Under The Radar, Lawmakers Quietly Exploring Areas For Potential Reform
Published By: The National Journal
July 11, 2008
by Anna Edney
Congress has had its hands full with the mad dash to wrap up major legislation, but proposals to revamp health care and make it more accessible and affordable are making shape as lawmakers and their staffs gear up for a healthcare overhaul in the near future.
Committees are working with each other and even across the aisle and the halls of the Capitol, though House and Senate healthcare leaders are employing different tactics.
Relevant Senate committees are or will soon hold stakeholder meetings, including two this week with Senate Health, Education, Labor and Pensions Chairman Edward Kennedy’s staff, Senate aides said. Meanwhile, House Ways and Means Health Subcommittee Democrats are focusing on the basics, keeping stakeholders at bay to avoid competing special interests, House aides said.
Kennedy’s staff plans to meet today with hospital and community health center groups, their fourth of about 10 stakeholder meetings that will last through much of the summer, a senior aide said. Staff met with business groups in Washington on Wednesday.
Kennedy was an early supporter of presumptive Democratic presidential nominee Sen. Barack Obama of Illinois and plans to use the stakeholder meetings, which are open to other health staff from both sides of the aisle, to help develop a consensus.
“He is laying the groundwork and bringing the parties together now so that we can hit the ground running with a new president in 2009,” Kennedy spokesman Anthony Coley said.
Senate Finance Chairman Max Baucus is following with stakeholder meetings and conversations with constituents about their experiences with the healthcare system in the fall, an aide for the senator said.
Meanwhile over in the House, Ways and Means Health Subcommittee Democrats do not see the benefit of meeting with stakeholders yet, aides said, citing the groups’ frequently agenda-laden proposals.
“You’re never going to get healthcare reform and have everybody sit in a circle,” one of the aides said.
Instead, Ways and Means Health Subcommittee Chairman Fortney (Pete) Stark, D-Calif., has held hearings on instabilities and disparities in health care and health savings accounts and is planning a fourth hearing next week on state approaches.
The House hearings have been more politically charged than those the Senate Finance Committee has held over the last few months and much more so than a popular bipartisan health reform summit committee leaders held in June.
“The witnesses they’ve brought forward haven’t indicated [Republicans] want to work with us,” a House Democratic aide said about Ways and Means Health Subcommittee Republicans.
One possible explanation is House Republicans’ desire to get behind their party’s presidential candidate, Sen. John McCain of Arizona. Republicans are being urged not to shy away from health care and to come up with an alternative to Democrats’ universal coverage proposals, said Sage Eastman, a spokesman for Ways and Means Health Subcommittee ranking member Dave Camp, R-Mich.
“The party is coalescing around an idea that systematically we need to get individuals and small businesses the ability to get into the market,” Eastman said.
Generally, the GOP wants to privatize health care and, under the plan offered by McCain, offer families rebates for purchasing individual health insurance. Democratic proposals envision a greater role for government.
Obama has proposed a federal plan everyone could access, supplemented by requirements for business to cover employees or pay into the national plan.
In the Senate, several members of the Finance Committee from both sides of the aisle are behind what is billed as the first bipartisan health reform bill in 13 years.
The proposal from Sens. Ron Wyden, D-Ore., and Robert Bennett, R-Utah, eliminates the link between employment and health insurance and as a result raises wages, and requires insurance companies to accept anyone who wants to sign up.
Several other members have their own proposals, including Senate Health, Education, Labor and Pensions ranking member Michael Enzi, who toured his home state of Wyoming in March talking about his market-based approach, spokesman Michael Mahaffey said.
Stark has a proposal as well that creates federal health coverage available for anyone without access to employer-based insurance.
Come next year, Wyden’s proposal will not be the only one to reach across party lines. The Bipartisan Policy Center, led by a group of former Senate majority leaders, plans to release a health reform proposal shortly after the election, said former Centers for Medicare and Medicaid Services Administrator Mark McClellan.
McClellan is helping former majority leaders Tom Daschle, D-S.D., Bob Dole, R-Kan., George Mitchell, D-Maine, and Howard Baker, R-Tenn., shape their plan.
McClellan leads the Engelberg Center for Health Care Reform at the Brookings Institution and envisions making health care more affordable starting with basing physicians’ payments on quality, not volume, as one change everyone can embrace.
He even tied it into the current congressional commotion over a bruising fight to pass legislation to stop a Medicare physician payment cut required by law when Medicare spending reaches certain levels.
The 18-month fix hangs in the balance as Congress waits to see if President Bush makes good on his veto threat.
“The better solution to this problem is to work out how to get from the payment system we have now in Medicare to one that actually supports doctors when they take steps to deliver better quality care at a lower overall cost,” McClellan said.
The Senate in particular, devolved into partisan bickering over the bill, but one aspect will change next year. McCain or Obama will be shaping the debate from the White House, and most observers agree that means some level of healthcare reform will become law.
