Tuesday, January 26, 2010

Health Care Reform Update: Implications of the MA Election

The following update is made possible through MBGH's membership in the National Business Coalition on Health. It was provided on January 20,2010.

Congressional leaders and the Obama Administration reportedly remain close to a very delicate and tedious agreement on several aspects of a final health care reform bill, though the process may be seriously influenced by result of the special senatorial election in Massachusetts (MA) yesterday to fill the seat of Senator Edward Kennedy (D-MA). The Republican senatorial candidate, Scott Brown (R) won yesterday with 52 percent of the votes against Massachusetts State Attorney General Martha Coakley, who garnered 46 percent of the votes.

IMPACT ON HEALTH CARE REFORM (HCR): Once Senator-elect Scott Brown is sworn in (the date has yet to be announced), the Democrats will lose their filibuster-proof "supermajority" in the Senate, and the House of Representatives could be compelled to pass the earlier Senate-passed bill outright or quickly negotiate a compromise bill before the new Senator can be sworn in.

At that stage, the budget reconciliation process (requiring only a simple, 51-vote majority in the Senate) could be used to advance a possible second health bill that would follow closely on the heels of the first measure to carry out the key provisions currently being negotiated among congressional leaders and the Obama Administration.

As a contingency plan, the Senate and the Obama administration also still seem to be “courting” centrist Senate Republicans such as Olympia Snowe (R-ME) to solidify the 60 votes needed to pass HCR. The White House and Senate leadership also is working to ensure their own caucus is behind the bill (i.e. Senators Nelson (OK) and Landrieu (LA). In addition, the House is struggling to maintain the 218 votes needed to pass their newest version of HCR when the time comes. Caucus defections are plentiful though the latest House version seems to be more moderate (no public plan and no Cadillac plan excise tax) which could capture more conservative Democrat votes (this is the group that defected during the original House vote in July due to cost and abortion language concerns).

In terms of advocacy, everyone still is moving forward in the belief that the final product can still be improved before its final consideration by the House of Representatives and Senate.

Some of the major priority employer concerns with HCR legislation include

• the need for the legislation to reduce health care costs and improve quality,

• avoidance of onerous mandates that would limit the flexibility and innovation that are the foundation of the employer-based system,

• maintenance of the ERISA regulatory structure and

• the need for supportive tax policy that will not undermine employer-sponsored health coverage or add to its cost.

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