During a nationally televised interview with Katie Couric prior to the Super Bowl, President Obama called for a bipartisan televised health care summit to be held at Blair House on February 25. There was decidedly partisan action going on as the snow piled up outside the Capitol. Democratic Senate staffers continued to ponder scenarios to move health care reform legislation acceptable to Democrats in both chambers forward using the budget reconciliation process. However, procedural hurdles still daunt them.
Since President Obama issued his call for a bipartisan summit on health care reform, political commentators have been abuzz discussing whether or not the summit will be, or even can be, a substantive policy discussion that will move health reform forward. Many think the administration and Republicans are just setting up for another clash. While, so far, congressional leaders have all appeared committed to at least attending the summit (though no formal invitations have actually been issued), there have been some commentators who have wondered whether or not the Republicans should even attend at all. In addition, the news has been filled with opinion pieces as to how both sides should behave at the meeting, and what ideas each should present.
In preparation for the summit, the Republican leadership in the House sent a letter to the President’s Chief of Staff, Rahm Emanuel, on Monday. In the letter, House Minority Leader John Boehner (R-OH) and House Minority Whip Eric Cantor (R-VA) pose a series of questions about the summit, including whether or not President Obama will abandon the campaign to use the budget reconciliation process to advance health care reform through the Senate, if congressional Democrats who have opposed the health care reform bill in the House will be included in the discussion, if state officials with concerns about the bills will be included, if outside experts will be included in the discussion and if those experts will include the Congressional Budget Office and Centers for Medicare and Medicaid Studies actuaries who have indicated the proposals on the table will not reduce health care costs, and if the Republicans will be allowed to invite their own experts to the meeting.
Even before the summit was announced, Republican congressional leaders were making a unified call for abandoning the two bills that are currently on the table and starting over in a bipartisan way. At first, President Obama seemed committed to using the two bills on the table as the basis for all negotiations, but he has softened his stance a bit. After meeting with congressional leaders, he said he was open to any ideas relative to cost-containment, eliminating the use of preexisting condition clauses by insurers and marking health insurance more affordable. However, at the same press conference, he also warned Republicans not to take his openness for granted. It has also been widely reported that Democratic congressional leaders hope to go into the February 25 meeting with an agreement and plan for their two bills, something that has eluded their caucus for months.
There was an attempt on bipartisan action on jobs legislation with health care implications in the Senate when Finance Committee Chairman Max Baucus (D-MT) and Ranking Member Chuck Grassley (R-IA) jointly released draft legislation known as the Hiring Incentives to Restore Employment (HIRE) Act of 2010. However, within hours of the bill’s release, Senate Majority Leader Harry Reid (D-NV) declared the legislation dead, and said that the Senate would soon consider a yet-to-be-released and significantly stripped down version of a jobs bill some time in the future.The Baucus-Grassley bill contains a seven-month fix to the Medicare Sustainable Growth Rate problem by extending the current reimbursement rate fix through September 30, 2010, but Reid said that the provider reimbursement provisions would not be included in his bill. That means, absent further congressional action, Medicare payments to providers will have to be cut by at least 21% on March 1. In addition, the bill contained a variety of other “Medicare extenders” in the bill, like a full-year extension to the Medicare therapy caps exception process. Baucus and Grassley planned to pay for the health components in their bill by a draw-down of $8 billion from the Medicare Improvement Fund.
The Baucus-Grassley HIRE Act also would extend the current federal subsidy of COBRA premiums to those laid off through May 31, 2010—a three-month extension of the current deadline of February 28, 2010—and Reid has not indicated whether or not this subsidy extension will be included in his stripped-down bill. Under the HIRE Act, subsidies for the newly eligible individuals would last for up to 15 months, which is the same as the currently eligible population. The bill would potentially create a new class of eligible individuals for the subsidy, too, by clarifying that individuals whose hours were reduced prior to being laid off entirely would become eligible for COBRA subsidies upon loss of employment. It also includes new penalty language establishing the ability of individuals to bring civil action against health plan sponsors and health insurance issuers relative to subsidy determinations, and a fine of up to $110 dollars a day for employers or health plan issuers that refuse to comply with federal determinations relative to the subsidy within 10 days of receiving such a determination.
