Sunday, October 25, 2009

Health Care Debate Likely To Extend Into Next Year

Unresolved issues in the merger of five committee measures on health care reform include Medicare reimbursement rates as a basis of payment to doctors and hospitals under any public option, regional disparities in payments to rural hospitals, coverage for medical devices, and the always thorny issue of federal funding for abortion services. Versions of the bill presently under consideration in Congress attempt to be “abortion neutral,” requiring availability of insurance plans covering abortions as well as plans which do not. The issue of how to account for premium payments from individuals required to buy private insurance, but subsidized by government tax credits towards their premium payments, is more complex. Can that person use federal subsidies to pay part of the premium for a policy covering abortion services? If not, how is that restriction not a denial of the individual’s right to get an abortion?

Congressman Bart Stupak of Michigan leads a group of about 40 legislators who say they won’t permit health care reform legislation to come to the floor unless a vote is allowed on an amendment specifically prohibiting federal funding for abortion. No one has as yet offered language parsing the accounting complexities enforcement of such a ban in the context of mandatory individual health insurance coverage subsidized in part by taxpayer money.

A floor vote in the House on health care reform is expected the week of November 6, with leaders advising Congressmen to expect to stay in Washington Saturday November 7 and the following Monday and Tuesday as well. The Senate vote will likely come later. According to House Republican Study Committee Chairman Tom Price, conference committee work merging the measures from the two chambers will likely “bleed into January or February.”
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