Dems feel healthcare fatigue

Healthcare reform fatigue has set in among Democrats, casting doubt that Congress will move much health-related legislation the rest of this session.

Measures in jeopardy include bills that would require more information on healthcare prices, empower federal regulators to sign off on premium increases and strip insurers of their exemption from antitrust laws.

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Democrats in the House and Senate alike are eager to focus on vote-getting issues such as job creation as the midterm elections approach.

“I have said for the last year and a half that we should be doing more on job creation, and I hope that we do move on,” said Rep. Daniel Lipinski (D-Ill.), a “no” vote on health reform. “I don’t think we’re going to be doing much more of anything on healthcare reform for the rest of the year."

Blue Dog Earl Pomeroy (D-N.D.), who voted for the health overhaul, said the debate has shifted to the Obama administration, which must now implement the bill.

“The healthcare bill is done,” Pomeroy said. “The action on healthcare is now in the executive branch as they implement the bill. It’s critically important that they implement it in a sound way, and I believe the attention of Congress is best spent on overseeing the sound implementation of this bill.”

Sen. Ben Nelson (D-Neb.) reiterated on Thursday his concerns with the antitrust measure.

“Every state has an antitrust law,” he said. “ Why do you need a federal antitrust law?”

Democratic leaders say they’ve heard members’ concerns and don’t intend to push more controversial healthcare votes.

Energy and Commerce Committee Chairman Henry Waxman (D-Calif.) agreed with the premise that “members would be wary of major health legislation after we’ve spent so much time — we do have other priorities.”

“I could see that people would be exhausted if we were doing something major and controversial,” Waxman told The Hill. “So I think that we’ll probably limit ourselves right away in terms of what we’ll be pursuing.”

Likewise, House Speaker Nancy Pelosi (D-Calif.) has vowed to focus on “jobs, jobs, jobs, jobs” and has told her members that they shouldn’t have to take hard votes first when the Senate is already sitting on some 300 House-passed bills.

Healthcare lobbyists and consultants say they’re getting the same vibe privately from the Democratic offices they’re in touch with.

“There’s no ‘freeze’ per se,” a Democratic health policy consultant tells The Hill, “just doubts that there’s additional healthcare reform legislation passed the remainder of the year.”

That wouldn’t preclude Congress from tackling popular health measures that aren’t tied to reforming the nation’s health system, however.

These include food-safety legislation, enhanced Medicaid funding for states and a freeze on scheduled Medicare payment cuts for doctors.

On other issues, centrist Democrats in tough reelection fights are wary of giving the GOP extra openings to criticize the health reform law.
The GOP’s attack strategy was on full display last week.

Energy and Commerce Republicans used a hearing on two bills they support to reiterate their request that the panel call on the Centers for Medicare and Medicaid Services’ chief actuary to testify about future healthcare inflation.

And this week, Republican lawmakers quickly pounced on a new Congressional Budget Office estimate of the bill to continue their attacks.
The Energy and Commerce hearing focused on three bills that would require healthcare providers to unveil their prices so consumers can make informed decisions.

The main vehicle, sponsored by Rep. Steve Kagen (D-Wis.) and endorsed by 54 Democrats, is largely seen by lobbyists as having little chance of passing; it would require all healthcare providers — doctors, hospitals, drugmakers, pharmacies — to “publicly disclose, on a continuous basis, all prices.”

Kagen, who faces a tough race for reelection this November, has been touting the measure. But providers argue that forcing them to disclose their negotiated prices would drive costs up for consumers.

“I really don’t think anything like [the Kagen bill] is going to move because of the short time that we have to get anything else done this year,” Lipinski said. “I really hope there’s going to be a focus on jobs for the rest of the year.”

Two more modest bills sponsored by committee Republicans Joe Barton and Michael Burgess, both of Texas, may yet have a chance as they have bipartisan and industry support.

“I’m glad Congressman Kagen introduced [his bill], because it makes ours look much more responsible,” said Rep. Gene Green (D-Texas), who has co-sponsored both alternatives.

Waxman and his Health panel chairman, Rep. Frank Pallone Jr. (D-N.J.), have stopped short of committing to a markup.

During the health reform debate, transparency “was greeted by strong bipartisan support,” Waxman said. “Whether we’ll have bipartisan legislation that we’ll report remains to be seen.”

Another bill that appears stalled is the effort by Sen. Dianne Feinstein (D-Calif.) and Rep. Jan Schakowsky (D-Ill.) to allow the secretary of Health and Human Services to conduct reviews of potentially unreasonable rate increases in states where the insurance commissioner doesn’t have that authority. HHS would have the option of blocking such increases or providing rebates to consumers.

Senate Health Committee Chairman Tom Harkin (D-Iowa) held a hearing on the bill on April 20 and said at the time that he intended to hold a markup or “at least do something to get this bill moving.” No markup has yet been scheduled.
The proposal has drawn criticism in the Senate from Republicans and Ben Nelson, and may not get 60 votes. Pomeroy, like Nelson a former insurance commissioner, said he also has issues with the bill.

“Basically we have state insurance commissioners to undertake that sort of oversight,” Pomeroy said. “So I’m not convinced at this point in time of its necessity.”

Still, the White House supports the measure, which increases its chances.
“We look forward to continuing to work with Congress to pass this proposal,” an administration official said via e-mail.

Feinstein said Thursday she wouldn’t offer the bill as an amendment to the Wall Street reform bill, suggesting that it didn’t have the votes to pass.
Schakowsky said attaching the rate review bill to “must-pass” legislation would make sense.

Americans still expect Congress to act to keep rising premiums under control, she said, and attaching the measure to the Wall Street bill would ensure it doesn’t get buried in Congress’s busy calendar. Having the Senate vote on it first also makes sense, she said, because “I don’t have any concerns” that it will pass the House.

Lobbyists also say they’re skeptical that legislation stripping insurance companies of their antitrust exemption will clear the Senate.

Senate Judiciary Chairman Patrick Leahy (D-Vt.) sought last week to breathe new life into the measure when he filed it as an amendment — co-sponsored by 21 senators — to the Wall Street reform bill. Similar legislation passed the House by a vote of 406-19 on Feb. 24.

But the measure was stripped from the Senate health reform bill because it didn’t have the votes to pass, and there’s no evidence the math has changed since then.