With Bill Release, House Readies for Floor Debate - November 3, 2009

On Thursday Oct. 29, House leaders released updated health care reform legislation that encompasses provisions passed by the chambers’ three committees of jurisdiction. The nearly $900 billion legislation creates a government-sponsored “public plan” that will pay providers at negotiated rates. As expected, it includes $20 billion in cuts to Disproportionate Share Hospital (DSH) payments, equally divided between Medicaid and Medicare DSH. It also includes creation of a grant-making program, championed by NAPH, to help safety net providers create community-based collaborative care networks to serve low-income populations. NAPH sent House Speaker Nancy Pelosi (D-CA) a letter supporting the House bill, but noting the Association’s eagerness to work with House negotiators to improve the bill in several areas, including extending 340B drug discounts to the inpatient setting—a provision dropped from the updated bill. House leaders expect to release a “manager’s amendment,” making technical changes to the legislation in the coming days and then bring the bill to the floor of the House by the end of the week.

Senate progress has slowed as leaders wait for the Congressional Budget Office to score a combined bill. NAPH continues to work to gather support for a “Dear Colleague Letter” in the Senate that asks Senate leaders to reduce the size of the DSH cuts proposed by the Senate Finance Committee—currently scored at $22.2 billion in cuts to Medicaid DSH and $22.5 billion in cuts to Medicare DSH.