July has been an active month for health reform in Washington, D.C. Three Congressional committees passed out their versions of the health reform legislation and the other two committees are engaged in extensive health reform negotiations. The goal of President Obama and Congressional leaders was to have bills pass out of the House and the Senate by the August recess, but it is unlikely.
The Senate Finance Committee has delayed release of its bill and the House’s markup in the Energy and Commerce Committee has been stalled. In the Senate, Chairman Max Baucus (D-MT) is committed to crafting a bipartisan bill and is negotiating with Republican senators on the committee. In the House, conservative Democrats--the so-called Blue Dog Caucus--and freshman representatives have slowed progress of the bill because they are concerned about its cost and how it will affect their constituents.
While there are many issues that have bipartisan agreement– including issues of importance to the bleeding disorders community, such as the elimination of annual and lifetime caps, pre-existing condition clauses, and out-of-pocket maximums--there remains fierce debate over several provisions of the bills. The controversial issues include the creation of a public insurance program; mandates for employers to either provide coverage or pay a fine or tax; and the extent of small business exemptions from this employer mandate. There are also concerns about whether the current bills do enough to lower healthcare spending.
A primary roadblock is securing full financing for the bill–President Obama and Congressional leaders have pledged that the health reform bill, which could exceed $1 trillion, will be fully paid for. While much of the financing for the bills has been secured (through savings in the Medicare and Medicaid programs, taxes on the wealthy and insurance companies and other provisions), there remains disagreement over the best ways to pay for health reform.
For more information about the components of the health reform bills, please click here.