Julie Miller
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August recess was anything but a vacation for Congressional leaders. The six Senate Finance Committee members who are charged
with crafting a bipartisan agreement met over recess to keep the momentum going. Here's the playbook:
Sen. Max Baucus (D-Mont.) is chairman and appears more of a centrist, seeking a bill some Republicans would support.
Sen. Jeff Bingaman (D-N.M.), also on the Health Committee, wants a public-plan option—Democrats' main focus right now.
Sen. Kent Conrad (D-N.D.), also chairman of the Budget Committee, has been touting co-ops and insists the panel "will not be bound by any deadline,"
even though Baucus is considering partisan options (i.e. reconciliation) if a deal is not reached by September 15. Sen. Michael Enzi (R-Wyo.) is also on the Health Committee and voted against the healthcare bill that contained a public plan.
Sen. Charles Grassley (R-Iowa) has taken a lead for Republicans on reforms and is known for keeping watch on spending. He favored private competition for
Medicare Part D.
Sen. Olympia Snowe (R-Maine) could offer the pivotal vote. A small-business advocate, she opposes taxing employer-sponsored benefits.
There are influential players along the sidelines, too. Some will sway final votes, and others will have responsibilities
in the implementation of policy changes (if any).
Nancy-Ann DeParle, the "health reform czar," has listened to the voices of industry groups.
Sen. Chris Dodd (D-Conn.), member of the Senate Health, Education, Labor and Pensions Committee, is leading negotiations in the absence of the committee's
chairman, Sen. Edward Kennedy.
Ezekiel Emanuel, author, professor, oncologist and special advisor for health policy to the director of the White House Office of Management
and Budget, helps the President craft his health policy strategy. His brother Rahm is chief of staff.
Sen. Orrin Hatch (R-Utah) co-sponsored the legislation that created the State Children's Health Insurance Program. He represents a potential vote on
a bipartisan bill.
Peter Orszag, director, Office of Management and Budget, drives the administration's decisions around cost and is a supporter of comparative
effectiveness.
Rep. Nancy Pelosi (D-Calif.), Speaker of the House, will have to coordinate House efforts. She's been outspoken about her distrust of private health insurance
companies.
Sen. Harry Reid (D-Nev.), Senate Majority Leader, is working with the White House and the committees on strategy and the possibility of budget reconciliation.
Kathleen Sebelius, Secretary, Department of Health and Human Services (HHS), will manage changes to Medicare and Medicaid and drive policy
implementation.
With partisan politics squarely at the center of the debate, some question whether these players will achieve reform policy
at all.
Vince Ventimiglia, senior vice president of B&D Consulting and former HHS assistant secretary, tells me some type of legislation
will pass toward the end of the year.
"There remains the political imperative in avoiding the 21% doctor pay cuts under the [Medicare sustainable growth rate] and
in providing mechanisms to provide insurance coverage for at least a portion of the enormous number of uninsured persons,"
he says. "The real question is what can be afforded in today's economic and political environment."
While Congress might be working hard to craft a bill, it will be industry's job to complete the far more difficult task of
carrying out the new policies.
Julie Miller is editor-in-chief of MANAGED HEALTHCARE EXECUTIVE. She can be reached at julie.miller@advanstar.com
