By John Reichard, CQ HealthBeat Editor
August 5, 2009 -- What's the liberal strategy going into the August recess for getting a health overhaul across the congressional finish line?
Judging from a press briefing Wednesday by a trio of Senate liberals, the answer seems to be: emphasize the continued suffering of many Americans from failing to ensure access to affordable care; put newly emboldened Republicans back on the defensive with the message that their nay-saying perpetuates that suffering; and slam, slam, slam insurers.
Fired up by comments Tuesday by President Obama urging his party to go all out during the recess in pursuit of an overhaul, West Virginia Democrat John D. Rockefeller IV expressed confidence that legislation would pass this year but chafed at efforts by Senate Finance Committee Chairman Max Baucus, D-Mont., to enlist Republican support, saying Baucus is weakening the proposal in the process.
Rockefeller in particular expressed alarm that the Finance Committee proposal would bring an end to the Children's Health Insurance Program (CHIP), a result he called "immoral" because he said that health insurance benefits that would be available to CHIP enrollees through new insurance exchanges would be watered down and wouldn't meet the needs of those with unusual health care conditions.
Rockefeller, who was joined at the briefing by Sens. Sherrod Brown of Ohio and Sheldon Whitehouse of Rhode Island, predicted that the three Republicans Baucus is hoping to attract to his bill—Charles E. Grassley of Iowa, Olympia J. Snowe of Maine, and Michael B. Enzi of Wyoming—won't vote for it in the end.
While Obama urged continued attempts to produce a bipartisan bill in his remarks Tuesday, the three liberals didn't play up that possibility in their remarks and instead focused on what they said is the failure of Republicans to respond to the long unmet health care needs of millions of uninsured Americans.
Rockefeller said that "none of what I read" takes on the 37 Senate Republicans for inaction on an effective overhaul. "I think that's a pretty big story. . .it makes me very angry," he said.
"People that we represent are just struggling so much," Rockefeller said. Referring to "heartbreaking" stories he hears from his constituents and from listening to C-SPAN Radio about people who have been "miserably treated," Rockefeller said "one of the groups by which they've been miserably treated is the insurance industry." He said, for example, that Cigna and other insurers engage in "purging" small businesses whose employees file many claims and cost the insurer a lot of money.
In a letter to Cigna that Rockefeller released Wednesday, the West Virginia senator recounted the testimony of a former Cigna executive at a hearing by the Senate Commerce Committee, which Rockefeller chairs. The letter quotes the former executive, Wendell Potter, as saying: "All it takes is one illness or accident among employees at a small business to prompt an insurance company to hike the next year's premiums so high that the employer has to cut benefits, shop for another carrier, or stop offering coverage altogether—leaving workers uninsured."
Rockefeller's letter asked for details on "purging," including how much money Cigna has saved as a result.
Rockefeller said at the press briefing that insurers are able to "get away" with such practices because the industry operates with little oversight.
"We've discovered how they play the game," he said. "It is a scandal—which the Democrats are going to stop."
Meanwhile, Rockefeller said, the Republican response on an overhaul "is just 'no.' They're against it. Anything we do, they're just against it." Rockefeller said that in contrast, he painstakingly sat through two years of meetings to negotiate an expansion of the CHIP program. Now that program is on the ropes in overhaul legislation, with enrollees supposed to go instead to new exchanges to get coverage.
"It's very hard to sit hour by hour by hour. I did during the children's health insurance bill. It took two years, sitting for hours, all week long, maybe just the four of us, senior on that [Finance] committee, trying to negotiate a really relatively simple bill, which has now been cast off into the exchange, so it's lost all its credibility. Can we get it back? I don't know. I will try my best."
Whitehouse pointed to a New York Times story from some 50 years ago on the burden on individuals of rising medical costs and said it is "astonishing" that "after all this pain and anguish" Republicans now "are ramping up the attack machine to defend the status quo."
Rockefeller said, though, that continued attempts at bipartisanship "are not a waste of time at all" but that after a certain time Democrats will have to look at other options, a reference to use of the reconciliation budget tactic that allows legislation to be passed by the Senate with a simple majority in favor.
Republicans have either supported or offered their own overhaul proposals. For example, Sens. Tom Coburn of Oklahoma and Richard M. Burr of North Carolina have announced a proposal to expand coverage through tax breaks. Some Republicans have signed onto the Healthy Americans Act introduced by Democratic Sens. Ron Wyden of Oregon and Robert F. Bennett of Utah, which would replace employer-based coverage with an individual mandate to buy coverage with subsidies funded by ending the exclusion of employer-paid premiums from taxable income.
Cigna issued a statement in response to the "purging" allegation saying that "the small percentage of our business that is 'risk-based' works as traditional insurance in that our customers' premium rates are based on their claims experience. We work with companies so that employers can effectively manage their medical costs. If together we are not able to work out a solution, at the end of their contract period we will offer rates that are based on the underlying costs of the overall program and are reflective of the competitive group health insurance market."
A committee aide didn't respond directly when asked whether the Finance overhaul would end the CHIP program. "Health reform would strengthen and reform CHIP the same way it will improve quality and affordability in the rest of the health care system," the aide said. "In fact, the committee is considering options that would ensure children currently enrolled in CHIP have the same, or in many cases more benefits under health reform than they do today."
Separately, First Focus, a children's advocacy group, released a letter Wednesday signed by some 150 groups calling for the protection of comprehensive coverage for children in any health overhaul.
"Movement of children out of the Children's Health Insurance Program and into the Health Insurance Exchange could potentially leave 9 million children worse off by providing fewer benefits and higher cost sharing than they currently have through CHIP," said First Focus president Bruce Lesley. "We strongly support last week's action by the Energy and Commerce Committee, which approved an amendment by Rep. Diana DeGette that ensured children receive comparable coverage. We urge the House to retain these provisions in the final version, and the Senate must act in a similar manner for health reform to be a success for kids."
Bart Jansen contributed to this report.
