Healthcare Reform Bill Includes Insurance Requirement, Exchanges, Greater Industry Oversight

Janice Simmons, for HealthLeaders Media , June 10, 2009

The pace of healthcare reform appears to be moving quickly on Capitol Hill this week with release Tuesday afternoon of a 615-page draft from the Senate Health, Education, Labor and Pensions Commission, chaired by Sen. Edward Kennedy (D-MA).

The bill, called the "Affordable Health Choices Act," will get its first hearing on Thursday afternoon. But between now and then, there's plenty to review in the bill including proposals calling for:

  • Requiring all Americans to be insured
  • Creating new insurance exchanges to provide near universal coverage
  • Stepping up government oversight of the insurance industry

"We still have a lot of work ahead of us," said Sen. Christopher Dodd (D-CT), in a statement, who has been ushering the bill through while Kennedy recuperates from a brain tumor. However, bipartisanship that was initially anticipated may be somewhat more elusive with this bill.

The committee's ranking minority leader, Sen. Mike Enzi (R-WY), has expressed his displeasure about how quickly the bill has been moving through the committee. "We've been meeting with Democrats for months to discuss healthcare reform, but from what I've seen in this proposal, it doesn't look like they listened at all," he said.

A joint four-page outline was released yesterday as well by the three House committees—Ways and Means, Energy and Commerce, and Education and Labor—on what will be included in their draft bill. The proposal calls for insurance market reforms, such as a health insurance exchange and a public health insurance option, "shared responsibility" or requirements that all get insurance; and rewarding high quality/high efficiency care.

The House proposal also calls for replacing the Sustainable Growth Rate, an arcane formula created in 1997 to calculate Medicare physician payments and limit spending on physician services—but was never successfully applied. However, it is not clear in the outline how it would be replaced.

Work is still continuing on the Senate Finance side as well. Committee Chairman Max Baucus (D-MT) is said to be looking at placing caps on the value of employer based health insurance plans that can be excluded from personal income taxes. But no word yet on the public plan concept, which was severely criticize by most of the panel's Republicans in a letter to the president on Monday.

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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