Yea or nay?

Democrats op­ti­mistic re­form will pass this week

Modern Healthcare - - The Week In Healthcare - Matthew DoBias

Democrats on Capi­tol Hill inched closer to fin­ish­ing a year­long ef­fort to re­shape the U.S. health­care sys­tem. House and Se­nate leaders com­pleted a last-minute agree­ment that im­por­tantly in­cludes a stu­dent loan mea­sure, with rank-and-file mem­bers say­ing they were op­ti­mistic that a bill can pass this week.

As al­ways, the process could prove tricky and time­lines are sub­ject to change, but on March 12, se­nior law­mak­ers said they had forged a path that would re­sult in dual pas­sage of the Se­nate’s re­form bill cou­pled with a White House­backed pro­posal.

Both mea­sures will move for­ward un­der a bud­getary pro­vi­sion known as rec­on­cil­i­a­tion, which ef­fec­tively al­lows the Se­nate to pass the mea­sures with a sim­ple ma­jor­ity vote.

“There has been a tidal change in the last 72 hours, so I think peo­ple are be­com­ing more con­fi­dent that we’re go­ing to get this done,” said Rep. An­thony Weiner (D-N.Y.).

Health­care-provider lob­by­ing groups didn’t ap­pear to be push­ing for or block­ing the fi­nal push. “We have a few con­cerns, like many in­ter­est groups do, but have set them aside,” said Larry Gage, pres­i­dent of the Na­tional As­so­ci­a­tion of Pub­lic Hos­pi­tals and Health Sys­tems, while speak­ing to House leaders last week.

Part of the pack­age in­cludes lan- guage that al­lows the fed­eral gov­ern­ment to make stu­dent loans di­rectly rather than just back them. The mea­sure passed the House ear­lier but faced an un­cer­tain fate in the Se­nate. House leaders said that pair­ing the stu­dent fund­ing with the health­care por­tion of the bill is needed to bal­ance out the rec­on­cil­i­a­tion process, which can only work if the leg­is­la­tion re­duces the fed­eral deficit each year for a decade straight. Without it, the health­care bill would not have met the re­quire­ments, sev­eral law­mak­ers said.

“From the House’s point of view, we don’t have much of a choice, given the rul­ing of the par­lia­men­tar­ian,” Rep. Gerry Con­nolly (D-Va.) said.

Rep. Ge­orge Miller (D-Calif.), chair­man of the Ed­u­ca­tion and La­bor Com­mit­tee, said the stu­dent loan mea­sure also helps Democrats cor­ral some votes for the bill that were pre­vi­ously on the bub­ble. “It’s crit­i­cal,” he said. “Peo­ple have made it very clear that they want to take this home.”

Party leaders also ap­peared to have reached an agree­ment on a few other thorny is­sues as well, in­clud­ing how to fund states that had al­ready ex­panded their Med­i­caid el­i­gi­bil­ity re­quire­ments.

Weiner: “There has been a tidal change in the last 72 hours.”

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