H.R. 3962 - How Will the House Reform Bill Impact My Community?

The Committee on Energy and Commerce prepared, for each House member, a district-level analysis of the impact of House Bill 3962: Affordable Health Care for America Act. This analysis includes information on the impact of the legislation on small businesses, seniors in Medicare, health care providers, and the uninsured. It also includes an estimate of the impacts of the surtax that will help to pay for the legislation.

You may access this information by clicking HERE.

House Passes Health Care Reform Bill

On Saturday, the House passed the Affordable Health Care for America Act (H.R. 3962) with a vote of 220-215. Even with the passage of the House bill, overall healthcare reform has some hurdles to clear. The Senate bill is still awaiting a score (cost) from the Congressional Budget Office (CBO). Once the CBO provides its analysis, the Senate will have a floor vote, which will most likely be contentious. If and when the Senate passes its reform bill, the House and Senate reform proposals will have to be merged before anything is sent to the President to sign.

To learn about the key points of the Affordable Health Care for America Act, please visit The Kaiser Family Foundation.

Stay tuned......

Health Reform Update 11.4.09

National health reform is still moving along, though where it is going to end up still reamins to be seen. Here is a quick update on both the House and Senate side as to where the two proposals stand......

House: The House has merged the three committee proposals that were passed this summer and the total price tag of the compiled House bill is close to $1 trillion dollars, according to the Congressional Budget Office. There are still some sticky issues in the House proposal that are being worked out and a floor vote is expected this Saturday, November 7th. Some key rural health provisions are not included in the House bill and it is unlikey that there will be many (if any) floor amendments offered. This means the Senate is the key focus of adding any rural health provisions. Some of these provisions include: improving reimbursement for Rural Health Clinics, allowing Critical Access Hospitals more flexibility with their bed count (currently capped at 25 occupied beds per day), and allowing CRNAs to be reimbursed at cost through Medicare.

For a complete list of the rural health amendments that are hoping to be addressed on the floor of the Senate, please visit the National Rural Health Association Health Reform page.

Senate: The Senate has compiled both proposals that were passed this summer/fall and have sent their bill to the Congressional Budget Office (CBO). The CBO will analyze the bill and provide a price tag to the proposed reforms. It is still unknown when the Senate will have a floor vote on their reform bill and there is talk it may be pushed into 2010.

Keep checking back regularly for updates!

Expanding Health Insurance Coverage for Rural Residents through Health Reform

The Rural Policy Research Institute recently released a report entitled "Assuring Health Coverage for Rural People," which was funded by the Robert Wood Johnson Foundation. The Health Reform brief suggests that the challenges that rural people face in obtaining health insurance are partly due to the structure of the rural economy: 64 percent of adults working in rural are employed in jobs where health insurance is provided, compared to 71 percent of their urban counterparts. At the same time, rural workers are far more likely to be self-employed. Rural businesses also pay higher premium costs than urban businesses for similar health insurance plans.

Please click HERE to access the report.

The Commonwealth Fund: Comprehensive Congressional Health Reform Bills of 2009

The Commonwealth Fund has relased a report that provides an overview of the key provisions in the health reform bills currently being considered in Congress.

Please click HERE to access The Commonwealth Fund website and report entitled: The Comprehensive Congressional Health Reform Bills of 2009: A Look at Health Insurance, Delivery System, and Financing Provisions.

Senate Health Bill Could Come This Week, 'Compromise' Public Option Now Seems Likely

The following is from Kaiser Health News.

Senate Democrats will need to move quickly if they want to pass some version of health overhaul legislation by the end of the year.

The Associated Press: With "time growing short," Senate Democratic leaders "still face key decisions..." In the Senate, that "means deciding whether legislation will give the government a role in the marketplace at all, and if so, what rights individual states would have in deciding whether to participate." The Senate is weighing its final choices as negotiators work to merge the bills from Senate Finance and from Health, Education, Labor and Pensions Committees. The latest talks have focused around getting rid of any mandate on businesses to provide health insurance for their employees (Espo, 10/26).

The Wall Street Journal reports that the Senate's finalized health bill could be ready as soon as early this week, when the leaders will submit the bill to the Congressional Budget Office for scoring. Senate Majority Leader Harry Reid "spent the weekend shoring up support for the bill from Democrats in the chamber. But some key moderate Democrats signaled Sunday that they remain uneasy about main planks of the legislation." Although some details could change, the "broad outlines are becoming more clear" (Adamy and Hitt, 10/26).

