The Path Forward Remains Unclear

The Democratic Congressional leadership continues to discuss the path forward on health care reform while the issues of jobs creation and deficit control take center stage in the wake of last night's State of the Union message. CQ Politics reports that House leaders plan to bring small-scale health care legislation to the floor before the chamber leaves for its Presidents Day recess on Feb. 11, aides to Speaker Nancy Pelosi said Thursday. The Politico reports that “Some of these sidebar issues are issues that are very important,” Pelosi said. “They can be done. They can move quickly. And that’s not about one thing over the other. That’s about time. Everything is about time.” The Politico cites stripping the health insurance industry of its federal antitrust exemption is an example of a sidebar issue. I expect that many of the so-called immediate reforms in the House bill, HR 3962, and the Senate bill, HR 3590.

This is the list of immediate reforms from the House bill:

Sec. 101. National high-risk pool program.
Sec. 102. Ensuring value and lower premiums.
Sec. 103. Ending health insurance rescission abuse.
Sec. 104. Sunshine on price gouging by health insurance issuers.
Sec. 105. Requiring the option of extension of dependent coverage for uninsured young adults.
Sec. 106. Limitations on preexisting condition exclusions in group health plans in advance of applicability of new prohibition of preexistingcondition exclusions.
Sec. 107. Prohibiting acts of domestic violence from being treated as preexisting conditions.
Sec. 108. Ending health insurance denials and delays of necessary treatment for children with deformities.
Sec. 109. Elimination of lifetime limits.
Sec. 110. Prohibition against postretirement reductions of retiree health benefits by group health plans.
Sec. 111. Reinsurance program for retirees.
Sec. 112. Wellness program grants.
Sec. 113. Extension of COBRA continuation coverage.
Sec. 114. State Health Access Program grants.
Sec. 115. Administrative simplification.

While I don't expect the Speaker's small scale bills to be limited to these immediate reforms, I can see many of these provisions included in the small scale bills.

Modern Healthcare reports from the Senate side that "Key Senate leaders met for about an hour to help plot a workable course to pass stalled health reform legislation, with one [Sen. Tom Harkin (D Iowa)] predicting that a pathway would emerge over the next two weeks." Evidently, neither the Senate nor the House leadership has ruled out use of the reconciliation sidecar approach discussed in the FEHBlog on Tuesday, but I can't see it happening. I would not be surprised to see small scale reform happen. After Hillarycare died in 1994, Congress passed the smaller scale reforms of HIPAA in 1996 followed by the State Childrens Health Insurance Program in 1998. History is instructive.