Leaders Will Skip Formal Conference Process for Health Reform - January 5, 2010

After a brief break since Senate passage of health reform legislation on Dec. 24, 2009, congressional leaders in both chambers are beginning discussions on blending the House and Senate-passed bills. It is expected that congressional leaders will not establish a formal conference committee, but will instead seek to find a compromise by an amendment process. Specifically, the House is expected to amend the Senate-passed bill and send it back to the Senate for that chamber’s approval. House and Senate leaders are expected to negotiate the changes ahead of time, ideally meaning that the bill, as amended by the House, could be passed quickly by the Senate and sent to President Obama for his signature. Leaders are hoping to finalize the legislation by late this month or early February.

Key areas for negotiation include treatment of health insurance exchanges (whether to be based at the federal or state level), federal funding of abortion, timing and details around the Medicaid expansion, and the cost and fiscal offsets for the bill. NAPH is advocating that the final bill include the House’s more reasonable Medicaid and Medicare Disproportionate Share Hospital payment reductions of $20 billion over ten years, rather than the much higher $43 billion reduction proposed by the Senate. NAPH is also recommending that the final bill include an extension of 340B drug discounts to the inpatient setting, as included in the Senate legislation.