi (R-Wyo.) said, "Attaching health care reform to a budget bill to lock out Republicans is short-sighted" (Armstrong/Wayne, CQ Today, 3/24).

Kennedy, Waxman Discuss Reform Options

Senate HELP Committee Chair Edward Kennedy (D-Mass.) on Tuesday in a statement said that in order to "guarantee that all Americans have access to quality medical services, we clearly must reform the current health insurance market," and pointed to the Massachusetts health insurance law as an example of "sensible reform" (Rhee, "Political Intelligence," Boston Globe, 3/24).

Meanwhile, at a House Energy and Commerce Health Subcommittee hearing on Tuesday, House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) said that in addition to universal coverage, an overhaul of the U.S. health care system must ensure there are enough primary care physicians and nurses to provide care. Witnesses at the hearing offered a wide range of solutions for improving access, including dramatically increasing the number of primary care physicians and enhancing Medicaid to address racial, ethnic and geographic disparities in access to care.

Brian Smedley of the Joint Center for Political and Economic Studies highlighted racial and ethnic disparities in health status and access to care, saying that "no single policy -- such as expanding access to health insurance -- will fully address health care inequality." He added, "Health care disparities are complex and are rooted in many casual factors" that require health care system, health care financing and workforce development changes.

Republican lawmakers stressed the need to reform the medical malpractice system to increase the supply of physicians (Reichard, CQ HealthBeat, 3/24). Subcommittee ranking member Nathan Deal (R-Ga.) said, "Any package that we send to the floor should include a significant medical liability reform provision" (CongressDaily, 3/24).

Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the Foundation's Commission on Medicaid and the Uninsured, said that Medicaid has improved access to care. She said, "Drawing on Medicaid's experience and already substantial coverage of the low-income population offers an appropriate starting point for extending coverage to the low-income, uninsured population through health reform" (CQ HealthBeat, 3/24).

Rowland's testimony is available online.

Public Health Care Plan

In related news, the New York Times reports that Obama's proposal to offer a "federal, Medicare-like insurance plan to anyone, at any age," is "vehemently" opposed by the insurance industry and others fearful of increased government involvement in health care. According to the Times, "While the details of a federal insurance plan remain vague, a central question is whether it would function like Medicare -- wielding the government's size and clout to essentially dictate the prices it pays for medical care," which would make it very difficult for private plans to compete.

Karen Ignagni, head of America's Health Insurance Plans, said, "There's no way to run a side-by-side competition within the current structure." Karen Davis, president of the Commonwealth Fund, said such a public plan "would transform the market for private insurance," estimating that the average premium for a family of four would be around $9,000 annually under a public plan, compared to $11,000 annually under a private plan (Abelson, New York Times, 3/25).