March Brings New Perspectives on Fight for Reform

[This article posted on March 1, 2010. It is posted within the following categories: CMS, via Michael Douglas, MD, MBA.]

House Speaker Pelosi says she is confident that healthcare reform will pass. This, apparently, is the major mode of thought coming from the Democrats as a result of the flurry of activity and speculation filling the Sunday morning talkfests yesterday. Relying on the sheer numbers of votes in her party, the pronouncement comes a few days ahead of President Obama’s announcement later this week of how he’ll proceed on reform.

Votes are one thing, but how those votes will be cast is quite another — and in the Beltway, perception is everything. The GOP is ready to counter any move by the Dems with criticism they hope to ride all the way to November. If it’s getting the bill through reconciliation (to avoid a filibuster)[1] or starting over from “scratch” — the GOP’s version of a legislative “gotcha” directed toward Obama — the Democrats seem to be playing a risky game with the nation closely divided on the reform bill as it stands today.

Spring break in Congress occurs on 3/26. Will things be wrapped up by them? Will the long road to reform end with votes to secure a bill, any bill? Or will it come down to reconciliation as the line in the sand: for the Dems, it means passing a bill to expand Medicaid, require employer-sponsored coverage, and require people to have coverage; for the GOP, it means fighting against reconciliation and turning Obama’s push for reform into a protracted referendum on the balance of power in Congress come November. | LINK

  1. The House would pass the health bill approved in December by the Senate, and both chambers would approve changes, separately. [↩]
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Obama Feverishly Courts GOP in Search of a Reform Bill Compromise

[This article posted on February 7, 2010. It is posted within the following categories: Healthcare Policy & The Media, Politics & The Law, via Michael Douglas, MD, MBA.]

Obama is currently changing the focus of  his administration’s effort at domestic economic fixes from healthcare to jobs creation.  But he hasn’t completely abandoned healthcare lately — in spite of the recent media coverage hinting of the president’s pressuring Nancy Pelosi to just go with the Senate version pronto.

At an effort to keep health reform from the jaws of death, Obama has invited GOP leaders to discuss possible bipartisan compromises in a meeting slated for the end of this month.

Asked if he was willing to start from square one, the president said he wants “to look at the Republican ideas that are out there. And I want to be very specific. ‘How do you guys want to lower costs? How do you guys intend to reform the insurance markets so people with preexisting conditions, for example, can get health care?’”

Haven’t we been here before? Over a year into his presidency and his dreams of reform passage still the stuff of pipes — patients, providers, and pundits are probably growing as weary as the GOP (now that filibuster is not a possibility) watching this fight play on.

A White House statement Sunday said Obama repeatedly has made it clear “that he’s adamant about passing comprehensive reform similar to the bills passed by the House and the Senate.”

“He hopes to have Republican support in doing so, but he is going to move forward on health reform,” the statement said.

Obama hopes? For all of those wondering just how flawed the Democrats’ bipartisan strategy has been up to this point with respect to reform, it is unfortunately totally being laid bare now. The battle for reform on Obama’s terms is rapidly slipping away. | LINK

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House and Senate Democrats at Minor Crossroads This Weekend Concerning Directions of Reform Bill

[This article posted on January 23, 2010. It is posted within the following categories: Healthcare Policy & The Media, Politics & The Law, via Michael Douglas, MD, MBA.]

The big question today on the Hill is where do the Democrats go from here? With respect to healthcare legislation, in a week that saw a rapid one-two punch to the hopes and aspirations of the once filibuster-proof Senate Democratic majority essentially knock the party down in a major way, the answer is who knows? I guess this is where the House Speaker and Senate Majority Leader come in to save the day.

Struggling to salvage health reform, Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi have begun considering a list of changes to the Senate bill in hopes of making it acceptable to liberal House members, according to sources familiar with the situation.

The changes could be included in separate legislation that, if passed, would pave the way for House approval of the Senate bill — a move that would preserve President Barack Obama’s vision of a sweeping health reform plan.

Could the House be attempting to pass the Senate bill via reconciliation — giving solace to those who are writing off the Democratic party in advance of the 2010 midterms? Perhaps, if already approved changes via Pelosi and Reid concerning deals with the unions to decrease taxes on high-end Cadillac plans and other improvements will still pass muster amidst a filibuster-challenged Senate Dem majority. Obama probably hopes so, as he has already begun to move on with other domestic policy matters — those pesky little thorns in his side often referred to as “unemployment numbers“. | LINK

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House-Senate Agreements within Reform Bill Signal Obama’s Pending Signing

[This article posted on January 9, 2010. It is posted within the following categories: CMS, Corporate, Politics & The Law, via Michael Douglas, MD, MBA.]

The quest for a public option has been watered down immensely since the end of the House debate on the matter. What seemed like a real sense of purpose among House Democratic congressional leaders in securing legislation to include a public option — even in the face of futile derailments by more conservative Dems and Republicans last month — has all but been abandoned now. In fact, total acquiescence to the Senate’s desires is the rule, according to many officials today close to the legislative process being worked out at this hour.

Essentially, the endgame is what I have predicted all along in the pages of this blog — a mandate not on public financing of healthcare, but the close rein on the influence of Insurance on healthcare financing.

In obvious maneuvering among House and Senate leaders, as well as the president, the goal of getting a reform bill out complete with all the trappings of the Democrats’ talking points of “achievements” and “future gains” is gaining momentum. Government insertion into Insurance is the major issue to be resolved by the time President Obama touts his health reform “accomplishments” in his annual State of the Union address in a few weeks. All of this rests against a backdrop of revised statements from Speaker Pelosi and Obama, to name a couple, carefully worded as the tepid bill awaits House-Senate merging.

  • Pelosi has recently listed “new” goals for the bill without ever mentioning the public options she has so long supported: We are optimistic that there is much that we have in common in both of our bills and that we will resolve or reconcile this legislation in a way that is a triple A rating: affordability for the middle class, accountability for the insurance companies, and accessibility to many more people in our country to quality, affordable health care.
  • Obama says that — although he has always favored a public option — it has never been an essential part of his desire to overhaul the nation’s healthcare system.
  • House Dems, who acknowledge the precarious nature of the inclusion of a public option, now are saying they favor reforming Insurance if they aren’t “let off the hook”.

Compromise or capitulation from the House? At this point, it really doesn’t matter. Just get the thing passed so we can start focusing on its influence in the second decade of 21st Century Healthcare. | LINK

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House Speaker Seems to Solidify Public Option Policy Doubts

[This article posted on December 10, 2009. It is posted within the following categories: CMS, Corporate, Politics & The Law, via Michael Douglas, MD, MBA.]

House Speaker Nancy Pelosi’s role in the debate on healthcare reform has been one of unmistakable inevitability; that is, she was either going to get the bill through with the public option, or die trying. Well, she’s alive and well today — which is more than anyone can say about her commitment to Obama’s crystal clear vision of healthcare reform. If one needed a reason to doubt the stability of public option language in the reform bill, he/she has it today. And all he/she needed to do was hear it from Pelosi’s lips:

The president has said, we believe, the House believes that the public option is the best way to hold the insurance companies honest, keep them honest and also to increase competition. If you have a better way, put it on the table. When we see something from the Senate, we’ll be able to make a judgment about that.”

That something is probably the 55-65 Medicare buy-in.

There is certainly a great deal of appeal about putting people 55 and older on medicare. That’s something people in the House have advocated for years.”

To say that she’s happy about this development would be an understatement. This raises the question for progressive Democrats: are you going to settle, or up the ante? | LINK via TPM

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