Washington was
rife with health care reform activity
again this week. On Wednesday,
Senate Finance Committee Chairman Max Baucus released his proposal for health
care reform, entitled "Chairman's Mark, America's
Healthy Future Act." Because the Senate Finance Committee is not required
to consider legislative language, Chairman Baucus' proposal is a conceptual
framework that offers a detailed narrative of priorities that will later
form the basis for the legislation that will go to the Senate floor for consideration. The Senate Finance Committee will meet on
Tuesday of next week to consider amendments to the proposal and is expected to
be finished by Friday. Once the Committee finishes its work, its proposal
will be merged with the Senate Health, Education, Labor and Pensions
(HELP) Committee bill into one package that the Senate is expected to vote
on in the last week of September.
A summary of provisions impacting oral health in the Senate Finance Committee proposal can be found on CDHP's web site.
Notably, the proposal includes a guaranteed dental benefit
for all children. Both the Senate HELP
Committee and the House Tri-Committee (Energy and Commerce, Education and
Labor, Ways and Means) bills also include a dental benefit for children. Having all three pieces of legislation
include dental coverage for children bodes well for efforts to include a
pediatric dental benefit in the final health reform package.
Less encouraging is the lack of an adult dental benefit in
any of the bills and a provision in the Senate Finance Committee proposal that
imposes a new excise tax on insurance companies based on the cost of
employer-based health benefits. This new
tax could have an incredibly negative impact on working families because
insurers are likely to pass the added cost of the new tax onto the
consumer. The formula to calculate the
new tax includes dental coverage in the list of taxable benefits, making dental
coverage all the more vulnerable to cuts by employers and workers who are
feeling the squeeze of rising health care costs. CDHP is seeking further clarity on this
provision and will work with allies to address any risk to employer-based
dental coverage.
The process is far from over, and many changes can be
expected from here. Chairman Baucus'
proposal is a first draft that will likely be heavily revised even before the
Finance Committee convenes to offer amendments.
If the Senate Leadership is unable to shore up the 60 votes necessary to
reject a filibuster and pass legislation by October 15th, they will circumvent
the traditional legislative process and use a process called budget
reconciliation to enact health care reform.
Under budget reconciliation, there are significant limitations on the
policies that can be included and thus, any legislation passed under this
process will be far narrower in scope.
Meanwhile, in the House of Representatives, the Energy and
Commerce Committee has not yet convened a meeting to consider the more than 50
amendments that it did not have time to take up before the August recess,
including a CDHP-supported amendment to add oral health expertise to any health
benefits advisory committee. CDHP will
be tracking this matter closely.
