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Next Steps for Health Reform Bill and the Issue of Affordability

October 19, 2009

As you all know, last week the Senate Finance Committee passed the health reform bill out of committee, with a vote from Senator Snowe, thus moving the bill forward.

The bill changed quite a bit during the mark-up hearing with a multitude of amendments changing the bill.

At this point, here are the things that have to happen:

  • The Senate needs to meld the two bills (the HELP bill and the SF committee bill) together into one bill that will go to the floor of the Senate. This could happen as early as Tuesday or Wednesday this week.
  • Senators Dodd, Baucus, and Reid and working on melding the bills, with a lot of input from the Obama administration.
  • If there is language in one of the bills, it can end up in the melded bill, but the language can’t change.
  • If there is something that is NOT in the two bills, it cannot be added to the melded bill.
  • If one committee bill has language about an area for which that committee does not have jurisdiction, they will have to negotiate what the language will be in the melded bill.

The House is also working on combining their three committee bills so they have a bill to take to the floor of the House.

Only AFTER a bills is passed in the House AND the Senate, will there be a conference committee between the two chambers of Congress. At that point, we’ll know what will really end up in the final bill that will again, need to passed on the floor of each chamber.

A major concern about the melded Senate bills is in regard to affordability – will people, specifically low-income people,  be able to afford health care coverage. Community Catalyst just  released “Common Sense Affordability Protections: How the Senate Can Deliver Health Reform that Works for Low-Income Families and the Country,” a joint paper that takes a deeper look at the affordability protections offered to low-income families in the current health reform bills. This paper details our specific concerns: the Senate Finance Committee bill would impose health insurance premiums that are unaffordable for families earning just over the federal poverty level (FPL), and would not sufficiently cap out-of-pocket health care expenses.

Paper Findings:

To protect low-wage workers and their families from potentially devastating financial consequences of unaffordable premiums and high out-of-pocket expenses, the report recommends Senate leaders merging the Senate Finance and HELP bills:

  1. Adopt the HELP bill’s Medicaid expansion up to 150 percent of FPL and recommended subsidies for those earning between 150 percent to 200 percent FPL.
  2. Reduce out-of-pocket costs for low-income families by adopting the lower cost-sharing proposed in the Senate HELP bill and capping annual out-of-pocket expenses at no more than 5 percent of family income, an amount lower than the HELP or Senate Finance bills currently offer.

This paper also outlines revenue-raising provisions to off-set the cost of improving affordability protections for low-income families.

We are concerned about the issue of affordability and what will happen to kids as a result of health reform. We want to be sure that kids will not be worse off after reform and certainly, that we don’t lose any of the gains we made with CHIP being reauthorized earlier this year.

Stay tuned for more information as the week progresses.

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