Value Based Purchasing and Health Care Reform

Senate to Debate Health Reform Legislation

On Saturday, the U.S. Senate voted to move forward with its version of health reform legislation.  By a vote of 60-39, the Senate voted to begin debate surrounding the bill released last week by Majority Leader Harry Reid (D-NV).    

All 58 Democrats and two Independent Senators voted in favor of moving forward with the floor debate.  However, the bill will most likely require revisions in order to gain enough support to pass the Senate.  Debate on the Senate floor is expected to begin after the Thanksgiving holiday and extend through most of December.

House Passes H.R. 3961

Yesterday, by a vote of 243-183, the U.S. House of Representatives passed the Medicare Physician Payment Reform Act of 2009, which is aimed at reforming the Medicare reimbursement system and avoiding scheduled reductions in Medicare payments to physicians beginning in 2010.  See the Reuters and Bloomberg articles discussing Thursday's vote.  The Senate has already voted against similar legislation.

Senate Unveils Healthcare Bill

This week, Senate Democrats released their version of health reform legislation.  According to the Congressional Budget Office Cost Estimate (released on Wednesday), the Patient Protection and Affordable Care Act would cost approximately $849 billion and yield a net reduction in federal deficits of $130 billion over the next 10 years.  The Senate plans to vote on Saturday on whether to move to debate on the 2,074-page bill, and could possibly begin the debate after next week's Thanksgiving holiday.  If Senate Democrats get the 60 votes needed to move forward, the debate on the Senate floor is expected to last through most of December. 

Text of the Patient Protection and Affordable Care Act

For information on some of the differences between the Senate bill and the House bill that was passed earlier this month, see the following interactive webpages:

New York Times

Washington Post

Senate Health Reform Legislation Expected Next Week

After watching the House pass its health reform legislation this weekend and a visit from former President Bill Clinton, Senate majority leader, Harry Reid, announced that he expects to have a bill on the floor next week and complete work on the bill before Christmas.  Senator Reid is still awaiting the CBO analysis of the bill, which is reportedly expected by the end of this week. 

The Geography of Saturday's H.R. 3962 Vote

On Saturday, the House passed its health reform bill (H.R. 3962) by a vote of 220 - 215.  Only one Republican voted for the bill and 39 Democrats vote against it.  As reflected on the New York Times interactive graph, 31 of the 39 Democrats who opposed the bill represent districts that were won by Senator John McCain in the 2008 presidential election.  The New York Times has also created an interactive map that displays the geography of the votes for and against the Affordable Health Care for America Act. 

House Passes Health Reform Bill By Vote of 220-215

"The House passed its $1 trillion healthcare overhaul late Saturday by the thinnest of margins, becoming the first chamber to vote on such a significant expansion of healthcare since Congress passed Medicare in 1965." See the article from The Hill.

"The House of Representatives approved a sweeping healthcare reform bill on Saturday, backing the biggest health policy changes in four decades and handing President Barack Obama a crucial victory."  See the article from Reuters.

"The House narrowly approved a sweeping overhaul of the nation’s health care system on Saturday, advancing legislation that the Democrats said could be their defining social policy achievement."  See the article from The New York Times.

Text of the Affordable Health Care for America Act (H.R. 3962)

Discussion of Health Reform Bills

"House Democratic leaders are offering a $1.2 trillion, 10-year health overhaul bill that expands coverage to millions of Americans. House Republicans have unveiled their alternative, after months of criticizing the Democrats' approach. In the Senate, Majority Leader Harry Reid, D-Nev., is finalizing legislation merging the work of two committees and making other changes.  Here are details...."

See the Washington Post's (11/6) discussion regarding coverage, cost, and elements of the three bills, here.

House Health Reform Vote Expected This Weekend

The House Committee on Rules is scheduled to meet this afternoon in order to establish guidelines that will govern this weekend's deabte regarding H.R. 3962 and the proposed amendments to the health reform legislation.  The Washington Post reports that the debate, which will likely include discussion of provisions relating to immigration and abortion coverage, is expected to consume most of Saturday and may even extend into Sunday.  Yesterday, House leaders announced that they expect a vote to take place on Saturday. 

Medicare Physician Payment Reform Act of 2009 (H.R. 3961)

While members of the House prepare for a vote on the Affordable Health Care for America Act (H.R. 3962), Representatives will also be considering a bill that would “permanently reform the Medicare physician payment system.”  According to the House Committee on Energy and Commerce, the "Medicare Physician Payment Reform Act" (H.R. 3961) would "repeal a 21 percent fee reduction scheduled for January 2010 and replace the physician payment formula with a more stable system that ends the unrealistic cycle of threats of ever-larger fee cuts followed by short-term patches.”

 

Sustainable Growth Rate (“SGR”) reform measures were initially included in the America’s Affordable Health Choices Act of 2009 (H.R. 3200) (Section 1121).  However, now the House will consider separate bills concerning health reform and the physician payments.  While the American Medical Association ("AMA") voiced its support of H.R. 3200 this summer (see July 16 post), the AMA has announced its support for the concurrent passage of both H.R. 3962 and H.R. 3961.

 

For additional information, see:

 

Summary of the Medicare Physician Payment Reform Act

CBO Cost Estimate (H.R. 3961)

AMA Letter to Speaker Pelosi (Nov. 5)

Health Reform Amendment Includes Biofuel Tax Credit Provision

While the Democrats Manager's Amendment to H.R. 3962 (see post below) contains many anticipated revisions to the reform legisation, TheHill.com points out that the Manager's Amendment includes at least one section, entitled "Second Generation Biofuel Producer Credit" (see page 14 of the Amendment), which one may not expect to see in a health reform bill.

The Second Generation Biofuel provision is based on a bill introduced by Rep. Chris Van Hollen (D-Md.) (The Second Generation Biofuel Producer Tax Credit Act of 2009 (H.R. 3985)).  The following is a statement posted yesterday (November 3rd) on Rep. Van Hollen's website:  

“The Second Generation Biofuel Producer Tax Credit Act will modernize the existing cellulosic biofuel tax credit while ensuring that taxpayers get the biggest bang for their renewable energy buck by making clear that only qualified, non-food feedstocks capable of powering America’s energy future are able to claim the credit.

“In addition to supporting homegrown renewable energy, it is my hope that this legislation will be added to the Manager’s Amendment for the House health care reform package making its way to the floor this week so that the savings generated by these improvements can help pay for health care for all Americans.”