• Political Maneuvering and the President's Health Care Plan
  • March 23, 2010
  • Law Firm: Bingham McCutchen LLP - Boston Office
  • President Barack Obama has mounted a push to pass a health reform plan following a "template" his administration recently unveiled. The president's plan includes provisions from the House and Senate bills (and possibly a few Republican ideas). Democrats intend to use the congressional "reconciliation" procedure, which requires "only" a majority vote in the Senate and would avoid Republican filibusters, to pass at least a large part of the health reform plan, though Republicans intend to try to block that bill by arguing numerous points of order and submitting an overwhelming number of amendments. The Democrats would meanwhile have the House of Representative separately pass the Senate bill which has already been approved by the Senate. Many House Democrats, however, are reluctant to do so unless the Senate provides ironclad assurances that it will later pass a reconciliation bill which includes items important to the House so that the original Senate bill will not be signed by the president. The reconciliation measure would serve as a "corrections" bill that would make changes to the original Senate bill so that the final plan would satisfy at least all Democrats. Groups of House Democrats, for example, seek elimination of the special treatment for Nebraska's and Louisiana's Medicaid programs and for Florida's seniors in Medicare Advantage plans, in the Senate bill as passed earlier. Others would like to revise the abortion language, improve subsidies for low- and middle-income families to purchase insurance and remove the excise tax on high-cost insurance plans.

    Key elements of the White House plan include:

    • Closing the Medicare prescription drug "donut hole" coverage gap;

    • Eliminating the Nebraska Medicaid exception and providing uniform support for state Medicaid programs for newly eligible individuals;

    • Increasing tax credits for health insurance premiums;

    • Federal review of insurance rates;

    • Delaying the excise tax on high-cost insurance plans and increasing the amount of exempt premiums;

    • Broadening the Medicare Hospital Insurance tax base to include unearned income of high-income households;

    • Tax credits for small businesses to support health insurance for their employees; and

    • Additional measures to combat fraud, waste and abuse in Medicare and Medicaid.

    For more information, visit the White House website.