Revisiting the Public Option: The Policy & Practice Podcast

Public Option supporters rally in 2009. Image via Flickr Creative Commons user aflcio.

Most of the health reform talk this summer has centered on how the Obama administration is implementing the new law or how its passage will affect lawmakers in the mid-terms elections. But last week, some Democrats in the House changed the conversation, bringing back a debate about the creation of a government-run health plan or “public option.” Rep. Pete Stark (D.-Calif.) led a group of House Democrats in introducing legislation (H.R. 5808) to establish a public health insurance plan to compete alongside private insurers in the Health Insurance Exchanges that will be created under the Affordable Care Act.

Rep. Stark said the public option is needed to create competition. He cited some recent double-digit premium increases by health plans and the plans’ big profits. Democrats who signed on to support the bill also touted the public option as a way to cut the deficit. The Congressional Budget Office analyzed the legislation and concluded that it would save about $68 billion from 2014 through 2020 and that the premiums charged by the public plan would be 5% to 7% lower than those charged by private plans in the exchange.

But will the legislation gain any political traction? It’s certainly an uphill battle. The mid-term elections are only a few months away and many Democrats are vulnerable this year. That means there’s not likely to be a lot of substantive lawmaking happening between now and the end of the year. And when the new Congress returns in January, there may be fewer Democrats left to support adding the public option to the health reform law.

Hear more about the public option bill, comparative effectiveness research, and the next steps in health reform implementation in this week’s edition of the Policy & Practice Podcast.

Take a listen and share your thoughts:

— Mary Ellen Schneider (on Twitter @MaryEllenNY)

What is ObamaCare?

Photo courtesy of Flickr Creative Commons user zenashots.

For months, opponents of the Democrats’ health reform plans have railed against “ObamaCare.”  Well, President Obama has finally put his own stamp on health care reform.

Just this morning he released details about the plan he favors going forward. So what does ObamaCare look like? It turns out it’s a lot like the Senate version of health care reform, passed back in December.

President Obama’s plan has a health insurance exchange, but no public plan. It has an individual insurance mandate, but no strict mandate for employers to provide coverage. Like the Senate bill, President Obama requires employees to contribute to the cost of providing coverage if their employees are receiving some type of federal subsidy for their coverage.

There are some changes though. President Obama would increase the threshold for taxing so-called Cadillac health plans from $23,000 in the Senate bill to $27,500. And that tax wouldn’t kick in until 2018. The President’s version of health reform also includes more insurance protections for consumers and gives the Health and Human Services department more oversight of the health insurance industry.

Given that the administration has spent the last few weeks complaining about insurance company rate hikes, these provisions shouldn’t come as a surprise.

Finally, the President’s plan borrows a few ideas from Republicans. The President hasn’t ceded any major policy turf to the GOP here, he simply included some of their ideas on curbing waste, fraud, and abuse.

The plan is the first time the President has definitively staked out his position on health care reform. Now this plan will serve as the starting point for the bipartisan health care summit scheduled for Feb. 25. Stay tuned for more developments out of that meeting.

— Mary Ellen Schneider (on Twitter @MaryEllenNY)

Cheaper Drugs, More Medicare: The Policy & Practice Podcast

Photo courtesy Flickr Creative Commons user mcclouds

The health reform battle slogged on last week, with new proposals emerging to break the stalemate: allowing reimportation of drugs from other countries, and ditching the public option in favor of expanding Medicare to include people aged 55-64. Meanwhile, physicians were left wondering whether Congress was going to act to stave off an impending 21% cut in Medicare reimbursement for doctors.

It’s all in the Policy & Practice podcast. Give a listen and let us know what you think.

–Joyce Frieden (Twitter @joycefr)

High Stakes for Physicians: The Policy & Practice Podcast

Photo by Mary Ellen Schneider.

From press conferences, interviews, and more around Washington, D.C.

Physicians have a lot riding on what happens in Congress this year. After months of wrangling over health reform, House Speaker Nancy Pelosi (D., Calif.) will try to get her version of the health overhaul bill through the chamber. The bill includes a public plan whose rates would be negotiated with physicians.

But that’s not the only legislative priority of great importance to doctors this year. Unless Congress steps in, doctors will face a 21% Medicare pay cut in 2010 and more cuts in the years to come. A bill that would have scrapped the widely criticized Medicare pay formula failed to gain traction in the Senate, but House Democrats are trying to keep the fix alive with their own bill.

Get all the details in the latest installment of the Policy & Practice podcast.

— Mary Ellen Schneider (@MaryEllenNY on Twitter)

Nearing the Finish Line?: The Policy & Practice Podcast

From hearings and press conferences in Washington, D.C.

The Senate Finance Committee is expected to vote on its health reform bill this week. Once out of the committee, there will be more merging, amending, and negotiating. And it’s anyone’s guess what will make it into a final package. In this week’s Policy & Practice Podcast, our reporters take a look at what didn’t make it into the Finance Committee’s bill, namely the public option.

