On Monday President Obama reveled his final plan for health-care reform on the White House Web site.   Highlighting the recent rate increases, President Obama is pushing for new government legislation to regulate insurance rate-increases as part of the overall change to the health-care system.  Below is an article from the Washington Post that outlines the key changes presented in the President’s final plan and provides opposing commentary from members of the Republican party.

The recent Republican victory in the Massachusetts’ Senate race earlier this week has made the passage of healthcare reform very uncertain. 

To further complicate makers, Speaker Nancy Pelosi released a statement just this morning that she did not have the votes in the House to pass the Senate version of the health care bill.  It has been assumed all along that the Senate could not muster the votes to pass the House version of the bill. 

While it is unclear what happens next, the highlighted from today’s Los Angeles Times provides some good perspective on some of the options Congress is considering at this point. 

Last night Senate Democrats reached an agreement, albeit a tenuous one, on removing the public plan option from the health care reform bill that will be negotiated by the full Senate.  The article below from the Washington Post does a good job capturing the delicate agreement and what it means in terms of the larger health care reform debate.

Compare health-care bill that passed in the House with legislation taking shape in the Sentate as President Barack Obama pushes to overhaul the system.  Details are still being negotiated and any final health care bill would have to meld proposals from the House and Senate.

With the struggle over healthcare entering an even tougher phase, President Obama has hit both a milestone and a speed bump in his dual pursuit of a major overhaul of the nation's medical system and a rebirth of progressivism in America.

House approval of legislation Saturday -- even if Democrats can move it no further -- was an accomplishment that has eluded presidents for decades. But the close vote and the exertions it took to secure a majority were laden with warning signs as the issue moves to the Senate.

Yesterday the House Democrats announced their proposal to overhaul the U.S. health care system.  A public option is part of their proposal, although it would be required to negotiate fees with providers instead of having the power to set reimbursement rates like Medicare.  The Congressional Budget Office estimates only 6 million people would enroll in the public option, a relatively small number of the package that could cover 36 million uninsured Americans.

As way to preserve a public option in the final health care bill, Democrats in the Congress have begun testing the concept of a public plan that would allow states to opt out of offering it.  The measure has initially met similar resistance from fiscally conservative democrats (“blue dogs”) as well Republicans as the original public plan concept.  This article from CNN.com does a good job summarizing the current approach and where it is receiving support and resistance.

One potential negative of this type of public option is that it shifts the political battle of whether a public plan is actually offered to each of the states; one can easily imagine long, drawn out negotiations occurring regarding having a public option in every one of the 50 states.

The Congressional Budget Office completed its analysis yesterday on the revised Senate Finance Committee’s Health Care Reform Proposal.  The analysis showed the proposal would lower the deficit and cover most Americans.  This article from latimes.com provides a good summary of the analysis and how it may impact the discussion on heatlh care reform.

Yesterday the Senate Finance Committee voted down two different amendments to include a government public plan option in the Finance Committee’s health care bill.  This article from the Washington Post provides a good overview of each proposal, which senators voted them down, and the rationale for doing so.  These votes have put into doubt the feasibility of getting a public plan option passed in the overall Senate.

Included in this update is an article from latimes.com that does a good job shaping up the expected battles in both the House and Senate on health care reform over the next two weeks.  As the article discusses, the public plan option and the cost/how to fund the reform are the two areas with the most disagreement.

The Senate Finance Committee is one of five committees in Congress with oversight on health care in the United States.  Until Wednesday, it was the only committee which had not released a bill on heatlh care reform. 

Read the Washington Post article that provides a good summary of the bill, how it fits in the overall national debate, and where the process goes from here. 

Following the President’s speech last night a number of newspapers not only summarized the content but also reviewed its accuracy.  This morning’s article in USA Today, written by John Fritze and Mimi Hall and included below, provided a particularly good perspective on the speech.  In addition, it included a comparison of President Obama’s speech last night to President Clinton’s speech on health care almost exactly 15 years ago. 

Amid the acrimony, Congress has consensus on some healthcare issues

Reporting from Washington - With a virtual civil war raging over parts of President Obama's healthcare agenda, the smoke of battle has obscured a surprising fact: Democrats and Republicans actually agree on a bundle of proposals that could make medical insurance better for millions of Americans.

Today we are sharing an article written from David Gergen, of CNN, on the new deficit numbers just released and their possible impact on the health care debate.  One highlight from the article is how poorly the federal government, under leadership from both parties, has done in estimating the cost of entitlement programs.  

• When Medicare was passed in the mid-1960s the House Ways and Means Committee projected that Medicare would cost about $12 billion in 1990; in 1990, it reportedly cost some $107 billion.

• When Washington enacted Medicare prescription drug reform just a few years ago, the price tag estimate was $400 billion over nine years; new estimates have projected a cost of $724 billion over nine years.

House Committees Approve “America’s Affordable Health Choices Act” Bill with Some Revisions

The three committees in the House with jurisdiction on health care reform released a revised version of the House Democrats’ bill.  These committees are Education and Labor, Energy and Commerce, and Ways and Means, and are using this revised bill as the foundation for the discussions and negotiations in the overall House.  A great deal of the language in the revised bill is similar to what we shared last week, but there are some notable changes including:

• New language regarding health plans to meet a medical loss ratio test in 2013 based on federal definitions and calculations
• Requirement that prohibits states from reducing Medicaid eligibility levels
• Termination of the CHIP program in 2013
• Removal of most people eligible for Medicaid from the Exchange
• New language on the individual market restricting certain underwriting and administrative practices

To read the entire discussion click here.

Yesterday the Democrats in the House released their plan on health care reform. The plan is over 1,000 pages long and contains mandates for both individuals to have coverage and employers to provide coverage or pay a fine (which will be set as a percentage of income for individuals and payroll for employers). It also contains subsidies to help people at 400% or lower of the poverty line pay for healthcare and additional taxes on Americans making $280,000 or more (depending on filing status). Finally, the plan includes both a public program and the formation of exchanges.

Currently, the proposals being negotiated in the Senate are substantially different than the proposal released by the House Democrats. As the negotiations continue, we will continue to provide updates as warranted.