2008-11-13

On Wednesday, November 12, Senate Finance Committee Chair Max Baucus (D-MT) released his blueprint for health-care reform. He offered a broad outline of a reform package that aims to ensure universal coverage, lower cost, and increased quality of care, and reflects his interest to play a major role in this issue. His proposal dovetails significantly with the plan proposed by President-Elect Obama during the campaign, and includes the creation of a national health insurance exchange, reform and expansion of Medicare and the State Children’s Health Insurance Program (SCHIP), and a mandate for most employers to either provide coverage or contribute to a national pool. His plan includes a mandate for all Americans to obtain health insurance, with subsidies for those who cannot afford it. Baucus’s proposal also includes several initiatives, such as the creation of a comparative effectiveness institute, designed to improve quality and reduce cost.

Baucus’s initiative has yet to be translated into an actual piece of legislation or proposed bill, and in a news conference today the Senator indicated that he hoped to work with the incoming administration as well as other members of Congress – in particular Senator Kennedy (D-MA) – to determine the best legislative avenue to implement his proposals. He did not specify a financing mechanism for his plan, though he did mention that the current tax law that exempts health benefits from taxation "has certain inefficiencies" and might be looked at as a source of financing. He also specifically mentioned the need to provide better reimbursement to primary care physicians, and indicated that this may involve shifting reimbursement from some medical specialties.

Given the current fiscal climate and deep divides over health-care reform issues, it remains unclear to what extent, and in what timeframe, comprehensive health-care reform will be feasible over the coming year. See more details about the outlook for health-care reform.

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