Coalition Urges Congress To Suspend Pay-Go Rules For Health Care Overhaul Package, Citing Savings Beyond 10-Year Window

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Health Insurance / Medical Insurance
Article Date: 11 Mar 2009 - 5:00 PDT

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A coalition representing 30 health care organizations on Monday asked lawmakers in the House and Senate to suspend pay-as-you-go rules when drafting and passing health care overhaul legislation, saying much of the savings introduced by such a plan would be realized beyond the rules' 10-year budget window, CongressDaily reports.

In a letter, the coalition wrote, "Requiring spending or revenue offsets for the entire cost of the health reform within a 10-year budget window ... will significantly reduce the likelihood of enacting legislation to achieve essential reforms for long-term savings" (Edney, CongressDaily, 3/10) The letter was signed by the U.S. Chamber of Commerce, the Pharmaceutical Research and Manufacturers of America, AARP, AFL-CIO and organizations representing hospitals, doctors and patients (Armstrong, CQ Today, 3/9). According to CongressDaily, some lawmakers, including Senate Finance Committee Chair Max Baucus (D-Mont.), a major player in the reform debate, have expressed similar concerns.

Families USA Executive Director Ron Pollack said major changes can produce trillions of dollars in savings beyond 10 years, but that many of the changes would require an upfront investment. He noted that private industry changes would not immediately produce federal savings but would contribute to the economic stability of the nation. "If we are stymied from doing health reform due to rigid short-term pay-go rules, which don't take into account the private sector, then we may be hamstrung from getting the long-term relief that is necessary" (CongressDaily, 3/10).

According to CQ Today, suspending pay-as-you-go rules would be "mostly symbolic" because lawmakers can waive the rules once a bill reaches the floor. However, choosing to disregard the rules from the start of the overhaul process would "avoid tough choices that could splinter" the coalition of industry and patient advocacy groups whose support is needed to pass legislation, CQ Today reports (CQ Today, 3/9).

Reform Effort
After "months" of closed-door meetings where senior lawmakers and their committees have been working on overhaul legislation and trying to "assemble a winning coalition of outside interest groups" to ensure the passage of a comprehensive health care bill, the debate "shifts into its public phase," The Hill reports. Hearings are scheduled this week for the Senate Finance Committee, Senate Budget Committee, House Ways and Means Committee, the House Education and Labor Committee and the House Energy and Commerce Health Subcommittee. Many congressional leaders have said they hope to have final bills to the floor in June.

Meanwhile, the debate is getting more specific. A Democratic health care lobbyist said, "So far, we've been dealing in broad themes and concepts and platitudes," but as "the details get shaped and vetted, people are going to move from that broad reform perspective" in favor of their own more focused interests. A Republican lobbyist said, "It's getting much more high-intensity, much more specific. We're moving way beyond principles" (Young/Snyder, The Hill, 3/9).

According to U.S. News & World Report, although Democrats and Republicans both want overhaul legislation to pass this year, "there are so many special interests involved, and so many Americans aren't sure what system makes the most sense, that the battle over health care reform will be intense, and it's only just the beginning" (Walsh, U.S. News & World Report, 3/9).

Dean Says Obama's Plan Right for Some Republicans
Former Democratic National Committee Chair and former Vermont Gov. Howard Dean in an interview with the Washington Times said Obama's health care reform plan should appeal to some Republicans, and that those who oppose it will hurt their 2010 re-election efforts. He said the plan is "perfect" and emphasizes choice, allowing people to keep their current coverage or join a new plan, which is "right up the Republican's alley." He added that expanding Medicare to all U.S. residents would be a good solution because "people like it" and "it works." According to Dean, a physician, "It's ridiculous to say care would be inferior. It's perfectly good for the millions and millions of people over 65 years old in the county." He said, "Not every Republican is a right-wing ideologue ... If they want to filibuster this to death, be my guest and let's see how they do in 2010" (Bellantoni, Washington Times, 3/10).

Boston Globe Profiles Baucus
The Boston Globe on Tuesday examined how Senate Finance Committee Chair Max Baucus (D-Mont.) has "stepped into an unexpected leadership void" in the effort to enact comprehensive health care legislation. Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.), who has been diagnosed and treated for brain cancer, and former HHS Secretary nominee and former Senate Majority Leader Tom Daschle (D-S.D.), who withdrew his nomination, were both expected to lead the push for "legislation that liberal Democrats have longed to pass for the last half-century," according to the Globe.

The Globe reports that Baucus's "tendency to hew to the political middle" previously caused many health care reform advocates to express concerns that he could potentially "decide that a health bill was too expensive amid an economic crisis." However, Baucus has "chosen a starkly different course, arguing with evangelical zeal that the economy's free fall is not an excuse to put off changes in health care but rather a compelling reason for a comprehensive fix," according to the Globe. The Globe reports that Baucus has argued that health care costs are "bankrupting individuals, businesses, and government."

According to the Globe, "That Baucus himself isn't passing the buck on health care reform has been the most encouraging sign in a tumultuous year for advocates of universal health care" (Wangsness, Boston Globe, 3/10).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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