In a letter to the Democratic and Republican leaders of Congress delivered to Capitol Hill Tuesday afternoon, President Obama signaled that his mind is open to several provisions raised by GOP lawmakers during last week's bipartisan health care reform summit, including medical malpractice reform, combating fraud, and killing off the special deal for Florida seniors secured by Sen. Bill Nelson, D-Florida.
“No matter how we move forward,” the president wrote, “there are at least four policy priorities identified by Republican Members at the meeting that I am exploring.”
Among them, the president said the health care reform bill he posted at WhiteHouse.gov last week already included ways to combat “fraud, waste, and abuse” but he was intrigued by an idea raised by Sen. Tom Coburn, R-Okla., a practicing ob-gyn, that “we engaged medical professionals to conduct random undercover investigations of health care providers that receive reimbursements from Medicare, Medicaid, and other Federal programs” to ferret out other abuses of the system.
The president suggested that while he had already directed Health and Human Services Secretary Kathleen Sebelius to award $23 million in grants for state-level demonstration projects to resolve medical malpractice disputes, he would be “open to including an appropriation of $50 million in my proposal for additional grants.” The current directive is an “authorization,” not an “appropriation,” so there is no guarantee the grants will be funded. This would change that and more than double the amount in grants.
Sen. Chuck Grassley, R-Iowa, last week raised the concern that Medicaid reimbursements are too low in many states, and the health care reform bill’s proposal to expand Medicaid to millions more Americans would therefore be problematic since it’s unclear there are enough doctors to treat these new Medicaid patients. The president said he would be open to increasing doctor reimbursements in a “fiscally responsible manner.”
The fourth priority would be to ensure language allowing high-deductible health plans in the proposed health insurance exchanges, which combined with Health Savings Accounts, many Republicans believe “are a good vehicle to encourage more cost-consciousness in consumers’ use of health care services,” the president said.
The president also noted that the Senate bill included provisions “that shouldn’t have been” added. One of these provisions was called the “Cornhusker kickback” – the federal government paying for Nebraska’s Medicaid expansion, a provision secured by Sen. Ben Nelson, D-Neb. – which the president announced last week he would remove from the Senate bill.
The president also agreed to eliminate what critics call “Gator-ade,” the provision to shield Florida seniors from cuts to the Medicare Advantage program, secured by Sen. Bill Nelson, D-Florida. The president said “my proposal does not include the Medicare Advantage provision, mentioned by Senator McCain at the meeting, which provided transitional extra benefits for Florida and other states.”
In his letter, President Obama criticizes the Republican advice of a more “incremental” approach to health care reform, saying he believes “piecemeal reform is not the best way to effectively reduce premiums, end the exclusion of people with pre-existing conditions or offer Americans the security of knowing that they will never lose coverage, even if they lose or change jobs.”