Pesky Technical Issues

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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