Health policy Monday

LAST HURRAH ON THE HILL

The House wraps up this week with plenty of unfinished healthcare business pushed off to after the August recess — or even next year.

One of the top unresolved health priorities is the six-month extension of enhanced federal Medicaid payments for states (the famous FMAP, or Federal Medical Assistance Percentages), which cash-strapped governors say is vital if they’re to avoid laying off tens of thousands of government workers such teachers.

Senate Finance Chair Max Baucus (D-Mont.) is said to be working on a new tax extenders bill that would include a six-month FMAP extension through June 2011. But any deal would have to garner support from centrist Republicans to get to 60 votes, and the usual suspects — Maine Republicans Susan Collins and Olympia Snowe — told The Hill late last week that no such agreement has yet been worked out.

SHOWDOWN OVER REGS

Meanwhile, state insurance commissioners are pushing back hard against allegations that they're conniving with the industry they regulate. The fiscally conservative National Association of Insurance Commissioners — they're charged with ensuring the long-term solvency of the insurance plans they regulate — is tasked with developing regulations, which the Department of Health and Human Services will certify.

They're having to defend their work against liberal lawmakers and their allies, particularly on the issue of medical loss ratios — how much health plans have to spend on healthcare. Particularly galling: Last week's report by Health Care for America Now suggesting that "(i)nsurers have an army of operatives working behind the scenes at state insurance departments and at the NAIC."

"We're going to do our job as regulators," Oklahoma Insurance Commissioner Kim Holland told reporters on Friday. "The politics can swirl around us, and whatever decision is made [by the Obama administration], if it's a political decision — well, shame on them. Because the fact of the matter is, we have done our job, we will continue to do our job, and we're going to do it based on our understanding of the law and what makes good solvency sense for the preservation of an industry that's protecting our consumers."

The NAIC has also been sounding alarm bells over the law's unintended consequences. Their latest warning: New rules requiring health plans to cover children with pre-existing conditions are leading some insurers to stop issuing new policies. That can mean higher premiums for some parents who had been buying separate policies for themselves and their kids rather than expensive dependent coverage. So far HHS has been blaming the plans, but the NAIC says it will press its case for the feds to address the problem.

BERWICK AND BRITAIN

With no confirmation hearing in sight, Republicans are ramping up their media campaign against the Obama administration's pick to head the Medicare agency. The GOP hopes to make Donald Berwick eat his words of praise for Great Britain's National Health Service, and they got more ammo over the weekend from England's Telegraph newspaper.

In a story titled "Axe falls of NHS services," the London daily unveils "secret plans for sweeping cuts to services, with restrictions on the most basic treatments for the sick and injured." The "astonishingly brutal" cuts include:

• Restrictions on some of the most basic and common operations, including hip and knee replacements, cataract surgery and orthodontic procedures.
• Plans to cut hundreds of thousands of pounds from budgets for the terminally ill, with dying cancer patients to be told to manage their own symptoms if their condition worsens at evenings or weekends.
• The closure of nursing homes for the elderly.
• A reduction in acute hospital beds, including those for the mentally ill, with targets to discourage (general practitioners) from sending patients to hospitals and reduce the number of people using accident and emergency departments.

The Chamber of Commerce unveils a new Web site where businesses will be able to register the effect of (read: grievances with) financial and regulatory changes in the healthcare reform law.

The event, titled “Behind the Curtain: The Health Care Law’s Impact on Small Business, is expected to feature Sen. Mike Johanns (R-Neb.) and several business executives. Doug Holtz-Eakin, former adviser to Sen. John McCain’s presidential run and now president of the American Action Forum, is also expected to attend.