Endocrine Insider
June 25, 2009

Last week, the House of Representatives released a bill more than 800 pages in length detailing its proposal for health care change. The House committees with jurisdiction over health care reform—Ways and Means, Energy and Commerce, and Education and Labor—released the information on Friday, June 19. As expected, the bill language includes the creation of a public health plan option maintained by the government through which individuals could obtain health coverage. The public plan would operate in competition with health plans offered by private insurers and would be subject to the same market reforms and consumer protections. The House bill would also create a health insurance exchange that would allow individuals and small employers to compare health plans available for purchase.

In addition to health coverage options, the House bill significantly reforms the Medicare payment formula, the sustainable growth rate (SGR), by setting the 2010 Medicare Fee Schedule update at the Medicare Economic Index and by establishing two separate target growth rates for the future—one for evaluation and management (E & M) services and another for all other physician services. E & M services to be included in the new target formula include:

•    New and established patient office services
•    Primary care services
•    Emergency department services
•    Consultations
•    Home services
•    Medicare preventive services

Full details of the House health reform proposal are available on the House of Representatives website or by clicking here.

The Senate Health, Education, Labor and Pensions (HELP) Committee has also drafted a proposal for health reform which was released earlier this month. Like the House version, the HELP proposal includes a public health plan option for obtaining coverage. However, the HELP plan does not include reform to the SGR, as Senate jurisdiction over the Medicare program lies not with HELP but with the Senate Finance Committee. Finance Committee Chairman Max Baucus (D-MT) has publicly stated he does not anticipate that physician payment reform will be addressed in any Senate health reform legislation this year. For additional information on Senator Baucus’ comments, please see the May 13 issue of Endocrine Insider located here.

As health reform discussions occur in Congress throughout the summer, The Endocrine Society will continue to share its own set of principles on health reform to help outline important issues affecting endocrinologists and their patients.