NASW Health Care Reform Roundup – November 24, 2009

Nov 24, 2009

Because Congress will be in recess for the Thanksgiving holiday, there will be no Health Care Roundup on Tuesday, December 1. The next publication will be on Tuesday, December 8.

Rally on Reproductive Choice in Health Care Reform

The U.S. House of Representatives passed an amendment to the health care reform legislation sponsored by Bart Stupak (MI-1) and Joe Pitts (PA-16). This amendment would restrict access to abortion procedures for consumers who receive subsidies to buy insurance in a reconfigured health care system. Pro-choice organizations are very concerned the new language threatens the availability of private insurance coverage for comprehensive reproductive health care services.

NASW is co-sponsoring a rally and lobby day on Wednesday, December 2. The day starts at 9am with a lobby training followed by a briefing from 9:30 – 10:30am. Lobby visits from 10:30-11:30.  There will be an event from 12:00-2:00 and more lobby visits from 2:00-4:30.  Events will take place in the Dirksen Auditorium G-50. A wrap up will take place at 4:30 in Rayburn Banquet Room B369. If you would like to participate in the lobby day, please contact Dina Kastner at (the mailbox is now accepting messages) so she can set up appointments for you.

Senate Opens Floor Debate on Health Reform

On Saturday, November 21 the U.S. Senate agreed to hold debate on health reform legislation known as the “Patient Protection and Affordable Care Act,” (H.R. 3590). The bill is expected to be on the floor for several weeks after Thanksgiving and will require significant changes to clear the filibuster hurdle of 60 votes to secure passage. NASW plans to strongly support passage, but will also support changes in the bill including those that improve coverage and protect against any weakening amendments of women’s rights to reproductive choices. NASW expects to be very actively involved in this debate; members wishing to keep up to date on our activities should visit our health reform webpage here.

Financial Impact of Health Reform

There is a great deal of analysis available on health reform legislation, but information from non-partisan congressional sources, such as the Congressional Budget Office, is frequently most pertinent to legislative decision making. Readers interested in learning more about the impact of health care reform legislation on federal spending may wish to view congressional analyses of the legislation.  These two inks summarize the budgetary impact of the House bill, HR. 3962: Health Care by the Numbers and Controlling Health Care Costs.

The Senate bill the “Patient Protection and Affordable Care Act,” (H.R. 3590) is still new so nonpartisan analyses of its budgetary impact are still becoming available. One summary is linked here and more information appears here. A brief comparison of the Senate and House versions of health reform legislation is available by this link to a Washington Post interactive site.

HHS Secretary Kathleen Sebelius on Monday announced the release of Health Insurance Reform: The Case for Change, a series of state-by-state reports highlighting the benefits of health insurance reform. The reports are available now here.

Medicare Fee Fix Passes House Floor Moves to Senate

The House passed legislation H.R. 3961 on November 19, which would prevent a scheduled 21 percent cut in Medicare doctors’ payment rates, although its fate remains uncertain. Without congressional action, payment rates for Medicare physician and clinical social worker services will drop by 21 percent on January 1, 2010. The prospect of steep payment cuts has raised fears that care to beneficiaries could be disrupted. The fate of corrective legislation that would permanently repeal the flawed sustainable growth rate (SGR) formula that determines future payment rates in Medicare and TRICARE remains uncertain. 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 corrective legislation that would halt scheduled cuts in Medicare payments to clinical social workers and other health professionals and has urged Congress to adopt a plan to recalibrate how those payments are set each year. See NASW’s letter to Congress here.

Correcting the problem before the rate cuts go into effect on Jan. 1, will be politically extremely difficult. The Senate’s huge health care reform bill (H.R. 3590) includes short-term Medicare rate relief, but this provision is highly controversial and may change during floor consideration. Currently, the Senate plans to return to its physician payment bill once they finish work on health care reform, likely meaning it won’t be considered until sometime after the cuts go into effect on Jan. 1. Congress in the past has occasionally failed to enact the physician payment legislation in time, but has simply later passed retroactive legislation that restores the payment rates. Current law requires even further reductions in Medicare physician fees, a loss which will total to a 40 percent cut by 2016. If the Senate agrees to separate physician payment legislation, it may simply approve the House passed bill, but for now, a politically acceptable solution has not been identified.

Health Technology Loan Measure Passed by House

On November 18, the House passed, by voice vote, a bill (HR 3014) creating a new program to be administered by the Small Business Administration that would guarantee small business loans to health professionals such as clinical social workers and physicians to obtain health information technology for use in small or independent health practices. Eligible health information technology includes computer hardware, software, and related technology that supports the meaningful electronic health record use requirements of Medicare and purchased by an eligible professional to aid in the provision of health care, including electronic medical records. Information technology whose sole use is financial management, maintenance of inventory of basic supplies, or appointment scheduling would not qualify for the loan program. The legislation has been referred to the Senate where action is uncertain at this time.

GINA Employment Provisions Take Effect

On November 21, the Genetic Information Nondiscrimination Act (GINA) took effect for all employers with 15 or more employees and it took effect for individual health insurance plans last May.

GINA was passed by Congress last year and prohibits the use by employers of genetic or family medical history in making hiring, firing, promotion or job placement decisions.  Employers cannot require employees to undergo a genetic screening or ask employees for such medical information.

In related news, NASW joined various groups on a letter to the Department of Labor, Department of Health and Human Services and the Internal Revenue Service stating our opposition to any delay or weakening of the GINA regulations.  The letter states, “any delay in implementation would continue to allow employers to inquire about employees’ private genetic information or their families’ medical history, while penalizing employees who choose to keep that information private; any such exemption would create a loophole to significantly weaken the protections afforded to employees and the American people under GINA”.