Monday, April 28, 2008

Weekly Newsletter: April 28, 2008

  • Genetic Non-Discrimination Act Returns for House Vote

    This week, the House is expected to vote on Senate amendments made to the Genetic Information Nondiscrimination Act (H.R. 493), in order to send the bill to the President’s desk. The compromise language negotiated between Senate sponsors and Sen. Tom Coburn (R-OK) allowed the bill to pass the Senate on a 95-0 vote last Thursday.

    The compromise language corrects several issues of concern to conservatives. Insurers and employers will be prohibited from discriminating against individuals on the basis of fetal genetic information, ensuring that individuals will not feel pressured into aborting their unborn children. In addition, existing policies on insurance underwriting for diseases already manifest in individuals will be maintained, and entities subject to existing privacy regulations under the Health Insurance Portability and Accountability Act (HIPAA) will not be subject to a new regulatory regime. Lastly, the compromise language improved a conservative concern that employers will not be subject to Equal Employment Opportunity Commission (EEOC) tribunals or lawsuits for decisions they make in their capacity as an insurer for their employees.

    Full House Votes to Override Medicaid Fiscal Integrity Regulations

    This past week, the full House by a 349-62 vote approved legislation (H.R. 5613) that would impose moratoria on several proposed regulations issued by the Centers for Medicare and Medicaid Services (CMS) to restore fiscal integrity to the Medicaid program. Although the bill was approved by the Energy and Commerce Committee 46-0, seven Energy and Commerce Committee Republicans opposed House passage— because of either substantive concerns about the legislation or as a protest against the expedited procedures under which the multi-billion dollar bill was considered.

    Despite the wide margin of passage, some conservatives may remain concerned by congressional actions to block regulations that respond to more than a dozen Government Accountability Office (GAO) reports released since 1994 highlighting the various ways states have attempted to “game” the Medicaid program and increase the amount of federal matching funds received. The history of these abuses has prompted the Administration to threaten a veto of any measure attempting to block CMS’ attempts to restore the fiscal integrity of the Medicaid program.

    Action now moves to the Senate, where Minority Leader Mitch McConnell (R-KY), Minority Whip Jon Kyl (R-AZ), and Finance Committee Ranking Member Chuck Grassley (R-IA) all support allowing CMS’ regulatory actions to continue without further intrusion from Congress. In addition, the American Medical Association (AMA)—which supports legislative action to block the regulations—on Friday expressed concern that HR 5613 would utilize funds from a physician quality improvement fund to help pay for the moratoria. Some conservatives may view the AMA letter as confirming the belief that, by using a physician quality fund “in a manner inconsistent with its intended purpose,” HR 5613 relies on budgetary gimmicks not consistent with the spirit of House pay-as-you-go budgetary scoring rules.

    RSC Briefs on the federal-state Medicaid relationship can be found here, here, here, and here.

    Article of Note: Broken Promises Ahead

    This week, The Hill reported that Congressional Democrats do not believe the fundamental health care overhauls advanced by Sens. Hillary Clinton (D-NY) and Barack Obama (D-IL) have a realistic chance of enactment in the near future. The story quoted several Democratic leaders:

  • Democratic Senate Campaign Committee Chairman Chuck Schumer (D-NY): “I am not sure that we’re ready for a major national health care plan;”
  • Senate Finance Committee Member Jay Rockefeller (D-WV): “We all know there is not enough money to do all this stuff;”
  • House Ways and Means Committee Member Kendrick Meek (D-FL): “The money is not necessarily there right now” to enact comprehensive reform;
  • Senate Finance Committee Chairman Max Baucus (D-MT): “If they try to solve all the problems, it’s going to be difficult;”
  • Former Senator John Breaux (D-LA): “You don’t want to rush and do something and do it incorrectly.”

    Some conservatives may not be surprised by the skepticism from within the Democratic Party, particularly as Sen. Clinton has recently admitted her willingness to raise tobacco taxes to pay for her reform plan, while also garnishing individuals’ wages who do not comply with an individual mandate to purchase health insurance. Rep. Meek’s comments that “there is…a Congress here with feelings and experience on this issue…this is not a kingdom, this is a democracy” speak to the reluctance of Congressional Democrats to accept their Presidential candidates’ desire to raise taxes and grow government-run health care. Some conservatives would argue that, by reforming health care to create new markets, the sector could slow its soaring growth, obviating the need for additional taxes and spending to finance new public health care programs.

    Read the article here: “Dems Hedge on Health Care