Compare the Senate & House Health Reform Proposals

The Kaiser Family Foundation has an online tool where you can look at a side-by-side comparison of the final Senate and House healthcare reform proposals. Once Congress convenes in January, these two proposals will have to be meshed before a final version is sent to the President to sign.

Click on the title of this blog to visit the Kaiser Family Foundation website.

Health Reform Update 12.28.09

The Senate voted for passage of the Patient Protection and Affordable Care Act at 7am on December 24 by a party-line vote of 60-39. Upon returning from recess in January, Congress will have to reconcile the differences between the House and Senate bills. The final healthcare reform bill will most likely resemble what is in the Senate bill. The tentative goal is to have a final bill to the President's desk by the State of the Union (mid to late January), though the White House has acknowledged that Congress has many priorities to tackle early in the year.

The National Rural Health Association has been working hard to ensure there are strong rural provisions in any healthcare reform proposal. Please visit the NRHA website to see specifics of what is included in the Senate and House proposals.

Health Reform Update 12.22.09

Well, it appears that the Senate will be voting on the Patient Protection and Affordable Care Act before Christmas. As of right now, the Senate is expected to vote at 8am on Christmas Eve. Senate Majority Leader Harry Reid has a Manager's Amendment that is 383 pages long and adds some important rural provisions to the bill. As soon as details come forth of what is included in the Manager's Amendment, I will be sure to post that information here.

Once the Senate passes their bill, a conference committee will occur between select House and Senate members to reconcile differences between the two healthcare reform bills coming from each respective chamber. It is believed a final healthcare reform bill will resemble the Senate's version since once a final bill is produced from the conference committee, the Senate will need 60 votes to ensure the bills passage before it can be sent to President Obama to sign.

The fun continues........stay tuned.......

Health Reform would Reduce Uninsured in Rural America from 8.1 Million to 3.2

As Congress continues to analyze and debate key details of health reform, the numbers of people covered under the current plans is receiving increased attention. According to a new analysis by the Rural Policy Research Institute (RUPRI), if fully implemented, the approach to covering the uninsured presented in H.R. 3590, the Patient Protection and Affordable Coverage Act, would reduce the number of uninsured from 8.1 to 3.2 million in rural areas. This increase in coverage would lead to a slightly higher coverage rate for people living in rural areas than for their urban counterparts (93.4% compared to 92.7%), largely because a lower proportion of rural persons are non‐citizens who would not be covered under any of the proposed reform approaches but also because the reform proposal reaches more low‐income persons who are more represented among the rural uninsured.

The report also provides state-by-state estimates of the effects of the legislation on overall health insurance coverage rates (for both rural and urban persons), as well as estimates of how the previously uninsured would be covered under the provisions of the legislation.

Please click HERE for the report in its entirety.

Healthcare Reform Update & Colorado State Revenue Forecast

Federal Healthcare Reform:
At 1 a.m. this morning, the Senate voted 60-40 to invoke Cloture on Majority Leader Reid's manager's amendment to health reform, limiting debate to 30 hours and ensuring its up or down vote. Monday morning's cloture vote was a procedural one that allowed Reid to make certain changes to the bill. It wasn't the big cloture vote, or even the last of the procedural votes that will be held -- there are four more to come, with the last scheduled for Christmas Eve. But the outcome of those is now not in doubt.

There is one big test remaining, of course -- after the Senate passes its version of the bill, it will have to iron out its differences with the House. That could mean more wrangling.

State Budget Revenue Forecast:
The most recent budget revenue forecast shows the state is $40 million short of what was projected in September. Revenue available for spending in the General Fund is $600.6 million below the amount budgeted for expenditure in FY 2009-10. It is already projected that the state is $1.5 billion short for FY10-11.

The upcoming legislative session will be tackling the FY10-11 budget. The General Assembly convenes Wednesday, January 13th.

Healthcare Update 12.18.09

The fun continues!

The House voted this week to pass an amended defense appropriations bill (H.R. 3326), that temporarily delays the scheduled 21.2% Medicare physician payment cut that was set to occur January 1st. Congress now has until Feb. 28th to come up with a plan to keep these cuts from happening. The bill provides a 0 percent update to the Medicare physician payment formula to allow Congress to establish a new permanent Medicare physician payment system upon returning in the new year. The Senate is poised to approve the defense spending bill in the coming days. Both the House and Senate tried to include a permanent fix in their healthcare reform proposals to the Sustainable Growth Rate (SGR), which is the reason these Medicare cuts were set to occur in the first place, but due to the fiscal impact of fixing the SGR, neither healthcare reform proposal addresses this issue.

The Senate will begin working on the healthcare reform bill again this weekend and there is still talk that something will be voted on by Christmas. What that "something" is remains to be seen.......
Stay tuned......

Senate Health Reform Vote by Christmas in Doubt....

Kaiser Health News has pulled together news articles from across the country regarding the issues that the Senate still faces in trying to get a vote on healthcare reform prior to Christmas next week.

