Health spending proposals, health law repeal divide lawmakers

The Wall Street Journal reports that proposals for cuts in health spending by President Barack Obama's deficit-reduction commission are drawing opposition from health companies, doctors and some consumer groups. "How to tackle health costs has become a sticking point for the 18-member committee, which last week concluded three days of meetings without a firm agreement among members. Under proposals from the bipartisan commission's two co-chairmen — Alan Simpson, a retired Wyoming Republican senator, and Erskine Bowles, a White House chief of staff to former President Bill Clinton — seniors in Medicare and military retirees would pay a greater portion of their health costs, doctors would get lower reimbursements and employers would face a cap on their tax exemption for providing workers with health insurance." It also opens the door for resurrecting the "public option."

"Responding to the draft proposals, advocates for seniors and other consumer groups said cutting Medicare and Medicaid would hurt the most vulnerable Americans. … [S]ome corners of the health industry, not wanting to take any chances, say they are preparing to fend off the draft report's recommendations" (Adamy, 11/22).

USA Today: As the health spending proposals are splitting lawmakers and health groups, the nation as a whole remains divided as support for the tea parties grows. "Just about as many Americans want Tea Party-backed members of Congress to take the lead in setting policy during the next year as choose President Obama, a USA TODAY/Gallup Poll finds. In a survey taken Friday through Sunday, 28% say Obama should have the most influence on government policy next year while 27% say the Tea Party standard-bearers should. GOP congressional leaders are chosen by 23%, Democratic congressional leaders by 16%." Tea Party members were swept into office in part around the furor over the health law (Page, 11/22).

The Washington Post: "Liberal groups in Wisconsin are bracing for a fight over contraception coverage under Medicaid. Battle lines are being drawn over sex education in North Carolina. And conservatives in several states intend to try to limit the ability of private insurers to cover abortions." The renewed challenges are part of a new GOP effort to bring social issues to the fore with their new power in Congress. The move is shocking some who saw the election as more a referendum on the economy, not on social issues like abortion (Somashekhar, 11/21).

CQ HealthBeat: Democrats are using the release of rules dictating how much insurers must spend on medical care to tout the law as a repeal try by Republicans looms. "Democrats in Congress included language in the law on a national medical loss ratio (MLR) as a way to curb health insurance premium prices without directly capping them, which politically would have been more difficult. Under the MLR standard, beginning in 2011 insurers will face new mandates on how they spend premium money and must issue rebates if they do not comply. The MLR standard is complex to explain and not easily captured in a sound bite. And it's part of a law not universally popular. Yet the announcement of the regulation offered battered Democrats a chance to highlight health care, hold out the possibility of rebate money going directly to consumers and again criticize GOP plans for the law's repeal. Beginning in 2012, $1.4 billion worth of rebates may go to policyholders, HHS said" (Norman, 11/22).

Roll Call: Republicans aren't silencing their dissent of the law, however. "The Senate is scheduled to vote after Thanksgiving on legislation to repeal a small but increasingly maligned provision of President Barack Obama's health care overhaul, and the Republican author of the repeal is optimistic that it will pass this time. … Sen. Mike Johanns said the changes that he made to the legislation since its defeat in a floor vote earlier this year should address opponents' concerns, including their suspicion that the measure's true purpose was to undermine the health care law. Johanns' revised proposal, to be voted on Nov. 29 as an amendment to a food safety bill, would repeal a change in tax reporting requirements ushered in by the health care law. Even Obama has conceded that the provision is onerous on small businesses and warrants adjustment" (Drucker, 11/22).

It's not the only showdown among Republicans and Democrats. The parties' leaders — Speaker Nancy Pelosi and Minority Leader John Boehner — themselves also appear headed for a showdown as they swap jobs, the Tribune Washington Bureau/Los Angeles Times reports. "They are a political and personal odd couple, a pair of wary prizefighters who nonetheless have maintained a cordial relationship and respect for each other's political skills. But when Republicans take control of the House in January, Boehner and Pelosi will swap jobs as minority leader and House speaker, and their interpersonal dynamics will be tested anew. … Boehner's priorities include trying to repeal the healthcare overhaul that Pelosi considers among her greatest accomplishments" (Mascaro and Simon, 11/23).

Other Republicans, including moderate Maine Sens. Olympia Snowe and Susan Collins, are signing onto a letter that supports the lawsuit challenging the health law's constitutionality, The Washington Post's 44 blog reports based on news accounts from Maine. "As the lone Republican on the Senate Finance Committee who voted to move the bill — which at the time included an individual mandate (though Snowe made clear then that she didn't support that provision) — to the full Senate last year, Snowe was the only Republican senator who supported the bill at any stage. She did not vote for final passage of the bill in March" (DeLong, 11/22).

One Republican congressman-elect who came under fire for asking why he had to wait a month after he takes office for federal health coverage is the target of a new campaign from liberal groups, CBS News reports. "Rep.-elect Andy Harris is the target of a new radio and Facebook campaign aimed at portraying the incoming Republican and his colleagues as hypocrites on the subject of health care. … The conservative Maryland doctor was one of many Republicans this year who campaigned against President Obama's health care reforms, so Democrats seized on his complaint and sought to portray Harris and others as hypocrites. Now the liberal advocacy group Americans United for Change is pressing that message with a new campaign directed at Harris' constituents. The group today launched a radio ad that will air this week in Maryland markets" (Condon, 11/22).

Las Vegas Sun: Confusion also remains among health care providers. "Doctors, hospitals, insurers and other medical professionals know they have to adhere to provisions outlined in the health care reform bill Congress passed in March. But with newly elected representatives and senators heading to Washington, many who have vowed to do away with health care mandates, the medical industry is hesitant to spend millions of dollars to redefine the way it does business for a law that could look very different very soon. … Because the changes are expensive, providers are loath to make them while Republicans, who will control the House in January, continue to promise widespread overhaul of the bill. Worse, health care practitioners say they don't know what changes to make because the government hasn't written specific regulations yet" (Goldberg, 11/22).

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This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.