Health Reform Discussions Pace Slows

VHCA (7/24/2009)

As a hopeful sign that some level of common sense exists in Washington, Majority Leader Harry M. Reid indicated on Thursday that the Senate will not pass health care reform before its August recess, an announcement that highlighted internal Democratic divisions on the legislation and is likely to result in significant modifications in the final bill.  In the Senate, a bipartisan group of Senate Finance Committee members are working behind the scenes to develop an agreement that both parties can back.  Discussions continue, but neither side appears ready to announce a deal. 

Last week in the U.S House of Representatives, America’s Affordable Health Choices Act (H.R. 3200), was reported out of both the House Ways & Means and Education & Labor Committees along a mostly party line vote.  During the Ways & Means mark up, Florida republican Representative Ginny Brown-Waite used a parliamentary tactic to offer and then withdrew an amendment that would have reduced the cuts to nursing homes contained in the bill.  Representative Brown-Waite’s actions helped secure an agreement from both the Chairmen of the full committee and Health Subcommittee, who will work with her to address the concerns of the nursing home community.
 
The House Energy & Commerce Committee has begun consideration of H.R. 3200 this week. After a late night session on Monday, Committee Chairman Henry Waxman (D-CA) suspended consideration of the bill to work with a contingent of moderate and conservative Democrats (also known as the Blue Dog Coalition), who have expressed concern with the legislation as it is currently written. On Tuesday, Blue Dog leaders had a lengthy meeting at the White House and are reportedly standing firm that the bill be modified in order to gain their support. 

During a primetime news conference on July 23, President Obama promoted health care reform efforts, including proposals to create an independent Medicare Advisory Council that would make recommendations about Medicare payments, including the skilled nursing facility (SNF) market basket. This new council, which would replace the current Medicare Payment Advisory Commission (MedPAC), would be granted the authority to recommend broader reform of Medicare’s financing structure. 

The American Health Care Association (AHCA) has expressed concern about such a narrowly focused effort, pointing out that any such commission needs to review all revenue sources. Having this broader scope is especially important given Medicare’s subsidization of chronic Medicaid underfunding of long term care. In addition, AHCA believes that it is important to understand the background and experience of those being appointed to the new council, noting that one of the shortcomings with the current MedPAC structure is that there are no long term care experts serving on the commission.  

In a meeting with HHS Secretary Sebelius late last week, and in a separate meeting with senior officials with the National Economic Council at the White House earlier this week, AHCA President & CEO Bruce Yarwood shared concerns of long term care providers about various issues, stressing the need for economic stability in our sector. In both meetings, Yarwood stated that we understand the need to take some cuts in reimbursement in order to help make health care reform work, but he also explained the impact that freezes or cuts in state Medicaid rates are having across the nation.