Please click HERE to read up on the obstacles the Senate is facing in reaching its deadline.

Senate Healthcare Reform Update - 12.16.09

Senate Majority Leader Harry Reid (D-Nev.) and the White House are still negotiating with key senators to reach agreement on outstanding issues so a manager's amendment can be finalized this week. This amendment is being designed to garner the 60 votes needed to pass H.R. 3590, the "Patient Protection and Affordable Care Act," before the holidays. So far, more than 430 proposed amendments to the bill have been submitted, although only a handful will be presented for a vote on the Senate floor.
A proposal circulated last week that would have allowed uninsured individuals between the ages of 55 and 64 to purchase Medicare coverage has been abandoned after generating opposition from centrist Sens. Joe Lieberman (I-Conn.) and Ben Nelson (D-Neb.), as well as from a group of Democrats representing states with relatively low Medicare payment rates.

It remains to be seen if there will be a vote before Christmas as originially planned. Stay tuned.......

Some Rural Communities Concerned Reform Provisions Could Hurt Medicare Services

Newspapers in Alaska and Washington state explore how health reform provisions might affect Medicare services in rural areas, while a Colorado newspaper looks at one senator's efforts to increase the number of doctors in rural areas.

Please click HERE to read these stories in their entirety.

12.9.09 - Healthcare Reform Update

The fun continues as the Senate moves into its 10th day of the healthcare reform debate. As of this writing, Senate Majority Leader has pulled the public option and has offered a compromise instead. The compromise consists of offering a private plan that is similar to the Federal Employee Health Benefit plan, which is the plan offered to members of Congress. The compromise also would allow those who are uninsured and between the ages of 55 - 64 years old to buy into Medicare. Even with this compromise being offered, there are some Senators who are still talking of allowing a "trigger" for a public option that would come into effect by a certain date if this compromised plan does not alleviate healthcare costs and reduce the number of uninsured.

There are still numerous amendments, including rural provisions, that have been officially filed, but not yet brought to the floor. There is no distinct timeline as to when the rural amendments will be offered, though Senator Reid is still claiming the Senate will have a complete bill before Christmas. Stay tuned.........

Critical Access Hospitals and Healthcare Reform

Critical Access Hospitals not only play a vital role in providing healthcare services to our rural and frontier counties, but they are also a main ecomonic driver in rural communities. The Patient Protection and Affordable Care Act does not adequately address some key provisions that would help increase the ability of CAHs to offer quality, comprehensive healthcare services. Now is the time to contact your Senators to ensure all of the following are addressed:

Reinstate "Necessary Provider" for Critical Access Hospitals - This would allow states to once again waive the 35-mile requirement and deem a hospital as a "necessary provider" based on unique conditions often only realized by local and state entities.

Allow Critical Access Hospitals flexibility in their bed count - CAHs currently are limited by a hard 25-bed cap. Allowing CAHs to maintain an average bed count of 20 improves patient access, especially in the case of seasonal or other unexpected influxes of patients.

Ensure Rural Access to Anesthesia Services - CAHs frequently use certified registered nurse anesthetists to provide anesthesia services in a cost-effective way. However, Medicare reimbursement is currently unreliable due to a lack of clarity in current legislation. Current legislation (S. 1585) would solve this problem and must be included in the final health reform bill. Additionally, H.R. 3151 seeks to close current loopholes and ensure that Critical Access Hospitals (CAHs) are properly reimbursed for their anesthesiology services.

Eliminate CAH "Isolation Test" for Ambulance Reimbursement - Under current law, CAHs can only receive cost reimbursement for ambulance services if they are the only provider of ambulance services within a 35-mile drive. This provision would eliminate the 35-mile requirement, ensuring that CAHs are appropriately reimbursed for providing emergency medical services.

To contact Senator Bennet click HERE or call: 202-224-5852
To contact Senator Udall click HERE or call: 202-224-5941

Senate Healthcare Reform Update

The Senate is currently debating H.R. 3590, the Patient Protection and Affordable Care Act. As of Sunday evening, a total of 165 amendments had been formally submitted, the vast majority of which will not be voted upon. There are many rural provisions that have been submitted, though it is unknown when or if these amendments will be voted on. Colorado's Senator Bennet has submitted an amendment entitled the Rural Health Access and Improvement Act, which would prioritize Critical Access Hospitals to receive grants to implement Health Information technology, expand participation in Drug Pricing Agreement program under Section 340B of PHS Act, provide for a study and report on Pharmacy Dispensing Fees under Medicaid, and provide continuing funding for the State offices of Rural Health. Colorado's Senator Udall also plans to submit an amendement that would create a grant program for medical schools to offer Rural Training Tracks, which encourages and trains medical students to practice medicine in rural areas.

Stay tuned for more updates as the Senate is expected to continue debating the healthcare reform proposal and the plethora of amnedments throughout the next few weeks. You can also visit the National Rural Health Association to stay on top of current healthcare reform news.