Interesting Developments

Earlier today, the Senate voted 53-47 against a motion to proceed to consider an American Medical Association (AMA) backed bill (S. 1776) to repeal the Medicare sustainable growth rate formula for controlling Part B payments to doctors. The Politico observed that

The vote was a bigger loss than supporters expected. The fact that Democrats, who hold a 60-vote majority, could not muster even 51 votes for the bill is a sign of rocky sledding ahead for health care. It is a warning shot that even popular legislation -- most lawmakers support the doc fix -- could be easily bogged down if it is viewed as a deficit busting vote. And comprehensive health care reform is anything but widely popular in Congress.

The size of the failure was also surprising given how hard the AMA had lobbied for passage. The AMA has always been seen as a major lobbying force, but today's vote calls into question its effectiveness.

Govexec.com reports that two Virginia Congressmen, Jim Moran and Gerry Connelly, have sent Speaker Pelosi a letter objecting to the application of the Senate Finance Committee's so-called Cadillac Plan tax to FEHB plans. The minority staff of the Congresional Joint Economic Committee recently produced a projection of when nationwide FEHB plans would reach the proposed premium threshold for this excise tax, which is imposed on plans, not directly on employees. It's not a pretty picture to begin with, and it becomes even uglier when you consider that the Senate Finance Committee bill also would allocate to the FEHB Program a large chunk of its $6.7 billion annual fee on health insurers.

The Dynamic Chiropractor cheerfully reports that "following months of negotiations" the American Chiropractic Association has achieved its goal of restoring chiropractors to physician (as opposed to allied health professional) status under the BCBSA FEHBP plan known as the Federal Employees Plan. This change takes effect next year.

Earlier this year, Wellpoint, one of the largest Blues organizations, sold its prescription benefit management unit to Express Scripts, one of the three big PBMs. Reports then circulated that Aetna and CIGNA were contemplating the sale of their PBM units. Reuters reports today that "Cigna Corp (CI.N) has decided to keep its pharmacy benefit manager unit after failing to attract viable takeover offers, a source familiar with the situation said.