Looking for a pulse

With plans for re­form thrown into dis­ar­ray, law­mak­ers pon­der scal­ing back their am­bi­tions

Modern Healthcare - - Cover Story -

What just weeks ago seemed in­evitable now seems im­pos­si­ble— un­less law­mak­ers and the pres­i­dent can re­vive mas­sive health­care re­forms bills that sur­vived both the House and Se­nate but were put on life sup­port by a spe­cial Se­nate race in Mas­sachusetts.

Ab­sent a mir­a­cle cure, every­one with a stake in the out­come is tak­ing a col­lec­tive breath to see how to pro­ceed next. Their op­tions range from tak­ing up more mod­est re­forms pro­pos­als to tabling re­form in­def­i­nitely.

“Ob­vi­ously, things have changed dra­mat­i­cally in terms of the po­lit­i­cal equa­tion and the mood” on Capi­tol Hill, said Richard Pol­lack, ex­ec­u­tive vice pres­i­dent of ad­vo­cacy and pub­lic pol­icy for the Amer­i­can Hospi­tal As­so­ci­a­tion. The path to re­form is at best, “murky” right now, Pol­lack said. “As each day, as each hour goes by, it seems like more op­tions are be­ing ruled out. We just don’t know what’s go­ing to hap­pen.”

The health­care re­form ef­fort col­lapsed last week as Repub­li­can Scott Brown’s win in Mas­sachusetts killed the Demo­crat’s fil­i­buster-proof ma­jor­ity in the Se­nate. The loss of that Se­nate vote de­liv­ered a blow to the health­care re­form bill, which House and Se­nate con­fer­ees had once hoped to de­liver to Pres­i­dent Barack Obama be­fore his State of the Union ad­dress, sched­uled for Jan. 27.

Dis­agree­ment in the House over such things as the ex­tra Med­i­caid pay­ments ne­go­ti­ated for Ne­braska, a tax on high-value health plans known as “Cadil­lac” plans and over­all af­ford­abil­ity had also boiled to the sur­face in re­cent weeks, cre­at­ing sep­a­rate road­blocks to re­form.

Some in Wash­ing­ton be­lieve the pres­i­dent’s up­com­ing speech may be the cat­a­lyst that could save one of his ma­jor do­mes­tic pri­or­i­ties. “I am still con­fi­dent that health­care re­form will be en­acted. It’s too much of a pri­or­ity for the ad­min­is­tra­tion, and Congress hasn’t sunk this much time into it” for it to fail, said Eric Zim­mer­man, a health­care lawyer who is a part­ner

Mas­sachusetts GOP state Sen. Scott Brown cel­e­brates his stun­ning elec­tion to the U.S. Se­nate last week, a de­vel­op­ment that sent Democrats scram­bling for a way to pass re­form.

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