Conservative Democrats Give Obama 10 Healthcare Reform Demands

Janice Simmons, for HealthLeaders Media , July 22, 2009

The House Energy and Commerce Committee—the only panel that has not completed mark-up of the House Tri-Committee healthcare reform bill (H.R. 3200)—cancelled Tuesday's session while members, including seven self-described fiscally conservative "Blue Dog" Democrats, paid a visit down Pennsylvania Avenue to the White House.

The committee, which has faced heated debate in recent days over the reform legislation, ended up cancelling Wednesday's session as well as it works out rough spots in getting legislation passed.

President Obama, trying to gather support for the healthcare reform package, met for several hours with the Democrats on Tuesday. According to one of the members of the Blue Dog group, Rep. Mike Ross (D-AR), the group arrived with 10 demands and spent most of the time focusing on two priorities—producing a deficit neutral measure and containing costs, especially Medicare and Medicaid costs.

One issue considered was the creation of a government advisory panel operating at the federal level to help set Medicare reimbursement rates. On Friday, White House Office of Management and Budget Director Peter Orszag wrote a letter to House Speaker Nancy Pelosi (D-CA) suggesting that the House and its health committees consider either expanding the power of the Medicare Payment Advisory Committee (MedPAC) or creating an entirely new group called the Independent Medicare Advisory Council (IMAC).

In one approach, introduced by Sen. Jay Rockefeller (D-WV), MedPAC—renamed the Medicare Payment and Access Commission— would be given new powers, such as determining payment rates for physicians and hospitals. An IMAC would have the authority to make recommendations to the president on annual Medicare payment rates, as well as other reforms. Either group would be made up of both public and private individuals.

Other issues the Blue Dog group have focused on in terms of health legislation are getting more value from healthcare dollars, implementing delivery reforms to bend the cost curve, and helping individuals, families, and small businesses purchase healthcare coverage.

Obama is said to be still keeping pressure on Congress to vote for healthcare legislation before the lawmakers go home for the August recess. The president has scheduled a news conference at 8 p.m. EDT today that is expected to focus on healthcare reform.

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

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