By Alexandra Sange
After a record three weeks spent marking up the America’s Healthy Futures Act of 2009, the Senate Finance Committee voted 14-9 to approve the bill as modified and report it out of committee. Although the committee would probably have approved the health reform bill without Republican support, Senator Olympia Snowe (ME)’s crossover vote gave the bill a bipartisan backing. This reinforces the provisions in this legislation over more partisan bills from the House and Senate Health, Education, Labor and Pensions (HELP) Committees.
The 10-year, $829 billion Healthy Futures Act would require all Americans to purchase insurance and aims to hold down spiraling medical costs over the long term. The reported Senate Finance Committee bill also includes, through amendments by Senators Snowe, Bingaman, Lincoln and Menendez, two critically important provisions for Community Health Centers: an update to the Medicare FQHC payment methodology to align reimbursement under the successful health centers-specific Medicaid Prospective Payment System (PPS); and a requirement that private insurance plans available for purchase in the federal insurance exchange reimburse health centers under the FQHC Medicaid PPS.
During their final day of closing statements, members of the committee had the opportunity to reinforce or rebuke the bill and highlighted provisions, concerns and questions. Senator Robert Menendez (D-NJ) used his time to praise the bill, specifically mentioning the importance of Community Health Center payment protections included in the package as ones that will help improve access and quality and bring down costs. We are very grateful for Senator Menendez’s continued championing of health centers – his support will help us protect and preserve the important gains we have made in reform so far.
Today’s vote moves us right into the second half of health reform. All five committees of jurisdiction in the House and Senate have reported bills and now the leadership in both chambers has some heavy legislative lifting to do. The bill that goes to the Senate floor won’t be the Finance bill, nor will it be the HELP bill, exactly, but a melding of the two. The blend will be overseen by Senator Harry Reid’s office and key players will include a select group: Senators Dodd (representing liberals) and Baucus (representing moderates), select White House staff and Senator Harkin, Chair of the HELP Committee. NACHC’s recommendations for reconciling these bills, where they have differences, are here. The blended bill that comes out of this process will move to the Senate floor where a vote could tally up less partisan than the Finance committee and may be more of a numbers game – Senators Snowe and Lincoln both explicitly stated that their support today would not necessarily mean their support for a final Senate bill, depending on the final product. Democrats will need to preserve at least 60 votes in support of the final bill to make sure they can stave off any Republican filibuster. In tandem with the Senate, the House continues to go through their own merging process and NACHC’s recommendations for resolving the differences in the House blend are here.
While all of the bills contain very promising investments and protections for community health centers it is important, now more than ever, that our advocacy grassroots stay strong, deep and active. Our voices have echoed loud and proud and our legislators have responded by growing and strengthening our program through the reform bills. But our provisions could be removed from any of the bills at any time as they move forward to become two, and then one. Our best strategy now is to make sure that every legislator across the country knows the promises and perils of health reform for their community health centers and patients back home.