Politico reports that Sen. Chuck Schumer also believes 60 votes are within sight. But "Senate Minority Leader Mitch McConnell said that Democrats still have work to do in rallying support within their ranks, pointing to last week’s overwhelming vote to strike down a so-called doc fix to Medicare physician reimbursement that would have added nearly $250 billion to the deficit. A group of Democrats crossed party lines on the vote" (Isenstadt, 10/25).

The New York Times: "Several Democratic senators voiced optimism on Sunday that Congress would pass a health care bill containing at least the germ of a government-run insurance program. Their expectations were grudgingly seconded by Senator John McCain, the Republican presidential candidate in 2008. 'I think the Democrats have the votes, and in the House, Blue Dogs bark but never bite,' Mr. McCain said on CBS’s 'Face the Nation,' using the nickname for conservative Democrats."

Democrats who said they see a public plan passing include Sens. Claire McCaskill, of Missouri; Chuck Schumer, of New York; and Russ Feingold, of Wisconsin. Sen. Ben Nelson, D-Neb., said he was willing to look at the proposal if the Senate allows states to opt out of that part of the plan (Berger, 10/25).

Senate Fails to Pass Permanent Fix to Medicare Physician Payments

On Thursday, October 22nd, the Senate voted to limit debate and bring S. 1776, the Medicare Physicians Fairness Act of 2009 to the floor for a full vote, but failed to get the 60 votes needed to do so. The final vote tally was 57 no votes to 43 yes votes. Both Senator Bennet and Senator Udall voted yes on the bill.

The cost of the bill, the reason it was defeated, was $245 billion over the next ten years and did not provide any offsets. This means that the Finance Committee’s Health Reform bill (S 1796), which included a temporary “fix” to the 21.5 percent payment cut via the sustainable growth rate (SGR) formula for Medicare physician pay, will most likely be included in the final bill brought to the Senate floor.

Colorado Backseat Budgeter

If given the opportunity, how would you go about balancing the state budget? With our state approaching a $1.8 billion deficit for Fiscal Year 2009-2010, state budget cuts are imminent. Due to certain constitutional mandates, balancing Colorado's state budget is no easy task; especially if you'd like to raise revenue. Colorado's Backseat Budgeter is a great tool to use to better understand Colorado's fiscal situation. Please visit the site by clicking HERE and enjoy!

Health Bills in Congress Won't Fix Doctor Shortage

Health Bills In Congress Won't Fix Doctor Shortage

By Phil Galewitz, KHN Staff Writer
Oct 12, 2009

Even as Congress moves to expand health insurance coverage to millions of Americans, it's doing little to ensure there will be enough primary care doctors to meet the expected surge in demand for treatment, experts say.

The American Academy of Family Physicians predicts that the shortage of family doctors will reach 40,000 in the next 10 years, as medical schools send about half the needed number of graduates into primary care medicine. The overall shortage of doctors is expected to grow to nearly 160,000 by 2025, according to the Association of American Medical Colleges.

Click HERE to read this article in its entirety.

Provide Feedback about Medicare to the Center for Medicare & Medicaid

On Thursday, October 29th, the Center for Medicare & Medicaid (CMS), Medicare Provider Feedback Group will be holding a town hall meeting that you can participate in via teleconference. You must register by 3pm (MST) on Friday, October 23rd.

For more information and to register please click HERE.

Call Senator Bennet & Senator Udall Today!

The U.S. Senate is finally moving on a bill (S.1776) that would eliminate Medicare's sustainable growth rate (SGR) formula. The SGR formula essentially cuts Medicare payment rates. For more information on SGR and S.1776 click HERE.

The Senate was set to vote on the bill today (Monday, October 19th) but the vote has been delayed for at least 24 hours.

Because the Senate's first vote could occur as early as tomorrow, Tuesday, Oct. 20, please call Sen. Mark Udall and Sen. Michael Bennet NOW and urge them to VOTE YES on S. 1776. You may use the American Medical Association's (AMA) hotline to contact them by calling: (800) 833-6354.

Never called a congressional office before? Check out the AMA guide to "Communicating with Congress."

To see how the cuts impact patients and physicians in Colorado, click HERE.

Health Reform Update

After receiving a final “score” from the Congressional Budget Office, the Senate Finance Committee has scheduled a meeting to vote on the America’s Healthy Future Act on Tuesday, October 13. The bill will likely pass out of the Committee, then move into a conference between Finance and HELP Committee leadership to bring one single version of the bill for the Senate floor.

