Weekend Update / Miscellany

On Friday, the House Energy and Commerce Committee by a 31-28 vote cleared for floor consideration its version of the House health care reform bill (HR 3200). According to Modern Healthcare,

The deal, offered in a series of amendments, would ensure that public plans compete with other plans on a level playing field, allow the CMS to negotiate drug prices with pharmaceutical companies, and help lower premiums and increase subsidies for working families.

In addition, the bill's public plan would use a drug formulary to control prices, and pharmacy benefit managers would be subjected to additional transparency requirements. * * *

A bipartisan amendment that would establish a 12-year patent exclusivity period for follow-on biologic products was approved, although [Committee Chairman Henry] Waxman didn't support it.

The Committee rejected also by a 31-28 vote a a Republican amendment that would have opened the Federal Employees Health Benefits Program to the general public. The Chairman declined to consider on procedural grounds a proposed amendment that would have required all elected federal officials to participate in the public option created by the bill.

On the Senate side, Senate Finance Committee Chairman Max Baucus advised that September 15 is the deadline for reaching agreement on a bipartisan measure according to a Politico report. "Baucus is also working to bring several governors to Washington next week to discuss the impact of expanding Medicaid on state budgets, according to a congressional source."

While the House has recessed for the month of August, the Senate will be in session for another week to consider Judge Sonia Sotomayor's Supreme Court nomination and the cash for clunkers extension. Kaiser Health News reports that the House majority and minority leadership sent their respective members home with talking points.

The Speaker's talking points build on her recent attack on the health care industry. The Politico reports that

“The glory days are coming to an end for the health insurance industry in our country,” Pelosi told reporters Friday afternoon.

“This is about inoculating against misrepresentations and educating about what is in the bill,” she said. “We all want bipartisanship…but you’re either with the insurance companies or you’re for something new.”

The Washington Post reports today that

Speaking of the 100 members of the Senate, White House health czar Nancy-Ann DeParle said: "I could get 100 votes" on the insurance changes being touted by Obama. If Congress enacted only the insurance provisions, it would still represent a significant achievement, though far less than the broad overhaul many expect.

Administration officials have also begun whispering a phrase used during the presidential campaign, speaking of putting the nation on a "glide path" to universal coverage rather than the insurance-for-all trumpeted by many Democrats.

Similarly, the New York Times reports today that

Lawmakers of both parties agree on the need to rein in private insurance companies by banning underwriting practices that have prevented millions of Americans from obtaining affordable insurance. Insurers would, for example, have to accept all applicants and offer a minimum package of benefits, to be defined by the federal government. Nearly all Americans would be required to have insurance. Lawmakers also agree on the need to provide federal subsidies to help make insurance affordable for people with modest incomes. For poor people, Medicaid eligibility would be expanded.

I don't see how the proposed insurance reforms in HR 3200 will reduce health care spending.

On Thursday, the Federal Workforce Subcommittee of the House Oversight and Government Reform Committee approved on a party line vote the bill (HR 2517) that would extend FEHBP dependent eligibility to same sex domestic partners of federal and postal employees and annuitants. Govexec.com reports that

At the recommendation of Office of Personnel Management officials, the subcommittee passed technical amendments ensuring that retirees are covered and clarifying the benefits included. During a July 8 hearing, OPM Director John Berry said his staff was concerned that the bill as written included only current federal employees, though its sponsors intended the benefits to continue into retirement. The subcommittee also approved language stating that the legislation covers all of the employment benefits made available to the spouses of heterosexual federal employees under Title V of the U.S. Code, the law governing federal pay and benefits.

Finally, the Centers for Medicare and Medicaid Services made a big announcement on Friday that will come as a relief to the Nation's hospitals:

[A]cute care hospitals will receive an inflation update in their payment rates of 2.1 percent in fiscal year 2010. Earlier this year, CMS had proposed to reduce payments to account for the effect of increases in aggregate payments due to changes in hospital coding practices that do not reflect increases in patient’s severity of illness.

Under the proposed rule, the increase would have been offset "1.9 percentage points to remove the effect of increases in aggregate payments due to changes in hospital coding practices that do not reflect increases in patient’s severity of illness." The federal fiscal year begins on October 1.