Endocrine Insider
October 15, 2009

(See full issue)

The Senate Finance Committee, the last committee in the House and Senate to consider health reform legislation, passed its version of comprehensive overhaul language earlier this week by a vote of 14-9.  Senator Olympia Snowe was the only Republican to vote in support of the legislation.  The Senate leadership will now merge the Finance package with the legislation passed earlier this year by the Senate Health, Education, Labor and Pensions (HELP) Committee for consideration by the full Senate.  Debate on the Senate floor could start as early as next week and is anticipated to take as long as three weeks.  The most contentious issue that must be decided is whether to include a public option in the final package, which the HELP Committee included but the Finance Committee did not.

Having passed its three health reform bills earlier this year, the House leadership is in the process of combining the language from the three bills for consideration by the full House.  It is expected that the bill will reach the House floor by the end of October.  Unlike the Senate, all three House committees did include a public option, but the House leadership must determine which public option to include in the final bill.  At the request of House leadership, the Congressional Budget Office (CBO) will score the bill with provider reimbursement rates based on Medicare plus five percent, as well as several variations based on negotiated rates. The alternatives to the Medicare-based rates include:
•    the public option approved by the Energy & Commerce Committee, which requires the federal government to negotiate rates with providers;
•    the negotiated-rates public option plan coupled with a bigger expansion of Medicaid, which would increase the income threshold for eligibility from 133 percent of the federal poverty level (FPL) to 150 percent of FPL;
•    the negotiated-rates public option with a trigger for Medicare-based rates if costs continue to rise; and
•    the negotiated-rates public option with a ceiling on rates based on average private sector rates.

Although the Society has not endorsed in full any of the health reform bills that have come out of the House or Senate, the Society has been advocating for the issues outlined in its “Guiding Principles for Health Reform.”