Week two of the Senate Finance Committee's consideration of health care reform has proven to be no less contentious than the legislation's rocky road up to this point.  The Committee finished its consideration of amendments yesterday and Chairman Baucus signaled his intent to move to a committee vote once the Congressional Budget Office provides a cost analysis next week.  Senate Majority Leader Harry Reid announced that he will cancel a week-long Columbus Day break scheduled for the week of October 12 in an effort to bring a health reform package to the Senate floor that week.  If Congress fails to act by an October 15 deadline, health reform will have to be considered under a procedural process called budget reconciliation.  This procedure severely limits the tools at lawmakers' disposal and will result in a package that is far narrower in scope than the bills that are currently being debated.
 
At issue in the Senate Finance Committee markup has been substantial disagreement over the inclusion of an excise tax on health insurers to help offset the cost of insuring more Americans.  Authors of the provision maintain that it will have little effect on working families because the tax is based on only the most expensive health insurance plans.  Opponents argue that health insurers will pass the cost of the next tax onto consumers, negatively impacting both middle and low income Americans.  Significant concerns remain over how this tax would affect dental insurance.  Faced with rising costs of health insurance that are likely to occur as a result of the tax, employers and patients may choose not to purchase dental insurance. 
 
Another major sticking point revolves around the inclusion of a public health insurance option that would compete with private insurance plans under the health benefits exchange.  The Senate Finance Committee failed this week to pass amendments to add a public option to its plan.  However, the Senate Health, Education, Labor and Pensions (HELP) Committee and the three committees of jurisdiction in the House of Representatives all include a public option.
 
When the Senate Finance Committee completes its version of the bill, it will be merged with a bill passed out of the Senate HELP Committee before being sent to the Senate floor for a vote.  As this process continues, CDHP will advocate for the retention or addition of key oral health provisions.  Specifically, the following provisions are top priorities:
 

• Pediatric Dental Benefit - At the least, benefits under the exchange must include the pediatric dental benefit that is currently included in both the Finance and HELP Committee bills.  CDHP is also making to case for adding adult dental coverage.  
• Oral Health Expertise - The Senate should follow the lead of the House of Representatives in recognizing that an oral health expert must sit on any health benefits advisory committee.  
• Workforce Improvements - Title VII provisions in the Senate HELP Committee bill to expand and improve the oral health workforce must be maintained.  
• Dental Disease Prevention and Public Health - Significant oral health related provisions under Title III of the Senate HELP Bill must be preserved.

CDHP encourages oral health advocates to contact their Senators to ensure that these provisions are preserved in the legislation that is sent to the Senate floor for a vote.  To find out who your elected officials are and how to reach them, call the U.S. Capitol switchboard: (202) 224-3121 or go to the web sites of the U.S. House of Representatives (www.house.gov) and U.S. Senate (www.senate.gov).