Health Reform Update - 7/27

HOUSE UPDATE The House Democratic health reform bill faced a setback last week, with opposition coming from key members of the House Blue Dog Coalition, a group of moderate House Democrats. The Coalition’s leader and House Energy and Commerce member Rep. Mike Ross (D-AR-4) says the Blue Dog’s opposition to the bill stems from its failure to contain costs, as well as its lack rural provisions addressing rural America’s access problems. Fellow Blue Dog Congressman Zack Space (D-OH-18), also a member of the Energy and Commerce Committee and strong rural advocate, recently posted on his blog concerns with the bill’s current version, stating it does not adequately protect small rural hospitals and small businesses, or sufficiently contain costs. Chairman of the Energy and Commerce Committee, Henry Waxman (D-CA-8), last week, suspended the Committee’s markup of the bill, citing the need to work out differences between the bill’s supporters and Blue Dogs. These closed door discussions, however, only amounted to a series of heated arguments between Waxman, Ross and others. Further dividing the groups, an announcement today that Pelosi and Waxman and other non-Blue Dogs representing rural districts came to an agreement to provide better reimbursement for rural Medicare providers, produced contempt from some Blue Dogs. Rep. Charlie Melancon (D-La-3), said the absence of his and other moderate members’ input on this agreement undercut him and other Democrats who have tried to fight for this from the very beginning. Still, House Majority Leader Steny Hoyer (D-MD-5) remains optimistic that Chairman Waxman will report the bill out of Committee and that Democrats will be able to come to a consensus before its final floor vote. He said recently the chances were “very small” that the floor vote on the bill would take place before the scheduled August recess, but also that they could push back the recess for another week if necessary. So…it remains to be seen whether or not Chairman Waxman will resume his Committee’s markup of the bill, or if rumors of his intent to bring it straight to the floor will be substantiated. Either way, with Republicans and most Blue Dogs set to vote against the current version of the bill, Chairman Waxman and Speaker Pelosi will most likely need to make at least some concessions, or risk not having enough votes. SENATE UPDATE Senate Finance Committee Chairman Max Baucus (D-MT), who has yet to release even a draft of the bill, has announced his intent to do so and begin the Committee’s markup sometime before the beginning of the August recess, which in the Senate is set for August 7th. Focused on reaching a bi-partisan agreement, Baucus has waited to release the bill in hopes of bringing its overall costs down while ensuring rural provisions are protected. Senate Majority Leader Harry Reid (D-NV) announced that the Senate will not take the bill to the floor before the August recess because of the Finance Committee delay, which gives Baucus and Ranking Member Chuck Grassley (R-IA) some breathing room to come to an agreement. Senator Grassley, additionally, seems optimistic about the Finance Committee’s version of the bill, and NRHA meetings with his staff have indicated his focus on important rural provisions. He hopes to support the final version of the bill, providing it is truly a bi-partisan effort. So…with the HELP Committee already having passed their version, we wait for the Finance Committee to release and markup its bill. It remains to be seen, however, if the Finance bill will garner any Republican support, unlike its HELP Committee counterpart, which passed on a straight party line vote of 13 Democrats to 10 Republicans. If it can, then it is likely the Senate will have the 60 votes needed to prevent any possibly filibuster, and therefore pass its version of the bill.

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