In an effort to keep you informed of the work NASW is doing on health care reform, we will periodically send out a roundup of activities.
NASW offices are closed December 24 – January 1. While we will be monitoring the developments of health care reform, the next Health Care Reform Roundup will be distributed the week of January 4.
Senate Breaks Logjam on Health Reform
After nearly 20 days of continuous debate, the Senate finally appears ready to complete consideration of its version of health reform legislation, HR. 3590. When Senate consideration is complete, a conference committee process between the House and Senate will occur, and conferees will negotiate a final agreement that must again pass both chambers. As the Senate completes consideration of their version, NASW has called on you to contact your Senators to support passage of their bill (H.R. 3590). A link to our most recent action alert is here.
The Senate breakthrough this week came in the form of a manager’s amendment that dropped the government-run insurance plan, or public option, which NASW supported. The now amended Senate bill would create a new system of national, private insurance plans supervised by the federal Office of Personnel Management (OPM), which currently administers health benefits for federal employees. OPM would be required to recruit at least two insurers to participate in a new system of national health insurance plans, and one must be a nonprofit. Additionally, states would organize and regulate their own insurance exchanges that would sell private plans available on a statewide basis. The new Senate amendment includes a financial requirement for private insurers that would establish minimums on insurers’ premium revenues that must be spent on medical claims known as the “medical loss ratio.” The latest Senate changes also tighten restrictions on insurance coverage for abortion, another crucial NASW concern.
Conference Committee Considerations
Conferees’ room for maneuvering is expected to be limited because any changes in the final conference bill could unravel the agreement that provided Democrats with the 60 votes necessary for final Senate passage. Conferees will have to find compromises on divisive issues such as abortion coverage, revenues to pay for expanded coverage, whether to include a government-run plan, and methods to expand coverage to those unable to pay full costs. On each of these issues the Senate is expected to have a stronger hand in negotiations.
At this time it is unclear what process House and Senate Democratic leaders will use for conference committee consideration. They may work out their differences in negotiations with a small group of Democratic leaders and committee chairmen, supported by key congressional staff. NASW expects the process will start at the staff level soon after the Senate passes its bill. Leaders hope to have the final bill on the President’s desk by late January.
When conference committee consideration begins, NASW will express its preferences among key competing provisions of the House and Senate bills. Among the differences NASW expects to weigh in on are provisions concerning Medicare Skilled Nursing Facility coverage of clinical social work services, workforce provisions under the Social Work Reinvestment Act, the public option, and reproductive choice. NASW is aware the final bill may not measure up to all the hopes of its members, but we will continue to press for improvements to the bill as it moves toward passage. To stay in touch with congressional developments and NASW’s response, please follow our webpage here.