The Power of A

Bloomberg News is reporting this morning that House Energy & Commerce Chair Henry Waxman (D-CA) sent letters to six insurance companies demanding information on their small business plans and specifically a response to allegations that the insurers routinely drop small businesses when their premiums increase due to employee illness.

The letters, which were sent to insurers including WellPoint and Aetna (seen here), demanded that the insurers produce relevant documents explaining their small business plans, policies to determine when to raise rates as well as drop coverage, and the maximum rate increase.  Congressman Bart Stupak (D-MI), a co-signer on the letter and chair of the committee’s oversight subcommittee, has promised hearings into the alleged purges of small businesses.

“As part of our ongoing investigation, we are now looking into the practice of health insurance companies terminating the coverage of small businesses when their employees become ill and their health insurance claims increase,” said Waxman in a statement. “We need to better understand how widespread this harmful and destructive practice has become, and how it is impacting small businesses and their employees across the country.”

A spokesperson for America’s Health Insurance Plans (AHIP), which represents the major insurance companies, called the letters a “fishing expedition.”  “This is just a continuation of a politically timed and politically motivated fishing expedition in an attempt to justify a new government-run plan,” said Robert Zirkelbach, a spokesman for AHIP. “Health plans are already highly regulated at both the federal and the state level, and the overwhelming majority of Americans are satisfied with their current health care coverage.”

Quick Hits

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Facing the August recess and constituents who have a wide range of opinions on health care, the House and Senate attempts to pass comprehensive health care reform hit major road blocks yesterday.

The much-rumored dissension on the Blue Dogs deal on HR 3200 was made public yesterday.  Some of the House liberal caucuses released a letter yesterday to the Democratic leadership pledging to vote against any bill that incorporated the changes requested by the Blue Dog.  They specifically cited reimbursement rates in the public plan not being coupled to Medicare repayments and the reduction in low-income subsidies.  The letter was signed by 57 members, more than enough to defeat any bill brought to a vote on the House floor.  However, news broke Friday morning that a deal had been struck to allow the Energy & Commerce Committee to pass the bill, although complete details have yet to be released.

On the Senate side, Finance Committee negotiators and Senate Democratic leaders admitted that a bill would not be released from the committee before the August recess.  Finance Committee Chair Max Baucus (D-MT) spent most of the day deliberating with his Democratic members on controversial aspects of the bill.  It may have been erroneous news reports, however, that helped torpedo the negotiations.  After some newspapers reported Wednesday that a bill was close to being released, Finance Committee Republicans stated that negotiations were still a ways off, with Senator Mike Enzi (R-WY) calling negotiations “a train wreck.”

The one place where progress was made on health care legislation was in the Energy & Commerce Committee, which held its fourth day of mark-ups on HR 3200.  Among the amendments adopted by the committee:

-          The Markey amendment: directs HHS to conduct a pilot program on physician home-care (agreed by voice vote)

-          The Rogers amendment: states the government will not use specific research to ration or deny health care (agreed by voice vote)

-          The Capps amendment: prohibits spending of government money by private insurers to cover abortions, and requiring all state exchanges to have at least one plan covering abortion and one not covering (agreed 30-28)

-          The Stupak amendment: codifies a conscience clause on abortion (agreed by voice vote)

Notable amendments that were not approved include:

-          The Burgess amendment(1): prohibits the creation of a public plan (failed 24-35)

-          The Burgess amendment(2): decouples the public plan payments from Medicare (failed 29-29)

-          The Deal amendment: prohibits illegal immigrants from receiving medical benefits (failed 28-29)

-          The Blunt amendment: requires the president, vice president, and members of Congress to enroll in the Exchange (ruled non-germane by a 36-22-1 vote)

Quick Hits

The House Democrats memo on how to discuss health care reform over the August recess was leaked… Senator Grassley promises not to sell out party… Are health care reform proponents blaming too much on the insurance companies?

At her press conference yesterday, Speaker of the House Nancy Pelosi (D-CA) told reporters that she had enough votes to pass comprehensive health care reform.  That assertion has been called into question over continued negotiations between House leadership and the Blue Dog coalition, and now one of the newest health care compromises threatens to open a new front in the battle.

On Tuesday, Energy & Commerce Committee chairman Henry Waxman (D-CA) announced that he had an agreement with Blue Dog leaders that HR 3200, America’s Affordable Health Choices Act, would contain language authorizing the Medicare Payment Advisory Committee (”Medpac”), as a newly independent executive agency, to review Medicare costs and make binding recommendations to cut costs to the program.  Blue Dog Democrats like the proposal because it creates an independent entity that can reign in Medicare spending without political pressure; currently only Congress has the authority to make cuts in the program.

However, some members of the Democratic caucus have concerns that the proposal would shift too much authority from the legislative to the executive branch.  “You’re outsourcing congressional responsibility,” said Rep. Richard Neal (D-MA), a member of the House Ways & Means Committee.  “It’s the equivalent of the line-item veto.”  Under the proposal, Congress could stop Medpac’s recommendations from going into effect with a vote within 30 days of the recommendation being made.

Associations are also stepping into the debate with concerns about the proposal (subscription).  The American Hospital Association (AHA) and Federation of American Hospitals put out an alert to their members yesterday asking them to call their members of Congress and voice opposition to the idea.  “We certainly cannot support an additional provision that would allow an entity that would be able to make significant additional reductions to hospitals,” said Tom Nickles of AHA.  Additionally, the American Osteopathic Association sent a letter to Speaker Pelosi expressing concern that its members would be unfairly regulated by Medpac.

Additional concerns were raised in this morning’s Roll Call (subscription) about the role of the House Ways & Means Committee in the negotiations with the Blue Dogs.  The language regarding Medpac and other Blue Dog concerns fall under that committee’s jurisdiction, but the negotiations are being handled primarily by the Speaker and Waxman.  While this is a Congressional procedure debate, the implications could mean additional Democratic members opposing the bill based on their exclusion from the process.

Quick Hits

The Finance Committee has still not released a bill, and the August deadline is now acknowledged by the Senate Democratic leaders to be dead… A summary of the president’s press conference on health care… The difference between health care reform and health insurance reform… The HELP Committee acting chair urges Senate Democrats to move quickly, even if it means sacrificing bipartisanship on health care reform.