Reform buzz picking up

The chatter about health reform is picking up a bit in advance of next weeks' summit. It has been wobbling, but it is also true that it is not dead. The President has pledged to release the text of a bill in advance of the summit. The two choices seem to be the resolution of House/Senate bills that passed late last year. Or the President releasing some proposed changes to the Senate bill, which has been the set point for reform discussions for awhile. There was apparently a deal between the House and Senate just before the election of Scott Brown put the brakes on the reform train. It is not clear how it may have shifted since then, but the tax on high cost insurance plans remains the most controversial issue among Democrats. It remains unclear exactly what will be released prior to the summit, but we should know soon.

Politico describing a sudden movement of Dem Senators calling for the inclusion of a public option via budget reconciliation. At first this seemed to be limited to Democrats running for relection and who were facing a potential left flank primary challenge (think the opposite of what John McCain is now doing), but it has gained a bit more steam. While I am not an expert on Senate rules of course, it is not clear to me that you could add a public option to the Senate bill after passed by the House, through reconciliation. However, it seems clear reconciliation could be used to legislate fixes to the Senate bill if passed by the House (like removing Nebraska Medicaid deal, altering tax on high cost insurance, and the like). Not clear if this increased reconciliation talk represents a momentum in that direction, or if it simply posturing heading into the summit next week.

And HHS released a report highlighting premium increases in individual purchase markets in different states....some of them quite large, again laying context for the summit. Anthem Blue Cross says it is essentially death spiral and not them gouging, and the rate increases are likley to take place eventually, in spite of the delay won this week after criticism by the White House. I wrote earlier that this type of increase foretells things to come sans reform.....The WSJ editorial board says the opposite, this is what will happen if 'Obamacare' becomes law. Now that we cleared that up, on to the summit....