The great mystery continues

Earlier this week, Senate Majority Leader Harry Reid (D Nev.) announced that he had submitted to the Congressional Budget Office for scoring a compromise under which the Senate bill would be amended to expand Medicare to folks aged 55 to 64, to create a health insurance exchange under OPM's supervision and to expand other public programs such as CHIP in lieu of a public plan option. Modern Healthcare reports that House members have not heard the details of this compromise although Speaker Pelosi tends to favor Medicare expansion according to the Wall Street Journal. The American Medical Association and the American Hospital Association are upset over a Medicare expansion because of the Program's low reimbursement rates to providers according to the Journal's Health Blog

Those of us interested in the FEHB Program are curious to learn the details of the parallel universe that would provide coverage to the uninsured. I do expect that the compromise will create separate risk pools for the FEHBP vs. the uninsured pool.
The Politico reports that "senators grew restless over a lack of information and declined to commit their vote until they could review the legislative language and the Congressional Budget Office cost estimate. Republicans also stepped up their criticism of the [compromise] plan."
In other news, the House approved by a 220-201 vote an omnibus appropriations bill for the current federal fiscal year that includes funding for the FEHB Program. According to Govexec.com, "Rejecting President Obama's recommendation to freeze locality pay at 2009 rate s, the House allocated 1.5 percent of the 2.0 percent raise to base pay and 0.5 percent to locality pay."

Bloomberg reports that a federal judge in New York City has given preliminary approval to the $350 million payment that United Healthcare has agreed to make in order to settle the American Medical Association's class action lawsuit alleging that the usual reasonable and customary databases owned by United subsidiary Ingenix underpaid out of network doctors. Since the settlement was announced last winter, objecting doctors have assailed the settlement as too little a sum. The judge disagreed. Here's another situation where the AMA successfully attacked and killed a means of controlling healthcare costs. The UCR schedules sensibly encouraged patients to use in-network providers. In my opinion, this settlement does a disservice to the providers and health plan members who have played by the rules. But I am glad that the judge is putting the case to rest.