The results of the HCR summit

THE RESULTS OF THE HCR SUMMIT…. President Obama is scheduled to outline his vision on moving forward with health care reform tomorrow, but today the president wrote to congressional leaders from both parties, explaining several areas of agreement with Republicans.

“No matter how we move forward, there are at least four policy priorities identified by Republican Members at the meeting that I am exploring. I said throughout this process that I’d continue to draw on the best ideas from both parties, and I’m open to these proposals in that spirit,” Obama’s letter explained.

The GOP ideas include:

1. Although the proposal I released last week included a comprehensive set of initiatives to combat fraud, waste, and abuse, Senator Coburn had an interesting suggestion that we engage medical professionals to conduct random undercover investigations of health care providers that receive reimbursements from Medicare, Medicaid, and other Federal programs.

2. My proposal also included a provision from the Senate health reform bill that authorizes funding to states for demonstrations of alternatives to resolving medical malpractice disputes, including health courts. Last Thursday, we discussed the provision in the bills cosponsored by Senators Coburn and Burr and Representatives Ryan and Nunes (S. 1099) that provides a similar program of grants to states for demonstration projects. Senator Enzi offered a similar proposal in a health insurance reform bill he sponsored in the last Congress. As we discussed, my Administration is already moving forward in funding demonstration projects through the Department of Health and Human Services, and Secretary Sebelius will be awarding $23 million for these grants in the near future. However, in order to advance our shared interest in incentivizing states to explore what works in this arena, I am open to including an appropriation of $50 million in my proposal for additional grants. Currently there is only an authorization, which does not guarantee that the grants will be funded.

3. At the meeting, Senator Grassley raised a concern, shared by many Democrats, that Medicaid reimbursements to doctors are inadequate in many states, and that if Medicaid is expanded to cover more people, we should consider increasing doctor reimbursement. I’m open to exploring ways to address this issue in a fiscally responsible manner.

4. Senator Barrasso raised a suggestion that we expand Health Savings Accounts (HSAs). I know many Republicans believe that HSAs, when used in conjunction with high-deductible health plans, are a good vehicle to encourage more cost-consciousness in consumers’ use of health care services. I believe that high-deductible health plans could be offered in the exchange under my proposal, and I’m open to including language to ensure that is clear. This could help to encourage more people to take advantage of HSAs.

The president also said his final package would do away with the special Medicare Advantage deal for Florida, and Ben Nelson’s Medicaid deal for Nebraska.

It’s not clear, at least not yet, how policymakers would act on this. President Obama is accepting some of the Republicans’ proposals, but GOP lawmakers will still not accept the reform package that incorporates ideas from both parties. Presumably, the White House would like to see the areas highlighted in the president’s letter incorporated into the reconciliation measure, but whether that would get approval from the parliamentarian remains unclear.

Nevertheless, it’s that much more difficult to suggest the Obama administration is driving a partisan process with no input from the GOP when the president keeps accepting Republican proposals (though the discredited minority won’t take “yes” for an answer).