Multiple issues still on the table in House-Senate health bill negotiations

Reports explored contentious policies in the House and Senate versions of the health-overhaul legislation that are part of the final negotiations.

The New York Times: One important - and until recently, rarely discussed - reform issue that splits Senate and House negotiators is states' roles in implementing the health care overhaul. "The House bill envisions a new federal agency to oversee a national marketplace in which people could buy insurance. … But the Senate bill calls for the industry overhaul to take place on the state level, with marketplaces, or exchanges, set up in each of the 50 states." The difference could mean people may end up with significantly better or worse health coverage depending on which state they call home (Abelson, 1/13).

CongressDaily: "Congressional leaders are asking the pharmaceutical industry to cough up an additional $10 billion to help pay for the healthcare overhaul as they search for revenue to fund what will likely be a more expensive final bill than the one the Senate produced last month." That comes in addition to an $80-billion-saving deal between the drug industry and key Democrats last year that companies believed would protect them from further cuts. "The revenue raised from the pharmaceutical industry in part would be used to help close the coverage gap in the Medicare Part D prescription drug benefit" (Edney, 1/13).

The New York Times: A separate report notes that Sen. Patrick Leahy, D-Vt., and 18 other senators have asked Democratic leaders to repeal an anti-trust exemption insurers have enjoyed since 1945 as part of the health overhaul. The House included the change in its version of the bill, but it was stripped from the Senate version (Herszenhorn, 1/13).

Modern Healthcare: "A proposal to create a Medicare advisory commission to better align provider payments will likely survive key House-Senate negotiations despite objections from some Democrats who say it takes the power of the purse away from Congress. Rep. Anthony Weiner (D-N.Y.) said late Tuesday that the provision—a carryover from the Senate's bill—could be tweaked to give lawmakers more sway over the process, but that such a move could ultimately lessen its financial impact on the Medicare program (DoBias, 1/13).

U.S. News and World Report discusses the effect of the requirement that everyone buy health insurance. "In most cases, people who don't have insurance would get slapped with a penalty, which could eventually be several hundred dollars or more. Democrats, of course, don't want healthcare reform turning into a massive penalty campaign with the IRS going after millions of Americans for playing hooky. The whole point of the mandate, after all, is to get more people covered, not to ding people for not being covered. And that means Democrats, in the next week or two, have to decide how much the government should be doling out to make insurance affordable" (Garber, 1/13).

NPR: "Both the House and the Senate bills offer the potential for a comprehensive approach to address obesity. Everything from counseling about obesity in the clinical setting to community prevention programs," Jeffrey Levi, the executive director of the Trust for America's Health tells NPR (Block, 1/13).