AAA Health Care Reform Update

December 11, 2009

The American Ambulance Association is distributing to its members each week an update on health care reform legislation being considered by Congress.   The update focuses on those aspects of health care reform legislation that are most important to ambulance service providers and professionals as businesses, employers, individuals and Medicare and health care providers.   The focus of this week's update is the recent tentative agreement on an alternative to the public option in the Senate health care reform bill.

This Update was developed by Patton Boggs and AAA staff.

Patient Protection and Affordable Care Act

On Tuesday, December 8, 2009, Senate Democratic leaders announced a tentative agreement to replace the Senate health care reform bill's public insurance option with a compromise focusing on piecemeal government expansion.   Although details of the plan are unclear at this time, Democratic leaders and President Obama hailed the compromise as a potential path forward in enacting health care reform legislation.

Under the proposed plan, a public insurance option would be dropped from the Senate legislation in favor of allowing those 55 to 64 years old to buy in to Medicare.   In addition, the proposal would create a new system of private, national health insurance plans administered by the Office of Personnel Management (OPM), which currently manages health benefits for federal employees.   If the government cannot find at least two entities willing to offer national plans independently, insurers who offer plans to federal employees under the Federal Employee Health Benefits Plan would be required to make the same plans available nationwide to the broader public.

The Democratic group negotiating the compromise sent several compromise options to the Congressional Budget Office (CBO) to be scored.   One of the options includes a proposal that would trigger a public health insurance option if the OPM idea is unsuccessful.

CBO will likely take up to a week to score the tentative deal.   Although Senate leadership hopes to pass legislation by Christmas, the timing of receiving the CBO score could push a final vote on the legislation past the Christmas deadline.   To speed passage of the bill, there has been increasing talk that Democratic leaders might bypass a House-Senate conference committee and attempt to pass the Senate' bill through the House without further changes.