Sen. Schumer proposes holding public health insurance option to same standards, rules as private insurers

Sen. Charles Schumer (D-N.Y.) on Monday proposed that any public health insurance option developed as part of comprehensive health care reform legislation be subject to the same rules and standards as private insurance, the New York Times reports.

According to the Times, congressional Democrats are trying to "shift the debate from the question of whether to create a public health insurance plan to the question of how it would work" in an effort to gain support from moderates.

Schumer said that his goal was "a level playing field for competition" between private and public insurance. However, Karen Ignagni, president and CEO of America's Health Insurance Plans, said, "It's almost impossible to accomplish that objective." Schumer set forth the following principles for such a plan:

• The public plan should be self-sustaining by paying claims with money accrued from premiums and copayments, rather than tax revenue or government appropriations;
• A public plan should pay physicians and hospitals more than Medicare;
• Physicians and hospitals should not be required to participate in the public plan simply because they participate in Medicare;
• Officials who regulate the insurance market should be different from those who manage the public plan;
• A public plan should be required to establish a reserve fund, just as private insurers do, for anticipated claims; and
• A public plan should be required to offer the same minimum benefits as private plans (Pear, New York Times, 5/5).

Even with the condensed schedule lawmakers have set for drafting comprehensive health reform legislation, House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) on Monday said that he plans to hold public hearings on the plans being developed by his and the other two House committees drafting legislation, CQ HealthBeat reports.

At a conference sponsored by Avalere Health, Waxman said that staff from his committee, the House Ways and Means Committee and the House Education and Labor Committee are working together to create a common "framework" in which each committee could move forward in its own direction. Waxman said that "next month or so, that proposal will be made public," after which he and House Energy and Commerce Health Subcommittee Chair Frank Pallone (D-N.J.) "intend to hold hearings to get the views of the stakeholder. We intend to follow a transparent mark up process."

Waxman at the conference said he predicts: "one, that the House of Representatives will pass a health reform bill by the end of July; secondly, that before this year is up the Congress will pass a bill; and thirdly, the president will sign it" (Reichard, CQ HealthBeat, 5/5).

However, Democratic and Republican aides are saying the self-imposed timeline set by members of Congress could be challenging particularly because of the difficulty the Congressional Budget Office is having in generating cost estimates for expanding coverage and financing the whole plan. According to CBO Director Douglas Elmendorf, part of the problem is that staffers are asking CBO to estimate a range of proposals all at once, adding, "This is as complicated as all get out" (Adamy, Wall Street Journal, 5/5).

Specter Still Swing Vote for Health Care Reform

Even after switching political parties last week, Sen. Arlen Specter (D-Pa.) is still considered a swing vote by health care reform advocates, Politico reports. During a recent appearance on NBC's "Meet the Press," Specter said, "I'm ready to put my shoulder to the wheel to get legislation adopted," but "I'm going to take a look at it piece by piece. ... I'm not committed" (Budoff Brown, Politico, 5/5). Specter went on to mention many proposals he favors that are in line with Democrats' ideas, but said that he is against the central Democratic proposal of a public health insurance option that would compete with private insurers (Zhang, "Washington Wire," Wall Street Journal, 5/5).

Patient Care Bill

In related news, Sen. Jay Rockefeller (D-W.Va.) on Monday introduced a bill calling for the creation of a new executive branch office that focuses on improving the quality of patient care in all federal health programs, Politico reports. The bill also would re-establish a council to coordinate efforts among agencies and grant more power to the Agency for Healthcare Research and Quality. Under the bill, the AHRQ director would be a Senate-confirmed position. According to Rockefeller, the bill is intended to serve as an alternative to the health care delivery reform proposals outlined last week by senior members of the Senate Finance Committee.

Rockefeller said, "The lack of clear quality improvement infrastructure has hindered our ability to improve patient health outcomes and reduce inefficiencies in our health care system," adding, "Quality must be a national priority in order to achieve true delivery system reform" (Budoff Brown, Politico, 5/4).

Health Care Reform Concerns

Summaries of recent news articles examining prospects for health reform appear below

• Compromise concerns: Many advocates for comprehensive health care reform are concerned that some congressional Democrats, particularly Senate Finance Committee Chair Max Baucus (D-Mont.), are too willing to compromise and will succumb to Republican demands for a less comprehensive plan, the Washington Times reports (Lengell, Washington Times, 5/5).
• Previous health reform attempts: It is unclear whether the lesson from the Clinton administration -- that U.S. residents prefer privately run health plans to a public plan option -- is still applicable because trust in the private sector has significantly dropped since the mid-1990s, the Boston Globe reports. However, some Democratic lawmakers are considering trading away the proposal of a public option in exchange for Republican support (Canellos, Boston Globe, 5/5).