When President Barack Obama signed the Affordable Care Act into law in March 2010, the White House understood that it would need changes. Setting forth a framework which would enable 32 million thus far ineligible Americans to buy into health insurance, it carried the lofty goal of insuring 94 percent of the country’s population.
The backlash against the Democratic plan of universal health care was swift: MSNBC outlined that virtually immediately there were lawsuits filed — by 14 attorneys general — who challenged the individual mandate to buy coverage. From that point on, band-aids applied to (and discussed for) the health care bill have been hit or miss.
Of current note is the up and coming April 5, 2011, U.S. Senate vote to do away with the tax reporting rule. The Insurance & Financial Advisor outlines that this vote mirrors the House vote that came out with 314 to 112 in favor of the measure. The rule stipulated that businesses would have to file 1099 documentation with the IRS whenever they spent in excess of $600 with any one entity. It is interesting to note that even President Obama called for a repeal of this particular measure. While the insurance industry has lobbied hard to get the repeal to a vote, it is unclear who placed it into the health reform bill in the first place — and why.
Of course, this is not the first band-aid that lawmakers are trying to apply to the legislation. At the end of March 2011, GOP members of the House health subcommittee took a vote that would disqualify federal officials from funding health care reform processes unilaterally. The Hill outlines that the stated goal of the vote was to present any funding requirements to Congress; Democrats assert that Republicans are trying a backdoor approach to de-fund the bill. The odds of the measure making it past the Senate are slim — in spite of the protestations of Commerce Chairman Fred Upton, who claims that “we must set limits, we must eliminate slush funds, and we must prioritize our spending decisions.”
Another band-aid solution is alternatively called the “Protect Life Act” or a conscience rights debate. At issue is H.R. 358, which was introduced in January 2011 by Rep. Joseph Pitts. Supported by the National Right to Life Committee, the bill seeks to ensure that funding for health care reform would not include abortion services. It is unclear if the GOP is playing to its more conservative base or attempting to include the 2004 Hyde-Weldon Amendment into the health care reform bill. Considering that the proposal has only minor bipartisan support, the odds are good that any vote will fall along party lines.
If all this points at a GOP attempt to derail health care reform via the purse strings, the push for a Congressional Review Act challenge makes it clear that this is indeed the case. The Hill outlines how Republican Conference Secretary John Carter in particular is attempting to stymie the rule that insurance companies must turn 80 percent of premium dollars into health care service expenditures. Born in part of lobbying efforts by the insurance industry, there is little doubt that any discussion is doomed to fizzle (again) along party line votes.
The Wyden-Brown proposal, aka S. 248, is an interesting waiver initiative that actually enjoys bi-partisan support. The premise is deceptively simple: States may opt out of the universal health care law if they can show that they have already met the reform targets — stipulated by the bill — via state-sponsored programs.
President Obama supports the initiative. Life and Health Insurance News quotes him as saying “If your state can create a plan that covers as many people as affordably and comprehensively as the Affordable Care Act does — without increasing the deficit — you can implement that plan. And we’ll work with you to do it.” Needless to say, it would do away with the states-right arguments.
Not yet progressed to the point of actually making it into the health care reform discussion in Congress — but just as poignant — is the malpractice reform suggestion from the American Enterprise Institute. Piggybacking on the stipulations from then-minority leader John Boehner in 2009, the organization argues that malpractice reform has largely gone by the wayside in the passed bill. It will undoubtedly not take long for Republicans to take up this battle cry as well.
At this juncture, the jury is still out on whether post-passage health care reform tweaks are affecting the hastily passed legislation in a positive or negative manner. It is fair to say that currently the facts support a positive development for the overall bill, while Republican efforts are by and large seeking to derail health care reform in its entirety. Bi-partisan efforts have the best chance at success and progress.