Health Law and Policy Update for March 10

Headlines of the week

Obama rallies for health care reform

President Barack Obama continued urging lawmakers to pass comprehensive health care reform, warning a Pennsylvania audience Monday that "if Congress fails to act, premiums will rise, insurers will deny coverage based on pre-existing conditions and more people will be without insurance."

Time is crucial. With the president's goal of moving health reform through the legislative process by Easter weekend, the House needs to vote on the Senate bill very soon so a reconciliation bill can be sent to the Senate. White House spokesman Robert Gibbs said last week he expects a House vote by March 18.

How many House votes are needed?

Confused about how many votes it will take to pass the Senate bill in the House? The short answer is a simple majority present and voting. With 435 House members, that number is 218.

But there will not be 435. After one death and three resignations, including that of Representative Eric Massa, Democrat of New York, on Monday, there will be 431 House members. With everyone voting, 216 members must vote for the bill in order for it to pass.

After the vote in the House, a reconciliation bill will be sent to the Senate. Senate Democrats control 59 votes, so passage of the reconciliation measure is expected. A reconciliation measure requires only a simple majority and is not subject to filibuster. The bill would pass even with a 50-50 tie because Vice President Joe Biden is the tiebreaker.

Former insurance exec offers inside look at industry

Wendell Potter, a former executive for Cigna Insurance, had some pointed remarks about factors driving decisions by insurance companies

in a Friday broadcast on PBS. Under the current system, the companies have incentives to deny health care as often as possible, Potter told journalist Bill Moyers:

"The reason why we have so many people who are uninsured and a growing number of people who are underinsured is precisely because of that. They are actually running business away-- they want to get rid of unprofitable customers. They've been doing that for a long time, and Congress is just now catching onto that. Yeah, one of the reasons why they've had to jack up the rates so much in the individual market to make money, is that they have put more people into that market by running off small businesses, for example. They're purging small businesses."

How health reform would benefit Colorado
The advocacy group Families USA released a valuable tool for understanding how health reform would play out in each state, including Colorado. The eight-page document examining Colorado describes how the health insurance system works now and how reforms would help. The report notes, for example, that now in Colorado "a health insurance policy may stop paying your claims if you exceed an annual or lifetime cap on your coverage," but under proposed reforms "insurance companies will be prohibited from placing annual or lifetime caps on Coloradans' insurance polices, making sure that they aren't left out in the cold if they get sick."

Status report

Bill that empowers insurance companies advances

House Bill 10-1160, a measure that grants health insurance companies the power to offer discounts to people meeting specific health outcomes, based on "health risk factors" passed the House of Representatives on Wednesday. The Colorado Center on Law and Policy opposes the measure because it moves Colorado's insurance market place away from the basic tenant of insurance- which is about pooling risk. CCLP does not support allowing health insurance companies to set up wellness programs that ultimately will tie the cost of insurance to whether people meet standards established by the industry, particularly when those standards are very broadly defined- including for example, "exposure to UV radiation." The bill now moves on to the Senate Health and Human Services Committee.

Who's doing what
Rep. Betsy Markey a pivotal vote for health reform

The last vote for a health reform package in the House had only one Democratic no vote in the Colorado delegation, and that was Rep. Betsy Markey. Now, with a slimmer margin in the House, there will be increased pressure on Markey to change her vote and support reform.

Post opinion columnist Mike Littwin also noted Markey's unenviable position: "Everyone will be watching. And, in the end, Markey has to know the real choices here, and that one might even involve doing the right thing."

A columnist in The Hill newspaper made a similar point about all "on-the-fence" Democrats: "At the end of the day, Democrats will benefit from having the courage of their convictions. Voters do get that."

Advancing the debate
Another resource for understanding reform proposals

The Commonwealth Fund has a useful side-by-side tool comparing versions of the House, Senate and administration provisions of health-reform legislation.

What you can do

Contact members of Colorado's delegation in Congress to urge them to pass comprehensive health care reform. Rep. Betsy Markey, in particular, should know her constituents support reform.

Contact your state representatives to express opposition to House Bill 10-1160.

Don't know who your representatives are? Find out at Project Vote Smart.

Let us know what you think of the update. Contact CCLP's communications director, Perry Swanson. We're eager for ideas on making it more useful.

Finally, a clarification on an item in last week's Health Law and Policy Update. The Colorado Center on Law and Policy opposes House Bill 10-1353, which would change eligibility requirements for legal immigrants to receive Old Age Pension. A state fiscal analysis estimates that by applying a five-year waiting period for legal immigrant eligibility, 2,447 people would be dropped from the program resulting in a savings of $14 million from that provision alone. The total savings is estimated to be $24.5 million for next fiscal year (2010-11). The analysis does not say how many more people would be affected by other provisions of the bill. CCLP continues to work to mitigate the effects this bill will have on legal immigrant OAP beneficiaries.