Big "I" Health Care Reform Report Week of February 15-19, 2010 …

President Releases “Consolidated” Health Reform Proposal.
In an effort to rekindle health care reform talks, the White House today unveiled their “consolidated” health reform proposal. The plan went live on the White House website at 10a.m., and is an attempt to merge the separate versions of health care reform passed last year by the House and Senate into one unified “White House preferred” package. This proposal will serve as the starting point for discussions at the bipartisan summit to be held on Thursday at the Blair House. The proposal largely tracks much of the Senate language, with some notable changes. Gone is the “Nebraska Kickback” that was included in the bill in order to get the vote of Sen. Ben Nelson (D-NE).  In an attempt to garner support from labor unions, the plan also increases the threshold for the “Cadillac Tax” from $23,000 per policy to $27,000 and delays its implementation until 2018. And, despite repeated calls from liberals to add a public option, the proposal does not include this controver sial provision.  

Finally, the legislation would create a federal rate board, called the Health Insurance Rate Authority, which would broadly determine what premium rate increases are reasonable and justifiable. The seven-member board would have consumer, industry and medical representatives, as well as experts in health economics. Attached to this update is the White House-prepared summary of their proposal, and the Big “I” will continue working on its independent analysis of the proposal. The White House is publicly stating it is attempting to restart bipartisanship with its consolidated proposal and Blair House Summit. The effort, however, generated one of the more humorous press quips by an unnamed health care lobbyist: "Saying that the president's proposal today is bipartisan because it includes a handful of Republican ideas on waste, fraud and abuse is like throwing a couple of chocolate chips into a jar of peanut butter and calling it a Reese's."

Blair House Summit. On Thursday the President will be hosting a televised, bipartisan meeting to discuss health care reform solutions/ideas in front of the American public. “The President’s Proposal” as it is called, will be the starting point for the discussions, though there are already questions about how well received the proposal will be on Thursday.  White House Communications Director Dan Pfieffer stated that “the President is coming to the meeting with an open mind.”  And although generally skeptical of the summit and its potential for restarting discussions, Senate Republican Leader Mitch McConnell stated that “I will be there and my members will be there and ready to participate.”   Whether this Summit ends up being a true path towards progress in negotiations, or just a political TV opportunity, won’t be known until Thursday, but we have our suspicions!

The Piecemeal Approach.  As promised by Democratic Leadership, while continuing to work on comprehensive health care reform they are also identifying and independently moving  less controversial ‘pieces’ of the health reform bills.  And first up, drum roll please…..is repeal of the McCarran Ferguson antitrust exemption for health insurers.  The bill, to be considered by the House of Representatives this week, would repeal the antitrust exemptions for health insurers only, thereby subjecting them to Department of Justice antitrust enforcement.  Currently, of course, health insurers are exempted from federal enforcement but are subject to state antiturst laws and enforcement. As recently as last week, reports were indicating that the House would consider legislation repealing McCarran Ferguson antitrust exemption for both health insurers and medical liability insurers. Additionally, there were very concerning plans by some to add language allowing the Federal Trade Commission (FTC) to investigate the entire business of insurance.  The Big I worked with a broad range of property/casualty associations and companies to lobby aggressively against both the addition of medical liability insurance (which is a property/casualty product) and any FTC language.  Though the Big I is still opposed to the repeal of McCarran Ferguson for health insurers, it was a major win for the Big I to have both medical liability and FTC oversight stripped from the legislation.