President Barack Obama has reignited the health reform debate in the last two weeks by voicing his commitment to facilitating the passage of reform legislation by Congress. The President also convened a bipartisan, bicameral, televised health care summit February 25 in an effort to pave the way for reform and to “bridge the gap” between Democratic and Republican proposals. White House Chief of Staff Rahm Emanuel and Health and Human Services Secretary Kathleen Sebelius invited House and Senate leadership of both parties, as well as the chairs and ranking members of committees of jurisdiction to participate in the daylong session that, despite efforts to find common ground, ended with each side as entrenched as they started.
A few days before the summit, the White House posted an 11-page health care reform proposal outlining changes to the Senate-passed reform bill to facilitate discussion on the “best parts” of the single-chamber–passed bills and areas for improvement. The skeleton bill in that proposal signaled that the White House is not ready to scale back the initiatives the House and Senate have already passed. Last week the President announced that he wants Congress to move as quickly as possible on a compromise measure amending the Senate bill using a procedure known as reconciliation. Such a procedure would allow a compromise bill to proceed in the Senate with a simple majority, but the contents of the package would be subject to stringent parliamentary rules requiring that each provision either spend or save money. To avoid another vote in the Senate on the broader underlying package, the House is expected to pass the Senate bill, and each chamber will pass the reconciliation measure amending the Senate’s provisions. However, it’s expected that the Senate would need to demonstrate that it has the votes to pass the reconciliation measure before the House will pass the underlying Senate measure that the reconciliation package amends.
With Congress adjourning March 29 for its two-week spring recess, the timeline is compressed for such comprehensive legislative action. GNYHA remains extremely concerned about several problematic provisions in the Senate bill, including the steep and damaging Medicare and Medicaid disproportionate share hospital cuts; the Independent Payment Advisory Board, which will preempt payment policy decisions from Congress; inequitable treatment of states that have already expanded their Medicaid programs (in terms of Federal matching support); and an overreaching and inappropriate readmissions policy. As Skyline News went to press, it was unclear which of these policies will be addressed in the reconciliation measure expected to be scored by the Congressional Budget Office this week.