Therapy Information

This Week in Health Care ReformAfter months of public debate and private negotiations, health care reform discussions stalled following Tuesday’s Senate vote in Massachusetts. The Democratic Senate lost its 60th vote supermajority when Republican Scott Brown was elected to the United States Senate in the Massachusetts special election.Health Care Reform Negotiations Post-Massachusetts Special Election

Massachusetts Election of Senate Republican Recasts Debate: Following the election of Republican Scott Brown to the Massachusetts Senate seat Tuesday night, Democratic leaders have been scrambling to revive what could now be a dying bill. The loss of the Democrat’s 60th vote in the Senate opens up the legislation to a Republican filibuster – something the Democrats have managed to avoid thus far in the debate.

House and Senate Democrats met this week to discuss how to move forward with the reform legislation in light of this election and promised Wednesday that they would push ahead. There are a number of options that Democrats are considering, but at this point they have not charted their course.

On Wednesday, Speaker of the House Nancy Pelosi (D-CA) attempted to rally House Democrats around a strategy to push the Senate bill through the House and onto President Barack Obama’s desk so as to avoid the need to again secure 60 Senate votes. However, the Speaker indicated on Thursday morning that she did not believe she has the needed 218 House votes necessary to move forward. This option would have allowed lawmakersto then propose additional modifications to the approved legislation through a process called “reconciliation,” which only requires 51 votes in the Senate.

The Patient Protection and Affordable Care Act was passed in March of this past year, and aims to improve all aspects of our country’s health services. One aspect that will be much-improved is the area of mental health care.

Insufficient coverage and a lack of programs that educate the public on mental illness have plagued the United States for quite some time. With the passage of the new law, a number of new provisions aim to change the public’s perception of mental illnesses and offer programs and other initiatives to help those who need mental health care. A few of those provisions include:

- Improvements to Medicaid (including the expansion of eligibility) that will allow more people to experience the benefits of mental health services
- Several new options for people with disabilities
- Improve coordination and communication between primary care and mental health services
- Much more…

Essentially, what this means is that, over time, individuals with mental illnesses will have access to health insurance that covers mental health and substance abuse services, giving people unprecedented help and cooperation from the government. Other services include prevention programs, new insurance plans for long-term community care, and more.

Health care spending projections for the next decade, published in the journal  Health Affairs last week, appeared to have a little something for everyone. Prepared by Medicare’s Office of the Actuary, the report notes that health care spending will increase 0.2 percent faster than previously projected due to the health reform law’s many changes to the system. As a result, The New York Times proclaimed that the “health plan won’t fuel big spending,” causing an annual spending increase of 6.3 percent rather than 6.1 percent. The Christian Science Monitor, on the other hand, warned that reform will definitely cause health insurance costs to rise and that Americans should be on guard for big increases in 2014 when many of the law’s major provisions kick in. Spending on health insurance is expected to increase 12.8 percent in 2014 as millions of uninsured Americans gain coverage. However one interprets the results of the report, it is clear that rising health care costs remain unfinished business.

ARIZONA: The Senate has established an Ad-Hoc Committee on the Impacts of Health Care Reform Implementation. The Committee will hold its initial meeting later this month. The preliminary agenda includes: Arizona Health Care Cost Containment System (Medicaid) requirements; insurance reforms; impacts on health care providers; and tax implications. Members appointed to the committee include AHIP retained counsel, clinical and employer representatives, and representatives of the Goldwater Institute, a conservative think tank.

The White House last week continued to rail against rising health insurance premiums to help build popular support for his health care reform package. But the effort to focus the blame for rising costs on insurers was questioned, in particular, by state insurance experts and economists quoted in a New York Times story last week. Insurance commissioners said that trying to hold down premiums before costs were under control would be very risky. This approach could mean solvency issues in some cases, they told the Times. To help educate Americans about the true drivers of rising health care costs, America’s Health Insurance Plans, the industry trade association, last week launched a new national ad campaign. The ad demonstrates that health insurance company costs represent a small slice of the overall health care cost pie.Federal 

With a cadre of staff operatives searching for the right health insurance reform provisions among those previously discarded from the House, Senate and the President’s proposals, Democratic leadership has been relentlessly pursuing every possible pathway to pass a final bill. The expected process would have: 1) the House pass the Senate-adopted reform bill (which most House members hate), 2) the House passing a bill to “fix” all the things it hates using a reconciliation legislative vehicle, followed by 3) the Senate passing the very same reconciliation bill – requiring only 51 votes in the Senate. The House Budget and Rules Committees are expected to start the review, hearing and mark-up process of the reconciliation bill this week. The Senate commitment to using reconciliation was made official in a scathing letter from Leader Harry Reid to the Minority Leader. Along the way the two Chambers will need to see the latest CBO “scores” on the bill before voting, and 216 House Democrats will have to resolve policy disagreements over abortion, federal health insurance rate review and authority, and other substantive issues. Additionally, the House will have to trust that the Senate can pass the reconciliation measure without changing one comma. Partisanship has blossomed into open hostility over health reform. Whether Congress can overcome these policy, process and political mine fields remains as murky as ever, but Democrats have chosen to try and will push for resolution by the Easter recess.