American Health Line's Editor's Roundup

Although traditionally the weaker of the two chambers, the House this week stole the spotlight. While Senate Majority Leader Harry Reid (D-Nev.) and other Democratic leaders worked quietly behind the scenes to merge their chamber's two versions of health reform legislation, House Speaker Nancy Pelosi (D-Calif.) was out in the limelight, introducing the House bill (HR 3962) and lobbying lawmakers to ensure she has the 218 votes needed to pass the overhaul.

The House's legislation experienced a setback even before it was released. On Monday, anonymous Democratic officials revealed that the gross cost of the House reform would be $1.2 trillion or more over 10 years, because of additional health care expenditures not included in the draft legislation initially submitted to the Congressional Budget Office. Preliminary CBO estimates found that the bill would cost $1.055 trillion between 2010 and 2019 and reduce the federal deficit by $104 billion.

When asked about the higher estimate, Brendan Daly, spokesperson for House Speaker Nancy Pelosi (D-Calif.), reiterated that the health reform bill "will not add one dime to the deficit," adding that "CBO said last week that it will reduce the deficit both in the first 10 years and in the second 10 years"

Undeterred, House Democrats on Tuesday released a manager's amendment to the chamber's health care reform bill, kicking off a 72-hour review period before House leaders can call the legislation to a floor vote. The amendment would:

• Require health insurers that sell policies through new health insurance exchanges to submit information on annual premium increases, which -- if judged to be excessive -- could mean expulsion from the exchange;
  
• Adjust a provision in the bill that would terminate some of the antitrust exemptions for health and medical malpractice insurers to allow insurers to continue some practices that could be considered in violation of antitrust laws, such as sharing history loss data;
  
• Grant an exemption to physician-owned hospitals that treat more Medicaid beneficiaries than their local competitors.
  
• Require HHS to establish a system to measure the quality of care provided to Alzheimer's patients;
  
• Authorize $30 million in grants to community organizations in 2011 that screen for and treat mental illness and substance use;
  
• Improve diabetes screening programs;
  
• Allow HHS to withhold payments for 90 days to durable medical equipment suppliers in areas considered breeding grounds for fraud;
  
• Establish new offices of minority health -- similar to one at HHS -- at several other government health agencies;
  
• Require the HHS secretary to identify grant programs in the bill that might mirror existing programs; and
  
• Improve the collection of statistics and data from birth and death records.
  

House Rules Committee Chair Louise Slaughter (D-N.Y.) on Wednesday said that she expects the chamber to hold a floor vote on the legislation during a rare Saturday evening session. The vote is expected at around 6 p.m. ET.

With that vote set, these past few days and upcoming hours have been and will be spent lobbying lawmakers. Pelosi on Thursday said that Democratic leaders will have the 218 votes needed for passage by Saturday, subtly acknowledging that House leaders might not have the votes as of yet. House leaders can afford to lose no more than 40 Democratic votes and that they are working to limit defections to the approximately 25 Democrats considered "hard no" votes.

Based on news reports, there are two main issues preventing Democratic leaders from being confident about passage: abortion and undocumented immigrants. According to some observers, abortion is the "greatest threat" facing House leaders, who continue to work on language that would be acceptable to antiabortion-rights members of their caucus. Meanwhile, House leaders are still trying to develop a workable compromise on whether to allow undocumented immigrants access to coverage under reform legislation. With both issues still up in the air, news reports have House leaders "working furiously" to ensure passage of the reform bill.

Tell us what you think: Will the House pass its reform legislation? If not, what does that mean for the overall prospects for an overhaul?

by Anthony Wilson, Editor