Re: Fw: From Capitol Hill: Health Reform Update

July 24, 2009

Do you know what groups comprise the

non-MD group that the ACA met with ?

s. fuchs dc

From:

[mailto: ] On Behalf Of vsaboe

Sent: Friday, July 24, 2009 10:17

AM

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Subject: FW: From

Capitol Hill: Health Reform Update

From: ACA Government Relations [mailto:GRacatoday (DOT) org]

Sent: Friday, July 24, 2009 9:07

AM

vsaboecomcast (DOT) net

Subject: From Capitol Hill: Health

Reform Update

July 2009

Welcome

Contact Information

E-mail: GRacatoday (DOT) org

Web: www.acatoday.org

National Health Reform Update Report Issued

July 24, 2009:

Controversy Builds Over National Reform

Proposals – Final Action Before August Congressional Recess Now

an Impossibility – Delay to Provide Chiropractic Community With

Additional Lobbying Opportunities

Background:

Efforts

to advance a comprehensive national health reform bill through Congress

on the timeline originally set by President Obama and Democrat

Congressional leaders, have run into a series of obstacles, including

growing concerns by centrist Democrats and others in Congress, that a

massive expansion of health care benefits for millions of Americans

currently without healthcare coverage would add dramatically to the

federal budget deficit and would not be economically sustainable.

Concerns about paying for the expansion have ballooned since release of

the draft text of the House Tri-Committee reform bill and passage of

reform bill out of the Senate HELP Committee earlier this month.

For these and other reasons, it is now abundantly clear that the Senate

will fail to pass a bill prior to the scheduled August congressional

recess and House action on a bill by this date looks seriously in

doubt, even though President Obama as recently as July 22, addressed

the nation on the need to rapidly adopt a national reform bill. Given

the growing controversy over the issue, no enactment of a final reform

bill into law is expected until the fall of 2009 at the earliest.

As a practical matter, the delays now facing Congress mean the ACA and

the chiropractic community as a whole will have additional opportunities,

especially during the August recess, to lobby Congress on issues of

specific concern to the profession.

ACA Continues Push for Adoption

of Acceptable Provider Non-Discrimination Provision:

As

reported in ACA’s July 16 Update Bulletin, the Senate HELP

Committee completed work on their version of a comprehensive health

reform bill Wednesday July 15. Over the opposition of insurance

industry interests (Blue Cross Blue

Shield in particular) the HELP Committee approved

inclusion of a “placeholder” provider non-discrimination

provision (Harkin Amendment

#202-Modified) in their version of the bill. The

placeholder amendment was adopted as a “temporary” measure,

with the acknowledgement of both Democrats and Republicans on the

Committee that the precise wording of the provision “needs

additional work” prior to the HELP bill being brought to the

Senate floor for further consideration. While inclusion of a

non-discrimination provision constitutes an important tactical victory,

the ACA remains concerned that the language needs to be modified in

order to make it fully effective. Towards that end, the ACA and other

non-MD provider groups met jointly on July 22 with representatives of

Senator Tom Harkin (D-Iowa),

Senator Dodd (D-Conn.)

acting Chair of the HELP Committee, and Senator Orrin Hatch (R-Utah)

longtime chiropractic supporter. Proposed modifications of the

provision and ways to address Congressional Budget Office (CBO) scoring concerns dominated

the discussion. It is hoped that ACA and coalition suggested

improvements to the provision will be agreed to in the near

future. Additionally, the ACA continues to seek opportunities

to insert a companion non-discrimination provision into the House Tri-Committee

reform bill. The ACA will report the extent to which

progress is made on this issue in future Update Bulletins.

