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Moving Forward

March 2, 2010 - by Donny Shaw

President Obama today sent a letter to leaders in Congress outlining his take-aways from last week’s bipartisan health care summit and what new Republican ideas he wants to include in the final bill:

1. Although the proposal I released last week included a comprehensive set of initiatives to combat fraud, waste, and abuse, Senator Coburn had an interesting suggestion that we engage medical professionals to conduct random undercover investigations of health care providers that receive reimbursements from Medicare, Medicaid, and other Federal programs.

2. My proposal also included a provision from the Senate health reform bill that authorizes funding to states for demonstrations of alternatives to resolving medical malpractice disputes, including health courts. Last Thursday, we discussed the provision in the bills cosponsored by Senators Coburn and Burr and Representatives Ryan and Nunes (S. 1099) that provides a similar program of grants to states for demonstration projects. Senator Enzi offered a similar proposal in a health insurance reform bill he sponsored in the last Congress. As we discussed, my Administration is already moving forward in funding demonstration projects through the Department of Health and Human Services, and Secretary Sebelius will be awarding $23 million for these grants in the near future. However, in order to advance our shared interest in incentivizing states to explore what works in this arena, I am open to including an appropriation of $50 million in my proposal for additional grants. Currently there is only an authorization, which does not guarantee that the grants will be funded.

3. At the meeting, Senator Grassley raised a concern, shared by many Democrats, that Medicaid reimbursements to doctors are inadequate in many states, and that if Medicaid is expanded to cover more people, we should consider increasing doctor reimbursement. I’m open to exploring ways to address this issue in a fiscally responsible manner.

4. Senator Barrasso raised a suggestion that we expand Health Savings Accounts (HSAs). I know many Republicans believe that HSAs, when used in conjunction with high-deductible health plans, are a good vehicle to encourage more cost-consciousness in consumers’ use of health care services. I believe that high-deductible health plans could be offered in the exchange under my proposal, and I’m open to including language to ensure that is clear. This could help to encourage more people to take advantage of HSAs.

Obama will officially unveil a final package of changes, including these four ideas, tomorrow. After that, we’re not likely to see many more of these packages of changes to the bill coming from the White House or the Democratic leadership. The negotiating appears to be over, dozens of Republican ideas have been included in the bill, and the areas where Democrats and Republicans differ have been clearly identified. As Greg Sargent put it, in his letter today to the congressional leaders, Obama’s message to the GOP is, “I’m thinkin’ of ya, but we’re moving forward.”

As the newly leaked health care timeline makes clear, The next step will be to shape Obama’s compromise ideas — both form today’s letter and last week’s 11-page proposal into legislative language that can pass under budget reconciliation rules. The challenge there will be twofold: craft a bill that can get at least 51 votes in the Senate and 216 in the House, and make sure it all qualifies under the 6 points of the Byrd Rule. If that can be done, the House can simply accept the Senate health care bill, since it has already passed the Senate.

The votes appear to be lining up. According to the AP, at least nine House Democrats who voted against the House health care bill are considering switching to “yeses” for passing the Senate bill. And some conservative Senate Democrats who were generally assumed to be “no” votes for the slightly more liberal bill that will be represented by the reconciliation sidecar are now indicating that they may actually vote “yes.”

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  • deborahg6 03/02/2010 12:50pm

    They’re going to go ahead with their own agenda as they planned from the beginning, against the will of the people. I watched the Health Care Summit last Thursday and am convinced that the Democrats had no idea what was even in this legislation. Shallow attempt at media manipulation, we are not fooled however.

    I have been tracking with this legislation from the beginning, I have attended health care townhalls in my city and I was amazed at the brilliant ideas the American citizens had in regard to reform. To throw this last minute “summit” when we know that our ideas have been ignored all along was an insult to the hard working American people. I am saddened by the lack of humility on display. History will remember this time well. We will tell our children about the era of “The Emporer (Congress, Administration, Media) with No Clothes”.

  • Activist77 03/02/2010 4:27pm

    wow can i just say deborhaq6 may have been doing this or that but has she really been listening? 53% voted for President Obama know exactly what HCR was be and if she really was listening she would have heard the President say now that i endorse some of the Republican suggestions Republicans have backed away from them. We live in a great country where we can speak our minds… i disagree with everything you said; i am among the 53% that voted for President Obama and some of us feel he hasn’t moved left enough, yet, i accept the moves he is making to be more centrist when needed, but we need to move forward with HCR; believe me you will love it in the end; ask Scott brown about the health care reform he voted for; most people in MA hated it now 80% love it

  • Comm_reply
    deborahg6 03/02/2010 6:21pm

    Oh, I have been listening. “Now” he endorses “some” of the “suggestions”? There is a fundamental difference to the approach to reform between the statist, tyrannical approach vs. liberty. We live in a Republic the last time I checked and we did not elect people to push legislation down our throats because “they” deem it good for us and we “will love it in the end.”

    Aren’t you grateful that you can disagree with me? It’s called liberty, something the majority of Americans would like to preserve.

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