2009-06-18

The Senate Committee on Health, Education, Labor, and Pensions (HELP) on June 9 unveiled the Affordable Health Choices Act, a comprehensive bill that addresses health reform issues under the Committee’s jurisdiction. The bill was met with significant criticism as the Congressional Budget Office estimates it will cost more than $1 trillion over 10 years  and will still leave about 37 million people uninsured, compared with 50 million who are uninsured now. In addition, major issues need to be worked out in the bill such as whether to create a new public insurance plan to compete with the private market and whether employers must provide health insurance for their workers. HELP Committee Chairman Senator Edward M. Kennedy is suffering from brain cancer and is not present, but his fingerprints are all over the legislation. His deputy on health reform, Senator Christopher Dodd (D-CT) reports that the Committee plans to move forward with finalizing and voting on this bill. 

The Senate Finance Committee, chaired by Senator Baucus, (D-MT), was to produce a draft bill on June 16, but decided to delay release likely because Senator Baucus wanted to find ways to reduce the cost estimate for the bill from $1.6 trillion to $1 trillion and also continued to seek bipartisan support. It is likely that major cuts in Medicare and Medicaid will pay for some of the new costs, but senators have disagreed about whether to tax employer-provided health benefits - something President Obama campaigned against. Also elusive is a compromise with Republicans on a new public insurance plan, which the GOP opposes. It is anticipated that the Finance bill will be more moderate than Kennedy's proposal and is considered Congress' best chance for a bipartisan bill.

Both the HELP and Finance Committee bills would create a new insurance market "exchange" where people could go to shop for insurance coverage, assisted by federal subsidies and encouraged by a federal mandate for individual coverage. 

On the House side, Committees on Energy and Commerce, Ways and Means, and Education and Labor issued a document on June 9 outlining their joint principles for reform and could introduce legislation later this week, with Committee votes after Congress returns from its July 4 recess. 

In addition, former Majority Leaders - Democrats Tom Daschle and George Mitchell and Republicans Bob Dole and Howard Baker - have released a $1.2 trillion proposal that would cover everyone and be fully financed with a combination of spending cuts and tax increases. The former leaders’ ideas serve as a point of discussion and to keep up momentum. 

ASH is committed to representing the views of hematologists in the ongoing debate. The Society has outlined core principles that it believes must be respected in shaping any reform package. ASH has been advocating for better payment for physicians and has supported efforts to fix the flawed Sustainable Growth Rate formula for Medicare physician reimbursement.

In addition, ASH has initiated an effort with internal medicine sub-specialty societies to advocate for maintaining patient access to specialists. Many proposals, appropriately, place an emphasis on improving primary care; however, ASH is committed to ensuring that this does not come at the expense of medical specialties.

The Society will keep members informed of all new developments as health reform continues to unfold.

back to top