Will the Dems' House Victory Make a Difference in Health-Care Reform?
Nov. 8, 2006 — -- We are committed at ABC News to making health-care reform a major part of our coverage leading up the 2008 presidential election.
We start that coverage this first day after the midterm congressional elections because we think the Democratic control of the House will lead to some significant changes in health-care policy even during the next two years.
Today, the ABC News Medical Unit asked leading health-care experts from around the country to comment on what this change in House leadership might mean.
Here is what those experts had to say.
Kenneth E. Thorpe
Robert W. Woodruff professor and chair, Rollins School of Public Health, Emory University, AtlantaHealth-care reform is back. Democrats will need to refocus the national debate over the high and rising cost of health insurance, the spotty quality of care, and how to extend affordable coverage to the uninsured. These issues have been ignored over the past six years. The election sets up the 2008 presidential race around the level and distribution of spending and tax cuts for corporations and very high income households.
Alan Sager
Professor of health policy and management, Boston University School of Public Health, BostonThe House will certainly try to empower Medicare to negotiate Rx prices with drug makers. This might include establishing a Medicare-run Part D drug benefit, somewhat similar to Medicare A and B. The hope would be that enough people would enroll to give Medicare the clout to win lower prices. This sort of action would take us closer to confronting the question of how to make meds affordable for all Americans -- and at a price payers can afford to pay.
We may well see House committees investigating the management of the new Medicare Part D. How much has been paid in federal subsidies? How much of that money has gone to finance administration, marketing and profits? How much has gone to bolster drug makers' own profits? How much has actually benefited Medicare patients?
John McDonough
Executive director, Health Care for All, BostonA key issue is that on Sept. 30, 2007, the 10-year authorization for the State Children's Health Insurance Program (SCHIP) expires. If the new Congress does not act, coverage for 5 million kids is in dire jeopardy on Oct. 1. Already, legislators are lining up to promote not just reauthorization, but a major expansion. You should expect to see coverage for kids as one of the major health-reform issues next year and a golden opportunity for the Democrats.
Changes Could Be Only Modest, Some Say
Uwe Reinhardt
James Madison professor of political economy and professor of economics and public affairs, Princeton University, Princeton, N.J.Private health insurers … will find a less-friendly audience in the House than they had in a Republican-dominated House.
[However] I doubt that it will effectively change much in health policy or our health system, because, whatever House Democrats might want to legislate, they are constrained by the federal government's large fiscal deficit and the president's veto pen. But I do believe a different mindset will rule, in the House at least.
Gail Wilensky
Former deputy assistant to President George H.W. Bush for policy development and senior fellow, Project HOPE, Millwood, Va.There will be some effect, but not wholesale changes in programs for a variety of obvious reasons.
First, there is not clear control by either party nor a clear-cut consensus on where the country wants to go. Second, the deficit will prevent major new spending programs from being enacted.
Some legislation is likely, however. SCHIP, enacted as part of the Balanced Budget Act, is up for renewal. It was always going to be renewed, but it may be expanded more than it would have been -- either in terms of including all or almost all children and/or including more of their parents. Second, the issues of "negotiating" prices for prescription drugs under Medicare will come up for sure.
Timothy Stoltzfus Jost
Robert L. Willett Family professor, Washington and Lee University School of Law, Lexington, Va.There might be some high-profile attempts to make minor changes, like allowing CMS (Centers for Medicare & Medicaid Services) to negotiate with drug companies in the Part D drug program. Unfortunately, however, I do not expect major initiatives as long as we have a Republican president.
Richard B. Saltman
Professor of health policy and management, Rollins School of Public Health, Emory University, AtlantaThe election will produce little change of any magnitude. Certainly not when assessed against either the scope of the current challenges or the character of current health policy in the rest of the developed world. Moreover, for all the sturm und drang, the Democrats have no meaningful alternative strategies -- they accept the same market-based premises that drive Republican strategy in the health sector.