WASHINGTON WIRE
June 26, 2009
Issue 206
Senate HELP to Continue Health Bill Mark Up after July 4 Recess
Senate Finance Committee Leaders Discuss Options for Lowering Cost of Reform Bill
CMS Publishes Advance Notice of Possible Changes to HCBS Waiver Process
Top Story
Senate HELP To Continue Health Bill Mark Up After July 4 Recess
The Senate Health, Education, Labor and Pensions Committee will continue to mark up draft healthcare reform legislation after the July 4 recess. The Committee has reviewed multiple sections of the bill, but has yet to tackle the most controversial parts, such as the sections of the bill regarding a public plan option and individual and employer mandates. HELP is expected to take up the long term services and supports section on Tuesday, July 7.
For its part, the Senate Finance Committee is reportedly close to completing a bi-partisan agreement. The two committees are marking up separate bills which will be merged before a vote on the Senate floor. Originally, the Senate Finance Committee planned to mark up its bill this week as well, but the mark up has been delayed until after the July 4 recess. The Committee has released three separate documents that list healthcare reform policy options under consideration, and slides outlining a number of potential provisions were circulating among stakeholders over the past week.
Democratic House leaders last week released a comprehensive Tri-Committee discussion draft, which House Committees of jurisdiction have held hearings on this week. The CBO has yet to score the House draft. The high price tag on the Senate HELP draft has fueled opponents of reform over the past week.
Health Care News
Senate Finance Committee Leaders Discuss Options for Lowering Cost of Reform Bill
On Thursday, June 25, CBO offered policy suggestions to the Senate Finance Committee that could help Committee leaders lower the cost of their healthcare reform bill. The Committee delayed release of a bill after initial CBO estimates priced the package at $1.6 trillion. Chairman Max Baucus (D-MT) said that he wanted to decrease the cost by at least $600 billion, and the CBO options could help the Committee reach that goal.
The Committee is considering cutting the amount of subsidies offered through the legislation; subsidies were one of the larger cost drivers in the draft bill that CBO scored. Other options for producing savings include delaying any Medicaid expansion until 2013. Besides cost, the members are still in discussions about significant substantive policies to be included in the bill, including whether to offer a public plan option and whether to require individual and employer mandates.
CMS Publishes Advance Notice of Possible Changes to HCBS Waiver Process
On June 22, CMS announced in the Federal Register that the agency intends to propose amendments to regulations regarding Medicaid home and community-based services (HCBS) waivers. The advanced notice of proposed rulemaking (ANPRM) says CMS is considering altering regulations to allow states to merge HCBS waivers target groups.
The ANPRM describes the type of living environment that would qualify for coverage under an HCBS waiver. The regulation also discusses allowing states to use HCBS waivers to design benefit packages based on service need rather than diagnosis. CMS would change a current requirement that requires separate HCBS waivers for each diagnosis group. Currently, states must get approval for separate 1915(c) waivers to serve more than one of the groups.
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Hearings
Congress will be on recess until July 6.
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