While Congress was on recess this past week, work on healthcare reform was not taking a break. Behind the scenes, on Capitol Hill and at the White House, closer examination was being paid on how to how to pay for reforms and keep momentum going.
On Thursday, President Barack Obama spoke on a conference call with grassroots supporters while flying back to Washington to tell them he needs their help to pass healthcare reform legislation this year. "If we don't get it done this year, we're not going to get it done," the president said. "We're going to need to mobilize all of you."
A group linked with Obama—called Organizing for America—is preparing to kick off a national campaign to win nationwide support for Obama's healthcare agenda. The group, part of the Democratic National Committee, is organizing neighborhood meetings to take place this Saturday in homes across the country where healthcare will be discussed.
On Friday, Office of Management and Budget Director Peter Orszag wrote in his White House blog that healthcare reform will likely increase total national spending as healthcare coverage expands under current proposals. However, reform actions eventually will slow the growth of healthcare spending. "What we see is that it takes only 10 to 16 years after reform for federal healthcare spending to be lower than it would have been in the absence of reform," Orszag said.
Also, within the 10 year budget window, the impact of healthcare reform on the budget will be "negligible" because the plan is fully paid for. The short term increase in spending will be offset with greater revenues. Over the longer term, the budget situation "improves considerably" because healthcare spending declines and because taxable compensation increases, Orszag wrote.
A separate brief issued by the Congressional Budget Office on Wednesday looked at how healthcare reform options with varying levels of government involvement would be applied to the federal budget. Those options, discussed by CBO Director Doug Elmendorf in his blog, include an individual mandate, expanding eligibility for existing public programs, health insurance exchanges, and a public plan.
Under one scenario, premium income—either for a public plan (or plans) and for insurance purchased through exchanges or in the private market—should be classified as revenue if there is an individual mandate and tight government controls of the insurance market, wrote Elmendorf. Corresponding expenditures should also be recorded as outlays in the budget.
On Capitol Hill, Sen. Edward Kennedy (D-MA), who chairs the Senate Health, Education, Labor and Pensions Committee, is expected to release this week a proposal that also includes a public plan option. His proposal is expected to include an expanded health insurance program for children—to cover those up to age 26—and higher proposed pay rates (about 10% more than Medicare rates) for physicians participating in a public plan.
Sen. Max Baucus (D-MT), chair of the Senate Finance Committee, who said his panel plans to have a markup of a healthcare reform bill by mid-June, issued a joint statement with Kennedy indicating that they intend to report out bills from their committees that are "similar and complementary" and can be merged quickly into one bill. The goal is to have a bill on the Senate floor before the August recess.
On the White House side, Nancy Ann DeParle, director of the White House Office of Health Reform, met Wednesday with 30 physician leaders from across the country, including medical school deans, teaching hospital CEOs, medical specialty leaders, and practicing physicians, to talk about current reform issues.
The discussions included having a healthcare system that guarantees choice of physician and plans, invests in prevention and wellness, improves patient safety and quality of care, and assures affordable health coverage.