NASW Health Care Reform Roundup – October 26, 2009

Congress Extends the Ryan White Act

Last week, Congress passed the Ryan White HIV/AIDS Treatment Extension Act of 2009. The bill will extend for four years the Ryan White Program, which provides lifesaving and life-extending health care, medications and support services to over 530,000 low-income people living with HIV/AIDS in the United States. On October 21, the bill passed the House floor on a vote of 408 to 9. On October 19, the Senate passed the same bill by unanimous consent. The bill is awaiting President Obama’s signature. The Ryan White HIV/AIDS Program was originally authored in 1990 and reauthorized three times since, always with strong bipartisan support.

Update Health Care Reform

On October 13, the Senate Finance Committee voted on its version of the bill to overhaul health care in the United States.  The Senate Finance committee was the last congressional committee of jurisdiction to tackle the issue of health care reform.  The Senate leadership is in the process of merging the Finance Committee legislation with a bill approved by the Senate Committee on Health, Education, Labor and Pensions (HELP). The HELP bill contained several provisions supported by NASW and not included in the Finance Committee proposal, including a public option plan.

According to Senate rules, they will permit a huge number of floor amendments, threatening perhaps several weeks of debate, if opponents have the votes to tie up consideration. It is likely that at least some of these amendments will raise high-priority concerns for NASW.   For example, one such amendment would focus on including the public plan option in the final bill.  Please go here to see an earlier NASW action alert supporting the public option plan.

The House leadership has been meeting over the past month in an effort to merge the bills passed out of three committees of jurisdiction (Energy and Commerce, Ways and Means and Education and Labor).

With important issues still outstanding in both the House and Senate versions, we believe it is vital to focus on NASW’s floor strategy and message points.  The NASW Government Relations department will be calling on its members to quickly contact their members of congress to take action, possibly on a variety of issues of importance to NASW members and constituents. We hope our strategy will maximize our advocacy effectiveness and enable us to best address the unique needs of social workers and our clients and ensure passage of meaningful health reform legislation that will help expand access to affordable and quality health care.  Thank you for your support and advocacy.

Congress Reconsiders Anti-Trust Exemption for Health Insurance Industry

Congressional Democrats are considering a new issue in health care reform and have recently conducted hearings anticompetitive behavior in the health insurance industry. The hearings concern identical new bills (S. 1681 and H.R. 3596) that NASW is watching. The legislation would eliminate a long-standing federal law that excludes the insurance industry from federal anti-trust regulation. Under the Constitution, regulation of interstate commerce is a federal responsibility. However, in 1945 the McCarran-Ferguson Act authorized states (in the absence of federal law or regulation) to regulate all insurance products, including health, leading to the state regulatory system in place today. This Act also exempted the insurance industry from federal anti-trust law. Therefore, the Justice Department cannot now enforce federal anti-trust law on the insurance industry.

NASW follows federal legislation that would preempt state regulation of health insurance. Among the profession’s concerns in this debate are state-level provider mandates and mental health parity laws. Because of the severe dysfunction in the current state-based health insurance market, over the long term Congress appears likely to “harmonize” state health insurance rules by shifting regulation of the market back to federal control. The subject of this new legislation is more limited in scope, focusing only on the industry’s anti-trust exemption. Currently the health insurance industry response to the legislation has been muted, arguing that they currently do not share health care pricing information and its elimination would not have a significant impact on their practices. Proponents of the measure believe it could fundamentally improve the competitive climate in the health insurance industry, benefiting consumers with lower cost policies. See here for hearing details.

Medicare Fee Schedule Update

Clinical social workers that participate in Medicare Part B will have their payment rates protected against a large cut provided the Senate acts favorably on the “Medicare Physician Fairness Act of 2009” (S. 1776). This legislation would permanently repeal the flawed sustainable growth rate (SGR) formula that determines future payment rates in Medicare and TRICARE. The SGR formula is frequently inappropriately described as the Medicare “physician fee” formula, but it actually sets the overall rate of increase or decrease for all Medicare Part B independent practitioners, including clinical social workers. NASW supports this bill, which would halt scheduled cuts in Medicare payments to clinical social workers and other health professions and has urged Congress to adopt a plan to recalibrate how those payments are set each year. See NASW’s letter to Congress here.

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