National healthcare legislation

There’s a growing realization that fixing the broken US healthcare system means creating a system that works for small business. Small business has disproportionately borne the brunt of runaway healthcare inflation, paying nearly 20% higher premiums for healthcare coverage than large businesses—a fact that has forced many small businesses out of the health insurance market entirely in the last several years.

President Obama and Congress are beginning to understand the plight of small business owners and their employees. It’s likely that several bills to make healthcare more affordable for small businesses will be introduced. More importantly, new comprehensive reform legislation is expected from President Obama and Congressional leadership.

A new president and new energy for reform
President Obama made healthcare reform a top priority during his campaign and during the transition. He has appointed a highly respected team to lead the effort:

• Kathleen Sebelius, the two-term Governor of Kansas, has been nominated Secretary of Health and Human Services (HHS). Gov. Sebelius has an extensive track record in healthcare reform, including serving for eight years as the state’s insurance commissioner, where she received high marks for bringing the agency out from under the influence of the insurance industry.
  
  
• Peter Orzag has been appointed to head the Office of Management and Budget (OMB). Orzag has universal respect and support in Congress, having led the Congressional Budget Office. He’s also a noted authority on the US healthcare system who has published extensive research on the unsustainable cost trends of our health system.
  
  
• Other long-time experts on healthcare reform include Jeanne Lambrew, a nationally recognized author and policy expert who previously worked for President Clinton, and who has joined HHS; Dr. Zeke Emanuel, an expert on bio-ethics, author and oncologist by training, who has joined the OMB from the National Institutes of Health; and Nancy-Ann DeParle, who has worked within both HHS and OMB, who has been appointed director of the White House Office of Health Reform.

White House hosts healthcare summit
On March 5, President Obama and his healthcare team held a White House Forum on Health Reform, convening representatives from the broad spectrum of stakeholders in the healthcare system. The president again emphasized his commitment to getting national healthcare reform done now, and urged Congress to move forward. A number of key policymakers from both houses were there, including those specifically mentioned below. John Arensmeyer, CEO of Small Business Majority, was there; read more about the summit and John’s breakout session.

Congress prepares for a reform push
In the last year the Senate Finance Committee, chaired by Senator Max Baucus of Montana, held many hearings on the status of healthcare in the United States. The recently published “Baucus White Paper” provides a detailed foundation for national reform legislation. Senator Edward M. “Ted” Kennedy of Massachusetts, chair of the HELP Committee, has also been working diligently on healthcare reform. A bipartisan group of senators has been meeting to try to draft a consensus bill to give the new Congress a starting point on the reform debate.

On the House side, Chairman Henry Waxman has geared up the Energy and Commerce Committee to make national healthcare reform a priority this year. Several Congressional leaders have also announced their expectation that work on national healthcare reform will be completed in 2009.

Reform efforts boosted by stimulus plan and children’s coverage
The first order of business for President Obama and Congress was the national economic stimulus plan, which they passed in mid-February.

President Obama and Congress established several key healthcare expenditures as part of the stimulus plan. The largest is $19B to build a national system of electronic medical records. There’s strong bipartisan support for this segment of the package, considered a necessary first step for healthcare reform—especially for control of costs by facilitating comparative effectiveness programs.

The president and Congress also passed legislation to expand coverage of 4 million uninsured children in the SCHIP program.

Healthcare is a budget priority for Obama
President Obama announced his budget proposal for the coming year and established national healthcare reform as one of the three top priorities for the country. The plan includes:

• Transforming and modernizing the healthcare system by setting aside a dedicated reserve fund of more than $630 billion over 10 years. Financing will come from cutting waste, realizing efficiencies in Medicare and Medicaid and changing some upper-income taxes.

• Reducing Medicare overpayments to private insurers through a competitive bidding process and improving Medicare and Medicaid payment accuracy.

• Reducing drug prices by establishing a workable regulatory, scientific and legal pathway that will accelerate access to more affordable generic versions of biologic medications.

On April 2, the House and Senate each approved budget plans that echoed the president’s key budget priorities. The House version calls for a deficit-neutral healthcare reserve for which House committees must complete legislation by Sept. 29. The bills will go to a conference committee to work out the differences. The result may leave the door open for a simplified approval process for healthcare reform through budget reconciliation, which requires only a majority vote. The use of this technique remains controversial, however.

Note: The following bills were introduced in the last Congress but failed to move. Most are expected to be re-introduced in the new Congress and be part of the healthcare reform debate going forward.