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Four Provisions Not Part of Obama's Reform Plan

Janice Simmons, for HealthLeaders Media, February 23, 2010

Almost as important as the items included in President Obama's proposed healthcare reform summary released Monday are those items that were excluded.

Many of these items initially were included in the House bill (HR 3962) passed in early November. As the President prepares to meet with congressional leaders on Thursday, here's a list of topics that appear excluded from the current discussion.

Public insurance option: One of the most hotly debated issues during the summer and fall was the inclusion of the public insurance option. Last fall, House Speaker Nancy Pelosi (D-CA) reaffirmed her support for a public option, calling it "the strongest lever one can use to get the best possible outcomes."

The public option proposal in the House bill would have required the Health and Human Services (HHS) secretary to negotiate rates with healthcare providers as private insurers currently do.

Surtax: Initially, the House Ways and Means Committee considered a surtax on annual incomes at $250,000 for individuals to $500,000 for families. In the bill finally approved by the House in November, this was increased: a 5.4% tax was called for amounts more than $500,000 for individuals annually or $1 million for families annually.

Antitrust legislation. Earlier this month, while healthcare reform legislation waited on the sidelines, the House moved toward repealing health insurer antitrust regulations found in the decades old McCarran Ferguson Act.

While the proposed summary mentions improving insurance protections for consumers and improving oversight in the states, no mention is made specifically of repealing antitrust legislation.

Abortion. While the topic is likely to be discussion in the Feb. 25 meeting, it is not discussed in the President's summary.


Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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