By John Sawyer
With just two weeks left in the House session before the August recess (three for the Senate), passing health care reform legislation through each chamber seems like an enormous task from where we sit. The success or failure of this effort will likely come down to whether Congress can find a convergence of three factors: the divergent politics surrounding health care, complicated policy proposals, and very narrow timeframe for action.
From the policy side, there are thousands of complicated and interwoven issues “on the table” in this debate. We’ve identified 27 specific proposals that we’re following which would directly impact health centers and our patients. Each of these proposals interfaces with one another and with the current system, and has a constituency, like NACHC, to advocate for or against it.
NACHC has focused our priorities on three priority areas that effect every health center: the need for full participation and appropriate payment in any coverage expansion, the need for continued growth of health centers, and the need for capital and infrastructure tools to make that growth a reality. Beyond those priorities, we’ve taken an active role on issues like finding solutions to the primary care workforce crisis, and promoting an expansion of Medicaid. Beyond that, we’re monitoring dozens of other provisions that would impact health centers, from FTCA changes to drug rebates to changes in National Health Service Corps eligibility.
While the policy is often mind-numbingly complex, the politics can be even tougher, as Members balance a need to be responsive to local concerns, the pressure for party unity, and the mid-term elections that loom next November. Already Democratic leaders in the House have run into obstacles in the form of their own, more conservative, “Blue Dog” coalition, a group of members demanding that the overall costs of the bill be less, and that in rural areas of the country, Medicare pay more.
Lastly, the clock is ticking. President Obama has said he’d like to see both House and Senate pass legislation before August, but most recently has fallen back to his desire to sign a bill into law this year. And yet from up close, it’s clear things rarely move that fast. The Senate HELP Committee, just one of the five Committees working through legislation, took nearly a month to “mark up” its bill in Committee. The House Energy and Commerce Committee is reportedly several votes short of what may be needed to pass their bill and is projecting they’ll go until at least Wednesday. The Senate Finance Committee hasn’t released its bill yet. Already calls to “slow down!” are coming from both parties and outside commentators.
Stay tuned to NACHC Action Alerts, Updates, and to our Health Reform Hub on the NACHC website for the latest – but one thing is certain: we’ll need every voice to be heard if we are giong to navigate the legislative triple-threat: policy, politics, and timing.