Senate Finance Committee to discuss public plan options; House Energy and Commerce Committee discusses state, regional plans

The Senate Finance Committee on Thursday will meet to discuss the inclusion of a public insurance plan in its health care reform legislation, the Des Moines Register reports (Beaumont, Des Moines Register, 5/14). Supporters of the public plan say it would allow middle-income workers a choice between their employer coverage and coverage offered by the government. The insurance industry and Republican lawmakers oppose such a plan.

The Finance Committee will consider a plan similar to Medicare but that would feature slightly higher reimbursement rates for providers. The plan would either be operated by the government or government-contracted private firms. Another option would allow each state to develop and oversee its own public coverage plan. The committee also will consider a proposal from Sen. Charles Schumer (D-N.Y.) that would allow a new public plan to compete with private insurers by requiring that the public plan be financed by premiums rather than tax dollars, that it follow the same solvency rules that apply to private firms and that it keep a reserve fund to cover liabilities. Schumer's plan also would allow doctors and hospitals the choice of participating. The public plan also would be required to follow the same consumer protection rules as private firms (Alonso-Zaldivar/Werner, AP/Contra Costa Times, 5/14). The panel also is expected to discuss employer or individual mandates (Edney, CongressDaily, 5/14).

Committee ranking member Chuck Grassley (R-Iowa), who has said he believes a public plan would eventually eliminate private insurance and force U.S. residents out of their employer-sponsored plans, said the committee meeting will reveal the likelihood of Republicans uniting against a public option. "We will have an idea how controversial it is and how strong people feel about it on both sides," Grassley said. He added, "I think before I would write it off completely, I would want to look at what those possible compromises are" (Des Moines Register, 5/14).

House Energy and Commerce Committee

The House Energy and Commerce Committee on Wednesday met to discuss a public plan, including potential state-run options, CongressDaily reports. Energy and Commerce Oversight and Investigations Subcommittee Chair Bart Stupak (D-Mich.) said a potential state- or region-based plan would address geographic variations that affect health care delivery and costs. However, he said that he is waiting for more details, especially on the cost of such an option, before supporting any specific public plan.

A former aide to a committee member said a public plan could include a federal exchange that featured public and private coverage options that meet certain coverage minimums. The aide said that states could opt out of the federal exchange in favor of creating their own exchange, which still would feature plans that meet the minimum coverage standards.

Committee leaders also said Democratic health care negotiators are considering a public plan that allows consumers to choose from three levels of coverage (CongressDaily, 5/14).

MedPAC Report

Republican lawmakers this week said that a report released on Tuesday by the Medicare Payment Advisory Commission that projected insolvency for the Medicare trust fund for hospital care benefits by 2017 does not bode well for a public plan under any health reform legislation, the Des Moines Register reports. Grassley said, "We can't afford the public plan we already have," adding that "if we create a government-run health care plan that's unaffordable and unsustainable, it isn't going to be any good for anyone" (Beaumont, Des Moines Register, 5/13). Senate Health, Education, Labor and Pensions Committee ranking member Mike Enzi (R-Wyo.) said, "Costs are definitely the gorilla in the room," adding, "There are a lot of plans out there. Some of them I think are ridiculous; some of them I think might work."

However, Democrats said the report suggests that overhauling the health care system could help address the issues that led to Medicare's financial situation. Schumer said, "It's a big issue no matter what, because it's a huge amount of money -- huge. ... And yet, if you ask the American people, this is one place they really want to see things happen," adding, "So, we're looking and checking out everything" (Drucker, Roll Call, 5/14).

Kind Bill

Rep. Ron Kind (D-Wis.) on Wednesday said he is proposing a bill (HR 2360) that would establish voluntary insurance pools to help businesses, farmers and ranchers find affordable health coverage, CQ HealthBeat reports. The bill, which Kind hopes will be folded into a comprehensive overhaul bill, would offer private health plans within state or nationwide pools. Small-business owners would receive a tax credit of as much as $1,000 per worker or $2,000 per family if they cover 60% of premiums and a bonus if they pay a larger portion. Self-employed people would be eligible for an $1,800 annual tax credit, or $3,600 for families, with which to buy insurance. The bill also would ban the rating of premiums based on health status and claims experience in these pools (Norman, CQ HealthBeat, 5/13).

Schumer

Schumer's entrance into the debate over a potential public insurance plan has "surprised health care insiders," but the senator's plan for creating a public insurance option that would "comply with the rules and standards of private industry" has "managed to soften the edges of the fight" over one of the most contentious issues in the health reform debate, Politico reports. The plan has gained support from some lawmakers who previously expressed opposition to the public option, including Rep. Jim Cooper (D-Tenn.) and Sen. Arlen Specter (D-Pa.) (Budoff Brown, Politico, 5/14).

GOP

House Republican leaders have asked President Obama to meet with them to discuss areas of "common ground" on health care reform, The Hill reports. In a letter to the president, nine top-ranking Republican lawmakers say, "Our hope is that such a dialogue will lay the groundwork for an honest debate and open process that will culminate in enactment this year of significant and truly bipartisan health care reform legislation." According to the letter, areas of agreement include affordable coverage available to all U.S. residents, including those with pre-existing conditions; allowing people to keep their current insurance; and allowing preventive care to be improved and expanded. The letter also lists some areas where Republicans disagree with Obama, such as setting up a government-run plan.

Members of the Republican Health Care Solutions Group, led by Rep. Roy Blunt (R-Mo.), are scheduled to hold a press briefing Thursday to discuss progress they have made on health reform since March. The group was formed by House Minority Leader John Boehner (R-Ohio) in order to create a Republican health reform proposal (Hooper, The Hill, 5/14).

DeParle

The Washington Post on Wednesday profiled White House Office of Health Reform Director Nancy-Ann DeParle and her "first gambit in the health battle" -- Monday's White House meeting with health care industry groups who are "known for killing health care reform 15 years ago" (Connolly, Washington Post, 5/14).

Broadcast Coverage

MSNBC's "The Ed Show" on Wednesday included a discussion on House Speaker Nancy Pelosi's (D-Calif.) pledge to have a House health care reform bill by July. The segment included a discussion about a single-payer system with Geri Jenkins, co-president of the California Nurses Association. The show also included interviews with Mike Farrell of Health Justice-Single Payer Action; Rep. Eric Massa (D-N.Y.); and a panel discussion with The Nation editor Katrina vanden Heuvel, MSNBC anchor Carlos Watson and radio talk show host Michael Medved (Schultz, "The Ed Show," MSNBC, 5/13).