The Senate Finance Committee on Wednesday during a six-hour meeting discussed proposed changes to the Medicare system from committee Chair Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa), the New York Times reports (Pear, New York Times, 4/30).
The lawmakers on Tuesday released a 48-page document outlining proposals aimed at increasing the number of primary care physicians, reducing hospital readmission rates, increasing transparency, overhauling Medicare Advantage plan payments and creating quality benchmarks for physicians and hospitals (Kaiser Daily Health Policy Report, 4/22). Baucus said that changes to Medicare could drive "transformation of the health care delivery system" (New York Times, 4/30).
Wednesday's meeting was attended by committee members, their staffs, Medicare Payment Advisory Commission Executive Director Mark Miller and Congressional Budget Office Director Douglas Elmendorf (Armstrong, CQ Today, 4/29).
After the meeting, Grassley said, "There was not a lot of disagreement on what was a problem," but "[t]here might have been some disagreement on how to solve the problem." Baucus said that most concerns were about proposals to reduce MA plan payments to private insurers (Edney, CongressDaily, 4/30). Baucus added, "Some of the concerns are to make sure the policies are applied fairly to different parts of the country." He also said that committee members raised concerns about how fast some of the proposals would be implemented. A Republican committee aide noted that Republican members "are really still digesting it," adding, "A lot of the day really was going through these options" (CQ Today, 4/29).
Meanwhile, interest groups are raising objections to some of the proposals. According to a source in the physician community, specialty surgeons and physicians are particularly concerned about proposals to base Medicare payments on quality benchmarks (CongressDaily, 4/30). In addition, some groups are concerned about a proposal to "bundle" Medicare payments for all the services provided to a hospital patient, including care provided at a nursing home or by home health care providers. Bruce Yarwood, president of the American Health Care Association, said, "This proposal is a little bit scary. I don't want to give hospitals full control of our Medicare payments" (New York Times, 4/30).
The committee is expected to hold two more closed-door meetings on how to expand health care coverage and how to finance reform. Grassley said, "The next two things we do are going to be a little more difficult, but this gets us off to a good start." The committee plans to mark up a health care overhaul bill by mid-June. According to Baucus, the committee is "on schedule" (Armstrong, CQ Today, 4/29).
Congressional Democrats Push for Public Plan
Fifteen Democratic senators and one independent senator on Wednesday sent a letter to Baucus and Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.) calling for the inclusion of a public health insurance option in reform legislation, CQ Today reports (Wayne, CQ Today, 4/29). The letter stated, "There is no reason to believe that private insurers alone will meet the public purpose of ensuring coverage for all Americans at affordable prices for taxpayers." Sen. Sherrod Brown (D-Ohio), who signed the letter, said that a public plan "would provide competition to the sometimes dysfunctional private insurance market" (Young, The Hill, 4/29). Brown added, "We don't have everybody in the Democratic Caucus convinced, but there's a lot of people who think that private insurance operates a step ahead of the sheriff" (Wayne, CQ Today, 4/29).
House Ways and Means Committee Hearing
At a hearing on employer-sponsored health insurance on Wednesday, the House Ways and Means Committee heard testimony from two witnesses who oppose proposals to establish employer health coverage mandates, CQ HealthBeat reports. The appearance of the witnesses was in response to accusations made by Republicans last week that committee Democrats want to hear only from allies as they craft health reform legislation. William Dennis, a senior research fellow at the National Federation of Independent Business Research Foundation, testified that mandates requiring employers to provide health coverage are "bad for small employers, bad for the low-income and bad for the economy." According to Dennis, mandates would result in job losses for low-income people, lower wages and fewer work hours (Norman, CQ HealthBeat, 4/29).
Senate HELP Committee Examines Health Care Costs
The Senate HELP Committee on Tuesday met to discuss how health care costs must be addressed in order to achieve sustainable health care reform, CQ HealthBeat reports. Committee ranking member Mike Enzi (R-Wyo.) said, "Our current pace of spending is not sustainable and we must get health care costs under control." Jon Kingsdale, executive director of the Commonwealth Health Insurance Connector in Massachusetts, said, "Near universal coverage is simply not sustainable financially unless we address health care costs."
Utah House Speaker David Clark (R) said that the federal government should preserve states' abilities to develop innovative health coverage programs, but he added that there are certain elements of reform that could be applied across states. He said, "If two states with such widely differing cultural, political and systemic backgrounds as Utah and Massachusetts can pursue similar reforms, then other states can do the same" (Attias, CQ HealthBeat, 4/29).
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