Given the controversial issues surrounding health reform from either side of the aisle, there will likely be considerable action on the Senate floor. Here are a few of the rural amendments that NRHA expects to be offered on the floor during debate:

S. 307 – Wyden – Allows flexibility in the CAH bed count
S. 1355 – Barasso/Wyden – Raises the RHC Cap to $92
S. 1171 – Pryor – Would waive the 35-mile rule for CAH designation

For copies of both Finance and HELP Committee bills, please see below:

Senate Finance Committee Links

Senate HELP Committee Bill (S.1679 – The Affordable Health Choices Act)

You may also click here to read the House's proposal (H.R. 3200: America's Affordable Health Choices Act of 2009)

Gov. Ritter to hold Town Hall Meetings - Oct. 8th - 10th

Governor Ritter will be holding public town hall meetings in Idaho Springs, Alamosa, San Luis, Antonito, Saguache and Monte Vista the next few days, and he's inviting you to attend and participate.

Thursday, October 8, 2009 - 11:30 a.m.
City Hall, 1711 Miner St., Idaho Springs

Friday, October 9, 2009 - Noon
Adams State College, Student Union Building, Banquet Room A-130,
Corner of 1st Street and Stadium Drive, Alamosa

3 p.m.
Centennial High School, 901 Main Street, San Luis

5 p.m.
Dos Hermanas Restaurant, 435 Main St., Antonito

Saturday, October 10, 2009 - 9:30 a.m.
Saguache Community Building, 525 7th Street, Saguache

11:30 a.m.
Gov. Ritter will visit veterans and community members at the Colorado State Veterans Center at Homelake and host a town hall meeting, 3749 Sherman Ave., Monte Vista.

Senate Finance Amendment Passes - Equity for Rural Providers

Finance Committee Focuses on Physician Payment
By Emily P. Walker, Washington Correspondent, MedPage Today
Published: September 30, 2009

WASHINGTON -- A GOP amendment that would pay rural doctors more money passed by unanimous consent during Tuesday evening's Senate Finance Committee markup.

The amendment, sponsored by ranking Republican Sen. Chuck Grassley of Iowa, would adjust the Geographic Practice Cost Index, or GPCI, helping to level the current payment differential between physicians in rural and urban areas for the same procedures.

The GPCI is part of the formula used by CMS to determine physician payments and reflects regional differences in practice costs, such as rent and employee wages.

"It's getting harder and harder for seniors to find doctors serving in rural areas," Grassley said in a prepared statement. "Part of the problem is Medicare payment policies that shortchange rural states. It's a question of fairness and accuracy to fix the problem of rural physicians getting paid less for performing the same procedures than doctors in other areas."

The amendment would not take money away from physicians practicing in urban areas.

Please click HERE to read this article in its entirety......

Booze, Guns, and the Rise in Rural Suicides

Daily Yonder article by Bill Bishop

Rural and urban suicide rates were about the same in the early 1970s. By the late 1990s, rates of suicide were 54% higher in U.S. rural areas than in U.S. cities.

Attempted and completed suicides take place at higher rates in rural communities, especially in areas that have more bars and taverns than other rural places, according to a new study.

The numbers of suicides were highest among white men.

Suicide rates were higher in both urban and rural places with concentrations of bars and taverns, according to the report by Fred Johnson, Paul Gruenewald and Lillian Remer. The authors speculate that a wide range of factors contributed to higher suicide rates in rural areas, including widespread use of firearms, local economic problems and alcoholism. Three out of four rural suicides involved firearms, according to the report.

Click HERE to read the story in its entirety.

Senate Finance Committee Health Care Proposal

Earlier today, the Senate Finance Committee began marking up the proposed bill that was introduced last week by Chairman Max Baucus (D-Mont). With over 500 proposed amendments to the bill, some interesting debate should ensue the next couple of weeks. To see a list of the proposed amendments, please click HERE.

The Washington Post reports: The bill would expand health coverage to millions without adding to federal budget deficits, and despite criticism of the measure from both parties, it has attracted the support of more moderate Democrats than any other proposal.

After a year-long effort to build a bipartisan consensus around the plan, Baucus has so far been unable to persuade any Republicans to sign on, and fellow Democrats have accused him of wasting his time courting conservative Sens. Charles E. Grassley (Iowa) and Mike Enzi (Wyo.).

The New York Times stated: The chairman of the Senate Finance Committee, Max Baucus, said Monday that he would modify his health care bill to provide more generous assistance to moderate-income Americans, to help them buy insurance.