Our guest blogger is Emma Sandoe, a Health Care Researcher at the Center for American Progress Action Fund.
Last week, in his invitation to Congressional leaders, President Obama promised to “post online the text of a proposed health insurance reform package.” Expected to be released Monday, 72 hours in advance of the February 25th bipartisan health care summit, the White House proposed reforms will likely be a set of compromises and the best policy ideas taken from the House and Senate passed reform bills.
With members of Congress away during the President’s Day recess, it is likely the package would look more like a collection of general ideas rather than final compromised agreements in legislative text as we have seen in prior bill releases. In recent days, the White House has indicated support for the reconciliation process to pass compromised reforms. So, the differences presented here could create a reconciliation, “fix it” bill to the bill passed by the Senate in December.
Here is what to expect:
– Closing the Doughnut Hole: Midway through the final Senate vote, Democratic Senate leaders promised to include a full closure of the coverage gap in the Medicare prescription drug program. This provision is included in the final House bill, but the Senate bill only begins to make efforts to begin to close it. AARP supported the Senate bill with the understanding the Senate would amend the bill to close the hole.
– Cadillac or Excise Tax Fix: White House aides say the “White House prefers instead to keep the version already agreed upon with unions.” Last month, the White House helped broker a deal between the House and the Senate on the excise tax to protect labor union members’ negotiated health benefits. In recent days, the negotiated deal has lost support among some labor leaders which could lose it support within the House.
– Subsidies: One of the main reasons the House bill is more costly than the Senate version is the greater level of subsidies it gives lower-income individuals. It is important for health insurance to be affordable under the reform proposal and subsidies are a straightforward way of making sure that happens.
– National Exchange: The House pushed hard for this provision last month. It’s sound policy and the President appeared prefer it last month.
– Fixing the Nebraska Deal: The deal to give Nebraska extended Federal Medicaid funds in exchange for Ben Nelson’s (D-NE) vote was never popular with Democrats or Republicans. Now that a reconciliation deal does not hinge on Ben Nelson’s vote, the provision will likely disappear.
What to not expect:
– Public option: The recent resurgence of support of the public option with the letter initiated by Sen. Michael Bennet (D-CO) has been heroic, but in this venue will be a non-starter. This does not preclude the potential addition of a public plan through the reconciliation process at a later point, but it is unlikely the White House will tread on the controversy at this point.
What to watch out for:
– Abortion and Immigration: It will be interesting to see how (or if) the White House handles these issues. On the one hand, not touching abortion and immigration would temporarily sidestep the politically charged arguments that intensified under the debate. However, if the White House wants to present a comprehensive plan that addresses these unresolved issues, it will have to make some choices.
Greg Sargent reports that Senate Majority Leader Harry Reid (D-NV) is signaling support for a reconciliation vote on the public option.