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Dear Advocates,

Following a Republican victory in Massachusetts’ special Senate
election last week, the future path of healthcare reform is
considerably less clear. Republican state Senator Scott Brown’s
election to the Massachusetts U.S. Senate seat held by the late
Senator Edward Kennedy means that Democrats no longer have
a filibuster-proof, 60-vote majority needed to advance legislation
in the Senate – causing the Democratic leadership to weigh
various options for proceeding.

At this time, Democrats appear to be considering several possible paths.
One is to push forward on a comprehensive bill similar to that passed by
the Senate, with some additional changes to make it acceptable to
House Democrats (e.g., closing the Medicare drug “donut hole”,
increasing subsidies for low income families, giving unions a 5 year delay
in the high value insurance plan tax). Another is scaling back pending
reform bills and including less controversial provisions that could possibly
garner bipartisan support. These include tax credits to help small
businesses provide coverage to their workers and new rules
prohibiting insurers from denying coverage based on pre-existing
conditions. However, a scaled-back bill would likely remove the
personal responsibility requirement from proposed insurance
reforms, which would enable people to wait until they are too sick
to purchase coverage. This would result in higher premiums for
everyone and run counter to reform goals. Democratic leadership has
emphasized that no decisions have been made.

On January 27, the President will give his State of the Union
address, where he is expected to give his views on how the Congress
should go forward on healthcare reform.
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