Filmmaker Michael Moore. Courtesy Bridgette Blair at Public Citizen.

 

And it’s the public option that has filmmaker Michael Moore riled up. Mr. Moore came to Washington last week to promote his latest movie and took time out to threaten congressional Democrats. His message: Include a robust public plan or pay the price at the polls next year.

Take a listen to the podcast and share your thoughts.

 

— Mary Ellen Schneider (Twitter @MaryEllenNY)

A Time to Amend… the Policy & Practice Podcast

Sen. Max Baucus (D-Mont.)

From Washington, D.C.:

After a long summer of waiting, journalists, policy wonks, and the public can finally start poring over the details of the Senate Finance Committee’s version of health reform legislation. But the work is really just beginning for the committee’s chairman, Sen. Max Baucus (D.-Mont.), who this week will have to manage debate on more than 500 amendments to his bill while also attempting to win GOP support and keeping his own caucus together.

Find out what’s in this draft bill, what business leaders think of reform efforts, and why physicians are still pushing for medical liability reform in this week’s installment of the Policy & Practice Podcast.

Take a listen and share your thoughts.

—Mary Ellen Schneider (on Twitter @MaryEllenNY)

Because You Just Can’t Get Enough About Health Reform

From press conferences, briefings, and hearings in Washington, D.C.

Sure, we promised you another installment of the Policy & Practice Podcast on Monday. But we’re so excited that we felt the need to post another one today. Listen here: Policy & Practice Podcast 6/24

Today’s installment covers the President’s visit to the AMA, primary care wants and woes, and early action from the Senate Health, Education, Labor, and Pensions Committee. Take a listen and stay up to date on health reform.

Like what you’re hearing? Drop us a line.

—Denise Fulton (@denisefulton on Twitter)

 

P.S. Check back later this week for previous installments of the Policy & Practice Podcast. We’ve done a few and are now able to post them.

Two Minutes on Health Reform: The Policy & Practice Podcast

Used under a Creative Commons license from flickr user cowtools

from meetings, press conferences, and briefings in Washington, D.C.

The details are beginning to emerge on health care reform–and to keep you up to speed, we present the Policy & Practice Podcast.

Policy & Practice Podcast 6/23

EGMN’s health policy reporters and editors–Joyce Frieden, Alicia Ault, Mary Ellen Schneider, Denise Napoli, Keith Haglund, and yours truly–scour the daybooks and cover the key events in the Capitol, then synthesize the news into a quick and timely audiobite for our U.S. physician audience. Our podcast is hosted by Todd Zwillich, longtime Washington reporter and EGMN alumnus.

Check in with us each Monday for a quick, 2-minute synposis of key events on the road to health reform. Like what you hear? Drop us a line.

—Denise Fulton; on Twitter @denisefulton

 

Public Plan Death Match

From a meeting sponsored by the Alliance for Health Reform, “Public Plan Option: Fair Competition or Recipe for a Crowd-Out?” in Washington, D.C.:

Who remembers ‘Celebrity Deathmatch’ on MTV? It’s a cultural touchstone. I think everyone currently debating health reform here on the Hill should be familiar with it (Wikipedia says they’re reviving it). And if these fools can’t figure this out in 2009, we should hold one. Set up a ring right on the South Lawn on the White House.

That was the image I couldn’t get out of my head this afternoon. In the blue trunks was the Commonwealth Fund and the Urban Institute, supporting the inclusion of a public plan in whatever health reform bill slouches toward Washington this summer; in the red trunks was America’s Health Insurance Plans (AHIP) and the Heritage Foundation, insisting that such a plan would eventually put private insurers out of business.

The main crux of supporters’ arguments was that a public plan offers too much to ignore. Karen Davis, Ph.D., president of the Commonwealth Fund, cited data from her organization forecasting that with the enactment of a public plan, $3 trillion could be saved between 2010-2020. That’s mostly from administrative savings.

Opponents to a public plan don’t necessarily refute these figures. According to Stuart Butler, PhD, of the Heritage Foundation, the savings with a public plan are obvious. But its precisely these savings that will make the plan unstoppable, driving other payers who can’t compete out of business. Further, this prospect threatens to compromise bipartisan (and public) support for any reform at all, and derail the whole effort before it has really even begun, he said.

courtesy flickr user Marco Veringa, used under a Creative Commons license

My blood lust aside, we’re at a stalemate. And maybe we need to just put this issue aside for a minute and fight about something else. As Karen Ignagni, of AHIP, pointed out, this incessant harping on this one issue of whether or not there SHOULD be a public plan is overshadowing discussion of the possible details contained in such a plan, and details about the rest of the health reform effort. Keep dancing, folks. We’ve got a few more rounds to go.

—Denise Napoli (on twitter @denisenapoli)