Kennedy Working Now for January Health Care Push

The ailing senator and his staff are moving quickly on a proposal likely to build on the existing concept of employer-based coverage.

By Martha Lynn Craver, Associate Editor, The Kiplinger Letter

September 25, 2008

Congress will lead the way on health care reform next year, not waiting for the next president, whoever he turns out to be. And key backers of a move toward universal coverage don't plan to waste any time either. Among the lessons learned from the last major attempt at health care reform in 1993 is that it needs to be tackled in the first year of the new Congress during the "honeymoon period" -- just after the election and before everyone starts focusing on the next campaign.

Sen. Ted Kennedy, the Massachusetts Democrat who has long championed health issues, plans to be ready in January, and he's determined not to let his own health issues keep him from being at the forefront of what will be difficult negotiations. Kennedy, who is chairman of the Senate Health, Education, Labor and Pensions Committee, is a man in a hurry. He wants to hit the ground running, introducing a plan soon after the new Congress convenes in January.

His goal: affordable and accessible health care for all. Kennedy is well liked on Capitol Hill, and there's a big emotional push to get this done "for Ted." Kennedy and his staff have already held meetings with his Republican counterpart on the Committee, Sen. Mike Enzi (R-WY), in hopes of crafting a bipartisan bill that will win broad support. Kennedy has a reputation for reaching across the aisle, and he and Enzi have partnered a number of times on other health care issues. But if the talks fall through, expect Kennedy to introduce a bill on his own and try to win bipartisan backing later.

Kennedy is also working with other committees in finance and budget jurisdictions committees, to ensure their cooperation so that the bill isn't bogged down by jurisdictional issues -- another lesson learned from the '93 battle. Major stakeholders are being called in as well -- business, labor, medical, insurance and consumer groups -- to sound them out on potential approaches. Also, Kennedy has added John McDonough to his staff -- he was in charge of implementing Massachusetts' groundbreaking universal health care law.

What will the proposal look like? Talks so far are just preliminary, with the more serious work to be done after the November election. But the betting is that it will seek to build on the employer-based system that now provides coverage for 177 million people. Universal coverage will be the goal, although it may have to be phased in, thanks to federal deficits likely to rise due to the financial crisis. The idea will be to make health care coverage available to all who want it, but not mandatory.

Getting coverage for the 46 million uninsured will focus on strengthening public programs such as Medicaid as well as providing more affordable options to people through the private insurance market.

Cost containment will be a big part of reform. Examples where there's great potential for agreement include:

• Health care IT to cut down on medical errors and duplicative tests.

• Comparable health effectiveness research to determine which treatments deliver the most bang for the buck.

• Generic versions of biotech drugs as an alternative for costly brand-name biotech pharmaceuticals.

• Pay-for-performance initiatives, to reward the best and most efficient caregivers.

• Wellness programs and disease management to better control chronic diseases, such as diabetes and asthma.

How to finance the plan will be the biggest challenge. The tax treatment of health insurance will be on the table, but it's unclear if it will be in Kennedy's bill. Big revisions to the tax code are unlikely, and there may be a cap on the health insurance tax exemption for high earners.

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