WASHINGTON WIRE
October 23, 2009
Issue Issue 219
Senate Finance Committee Releases Legislative Text; Leadership Merges Bills
House Lacks Votes for Strong Public Option, Could Stay in Session until December 18
Senate Fails to Pass Cloture Motion on SGR Bill
House Committee Passes Bill to Repeal Antitrust Exemption for Health Insurers
GAO Releases Report Critical of FDA Reporting on Medical Devices and Adverse Events
Top Story
Senate Finance Committee Releases Legislative Text; Leadership Merges Bills
This past week, the Senate Finance Committee released over 1500 pages of legislative text for their version of the healthcare reform bill, America's Healthy Future Act of 2009. Senate leadership is merging the Finance bill with the HELP Committee bill, and could be finished as soon as Monday morning. The bill will be sent to the Congressional Budget Office, where it will take approximately two weeks to be scored. It is expected that the Senate could take up the bill before Thanksgiving.
The Finance Committee earlier this month passed the bill with one committee Republican, Senator Olympia Snowe (ME), voting in favor of the legislation. The vote solidified her position as a key legislator in the bill negotiations once the debate moves to the Senate floor. Snowe indicated that although she voted to pass the bill out of committee, she would not guarantee a vote for the bill once it was brought to a vote on the floor.
The Finance proposal would require individuals to have health insurance, expand eligibility for Medicaid to 133 percent of the federal poverty level, block a 21 percent cut to Medicare physician payments and include a one year update, create state health exchanges for the individual and small group markets and authorize the development of non-profit cooperatives. The HELP is considered the more liberal proposal, in no small part because it includes a national public option to be included in the exchange and an employer mandate - both absent from the Finance version.
Health Care News
House Lacks Votes for Strong Public Option, Could Stay in Session until December 18
Last week, House Speaker Nancy Pelosi (D-CA) told reporters that the House lacks enough votes to include a strong public option in HR 3200, while House Majority Leader Steny Hoyer (D-MD) said that a new target adjournment date could be set for just before the Christmas break, on December 18. Hoyer also indicated that if the House took up healthcare reform legislation in early November, that Representatives should prepare to work through part of the weekend of the 7.
Since Pelosi's announcement, it is expected that the House will include a less robust public option, such as a fall-back "trigger" option that would implement a public option only if reforms to the private insurance industry failed to expand coverage to enough of the uninsured or failed to control rising healthcare costs. Senate Majority Leader Harry Reid (D-NV) is reportedly proposing a national public option that would allow states to opt out of the plan.
The House is expected to break for Thanksgiving and Veteran's Day.
Senate Fails to Pass Cloture Motion on SGR Bill
On Wednesday, October 21, the Senate voted 47-53 on a cloture motion to stop debate on the Medicare Physician Fairness Act of 2009, which would provide a permanent fix to the "physician fee problem" - a problem that will result in a 21 percent reduction in Medicare payments to doctors in 2010 if not fixed. Previously, Congress has blocked the cuts and provided annual updates for physicians under Medicare. This bill blocks the cut and prevents similar cuts in future years while Congress creates a new payment system.
The bill, introduced by Debbie Stabenow (D-MI), is separate from the larger healthcare reform bills in the Senate, and is not offset. The legislation would "reset" to zero the baseline used in the sustainable growth rate formula. Some Republican lawmakers and fiscally conservative Democrats expressed skepticism about the bill, however, saying the $245 billion price tag needs to be fully offset. House Blue Dogs have also expressed concern about the need for an offset. House Democratic leadership is considering whether to take up a permanent physician payment fix separately from the House healthcare bill, which now includes a permanent fix.
House Committee Passes Bill to Repeal Antitrust Exemption for Health Insurers
On Wednesday, October 21, the House Judiciary Committee approved a bill to partially repeal an exemption from antitrust law for health insurance companies. Press reports indicate that House Speaker Nancy Pelosi (D-CA) is considering attaching a provision that would repeal the exemption to the chamber's healthcare reform bill.
The Chairmen of the Senate and House Judiciary Committees introduced the legislation last month. The bill would apply federal antitrust laws to health and medical malpractice insurers and repeal the insurers' current exemption from Department of Justice and Federal Trade Commission antitrust regulations.
Insurers generally were granted statutory exemption from federal antitrust laws in the 1945 McCarran-Ferguson Act. Insurers argue that the repeal is unnecessary since they are already prohibited against price fixing and collusion on claims settlements.
GAO Releases Report Critical of FDA Reporting on Medical Devices and Adverse Events
The Government Accountability office released a report recommending that FDA improve the protocol for reviewing adverse event reports and that FDA seek legislative authority to eliminate the regulation requiring user facilities to submit annual reports, which GAO says are redundant to other submitted reports.
The report found that the Center for Devices and Radiological Health (CDRH) does not use adverse event reports in a systematic manner to detect and address safety concerns about medical devices. GAO researchers found that CDRH has not documented follow up on adverse events, has not consistently read adverse event reports for the first time in a timely manner and that CDRH rarely acts when manufacturers and user facilities submit reports late.
GAO conducted the study to determine the extent of adverse event reporting from 2003 to 2007 by manufacturers and facilities that use medical devices, to report the extent to which manufacturers and facilities that use medical devices comply with adverse event reporting requirements for medical devices and to assess how the FDA uses medical device adverse event data to identify and address safety concerns.
Upcoming Events
Hearings
Tuesday, October 27
Federal Response to the H1N1 Influenza Pandemic
House Homeland Security - Subcommittee on Emerging Threats, Cybersecurity, and Science and Technology
2 p.m., 311 Cannon Bldg.
Wednesday, October 28
Health Care Fraud
Senate Judiciary Committee
Full Committee Hearing
10 a.m., 226 Dirksen Bldg.
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