Senate Awaits CBO Score on Public Plan Compromise - December 15, 2009

Senate Majority Leader Harry Reid (D-NV) has asked the Congressional Budget Office (CBO) to score a public plan compromise plan. The plan—hashed out by five moderate Democrats and five progressives—would apparently involve dropping the public plan currently included in the Senate bill and replacing it with a set of private, non-profit plans overseen by the federal government’s Office of Personnel Management, which currently manages federal employees’ health care. The compromise may also include an option for some people over age 55 to “buy into” Medicare coverage and an expansion of Medicaid to people in families with incomes as high as 150 percent of the federal poverty level. Details of the plan have not been released publicly, but several moderate Democrats have backed away from supporting certain aspects of the plan—particularly the Medicare buy-in and Medicaid expansion.

Pending the score from CBO, Senator Reid hopes to release a manager’s amendment that would include the public plan compromise and other changes to shore up support for cutting off debate and moving to final passage in the Senate. NAPH is urging Senator Reid to include in the manager’s amendment a reduction in the $43 billion in Medicaid and Medicare Disproportionate Share Hospital (DSH) payment cuts currently included in the Senate bill. Additionally, NAPH is urging the Senate to retain language currently in the bill that would extend 340B drug discounts to the inpatient setting of safety net hospitals. It is not yet known how congressional leaders will merge the Senate bill with the legislation passed by the House, but it is becoming increasingly unlikely that a final bill will be sent to the White House for President Obama’s signature before the end of the year.