Health Care Reform Leads Fall Agenda
Goolsby, Larry, Policy & Practice
For more details on these and other policy issues, contact Larry Goolsby, director of legislative affairs, or see the APHSA web site.
Health care reform remains a major focus of both the Congress and the Obama administration. At this writing, Congress has just returned from its summer break and the president has announced a major address on the issue to a joint session of Congress. Initial prospects for comprehensive reform seemed promising with industry groups, patient advocates and congressional staff joining to negotiate and compromise on legislative proposals. However, the debate became increasingly contentious over the summer months. During the congressional recess, a number of lawmakers hosted town hall-style meetings to discuss the legislation, provide clarity on proposals and solicit feedback from their constituents. Many of these meetings were disrupted by protests from opponents and supporters of the proposals. These protests, coupled with resistance from various stakeholders to key components of the legislation, have left the future of the legislation uncertain. A group of six senators from the Finance Committee--three Republicans and three Democrats--worked on a possible compromise bill during the late summer, but so far have not reached an agreement.
Some of the more contentious aspects of health reform include:
* Proposals to create a government-run health insurance plan, referred to as the "public option": Many Democrats assert that the plan is necessary to compete with private insurance and control costs, but Republican leaders argue that it will have an unfair advantage and will ultimately constitute a government takeover of the health insurance industry.
* A proposal to fund end-of-life counseling through Medicare: Proponents of this measure contend that it offers older individuals an opportunity to ensure their affairs are in order and that their desires are respected in the event that they are unable to communicate with medical staff. Opponents argue that it promotes euthanasia and establishes panels to determine whether an individual lives or dies. The "death panel" claims have been widely discredited but remain a volatile political issue.
* Government funds may be used finance abortion procedures under a public plan: The House and the Senate Health, Education, Labor, and Pensions Committee bills both remain silent on the issue, but opponents say the public option will likely finance some of these procedures.
* The coverage of immigrants: The House bill clearly states that undocumented immigrants will not be covered, but opponents contend that it would provide coverage to illegal immigrants.
* Costs: Budget estimates for the various proposals range from about $800 billion to nearly $2 trillion. Congress was initially considering taxing employersponsored health insurance plans, but discarded that proposal. …