Additional Provisions Sought by

the ACA:

In

addition to an acceptable non-discrimination provision the ACA

continues to work for inclusion of provisions that would address the

design of the “minimum benefits” packages that would be

established under any “public plan” or private plans that

would have to meet federally defined benefit standards. The ACA

is circulating various relief provisions that would: 1) require the

benefits package to, as a minimum, include those benefits under

Medicare Parts A and B -- a potentially critical provision especially

if the ACA wins a future expansion of Chiropractic services in

Medicare, a goal that remains a top priority of the Association;

2) require the benefits package to reflect those benefits and

insurance guarantees available in a majority of states, including

chiropractic care; and 3) Outline for the Secretary of HHS a series of

other factors (favorable to chiropractic)

that would have to be taken into consideration in terms of the benefits

package design. The ACA is hopeful that one or more of these

provisions will be incorporated into any final bill emerging out of

Congress, although none of these provisions has yet to be adopted by

any of the various committees of jurisdiction. The ACA remains opposed to the adoption of any

provision requiring providers to participate in any public plan or to

only be reimbursed at Medicare rates for services provided.

Future Expected Senate Action:

Thus

far, the Senate Finance Committee, chaired by Senator Max Baucus (D-MT) has not produced a

completed draft bill for public review, nor has the Committee begun a

formal mark-up session. The precise timetable for this committee’s

action remains unclear; however, release of a draft bill could take

place prior to the August recess. Formal markup is not expected

until September. At present, we do not expect the Senate Finance

Committee to address provider non-discrimination issues in their

version of the bill.

At

some point – after the planned Congressional recess in August

– Senate Majority Leader Harry Reid (D-NV) will attempt to

“meld’ the Senate HELP Committee bill and any product

emerging out of the Senate Finance Committee into one overall package

which he would bring to the floor of the Senate at a time of his

choosing, again most likely in the fall of this year.

Current Status in the U.S.

House:

The

three committees of jurisdiction in the House have released a common bill

known as the “Tri-Committee” reform bill. The

Tri-Committee bill does not contain a provider non-discrimination

amendment. The Ways & Means Committee and House Education

Committees have already approved their portions of the bill. The

House Energy and Commerce Committee Chaired by Representative Henry

Waxman (D-Cal) has,

as of the date of this report, been unable to report a bill due to

opposition from centrist Democrats on the Committee including so-called

“Blue Dog” Democrats concerned about federal deficit and

other controversial issues. If this committee remains deadlocked

over the content of the bill, House Speaker Pelosi could simply

by-pass the Committee and bring (through

the House Rules Committee process over which she has great influence)

a bill to the House floor for a vote. If opposition to portions

of the Tri-Committee bill continues to build, she may be forced to take

this action. Theoretically, a bill could be brought to the House

floor prior to the scheduled August recess period and no bill would

likely come to the floor unless Speaker Pelosi has calculated she has

the votes to pass it, and those votes may not materialize in the time

remaining before the recess begins.

Joint House Senate Conference

to be a Major Battleground:

Eventually,

presuming the reform efforts does not collapse, both the Senate

and House will pass separate, differing bills, and the two versions

would be reconciled into one final package in the

“conference” process that will essentially take place

behind closed doors and over a timeframe that could take several weeks.

During the conference process groups, including the ACA, will likely

attempt to seek a range of modifications to the final bill that will

emerge from this process and return to the House and Senate for final

action.

August Recess Period a Major

Grassroots Lobbying Opportunity:

The

ACA, in conjunction with its “Summit” partners is expecting

to issue one or more Alert Bulletins applicable to the congressional

recess period. All DCs should watch for and respond as

specifically directed to these future bulletins, as the recess period

will serve as a prime grassroots lobbying opportunity for our

profession. Additionally, the ACA will be coordinating with

select state chiropractic associations, including the Congress of

Chiropractic State Associations, a group of important targeted meetings

(state and local district based)

with select members of the Senate and House in a position of help

address issues of concern to us.

Please Support the ChiroVoice

Project NOW if You Have Not Yet Begun to do So:

It

remains extremely important that DCs continue to support and

participate in the CHIROVOICE

project to construct and activate a national database of chiropractic

patients, via their e-mail addresses. Go to CHIROVOICE for details and

instructions on how to participate if you have not already begun to

support this vital project.

Follow

health care reform at www.acatoday.org/hcr.

If

you have any questions about the material contained in the bulletin

please contact gracatoday (DOT) org

Association | 1701 Clarendon

Blvd. Arlington, VA 22209

| 703 276 8800.

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States

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July 24, 2009