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Waxman Predicts Panel Will Okay Overhaul by August

By John Reichard, CQ HealthBeat Editor

March 3, 2009 -- House Energy and Commerce Committee Chairman Henry A. Waxman, D-Calif., said Tuesday that he expects the panel to approve health overhaul legislation before the August recess and that he would meet later in the day with the chairmen of two other key committees to coordinate efforts.

Waxman made the comments in response to questions following his speech at a Washington, D.C. conference sponsored by the Federation of American Hospitals in which he urged for-profit hospitals to help him put together legislation that can get through Congress. "You can be and must be our partners in this endeavor and I look forward to working with you," Waxman said. "I commit to you we will work with all of you" to create legislation that works.

Waxman said in his remarks to the hospital executives that he, along with House Ways and Means Committee Charles B. Rangel, D-N.Y., and House Education and Labor Committee Chairman George Miller, D-Calif., are "all working hard and are determined to pull in the same direction" on a health overhaul. Energy and Commerce has jurisdiction over the Medicaid program and State Children's Health Insurance Program and shares jurisdiction over the Medicare program with Ways and Means, which also would handle tax issues relating to an overhaul. Education and Labor handles issues relating to health benefits offered by self-insured corporations.

Waxman said after his speech that there may be differences at the committee level in terms of legislation but predicted that a unified bill would be ready in time for House floor action. He offered no specifics on when he would unveil an Energy and Commerce Committee proposal or on its provisions. "You're asking me questions I don't know the answer to," Waxman said when asked whether a public plan option would set a fee schedule for providers, for example.

Separately Tuesday, Senate Finance Committee Chairman Max Baucus, D-Mont., said he hoped to have a health overhaul bill on the Senate floor by June or July, even as he acknowledged the complexity of the legislative task before him.

Waxman repeated earlier statements praising President Obama for urging an overhaul that builds on the existing system and allows Americans to keep the coverage they have. And he reiterated earlier assertions that the proposal must offer Americans a choice between signing up for coverage in private plans and in a government-run plan.

The overhaul should build on employer-sponsored coverage, the Medicare program for seniors, and Medicaid and the State Children's Health Insurance Program for lower-income Americans, Waxman said. Medicaid meets needs that "quite frankly" will never be adequately met by private health plans, he added.

Rather than pick a system in which the uninsured could only select private plans or a government-run plan, "there has to be a significant role for both," he said. That's the best way to avoid gridlock between those who favor a single-payer, government-run system and those who want a private-sector based system, according to Waxman.

The California Democrat praised Obama's proposal for a reserve fund setting aside some $630 billion over 10 years as a down payment on a universal coverage system. "When it covers half the funds you need you've got a fiscally responsible approach," he said.

Obama would come up with the $630 billion by reducing the value of tax deductions for those with incomes more than $250,000 a year, cutting payments to private health plans offered by Medicare in the Medicare Advantage program, raising premiums paid by affluent Americans for Medicare prescription drug coverage and reducing federal outlays under current law for hospitals, home health agencies, medical imaging and pharmaceutical companies.

Waxman said he realizes these are "difficult policies for many," and that he doesn't like all of them himself. But given the goal of universal coverage he is willing to listen to them, he said. Asked later whether there were any specific cuts he would oppose, Waxman said, "none that I can single out at this point."

Obama's outline leaves it up to Congress to come up with another $600 billion or so to fund universal coverage. Waxman was non-committal about how that could be done but in comments after his speech didn't rule out tax code changes such as limiting the deductibility of employer-paid health insurance premiums in counting individual income and additional cuts in payments to providers. Waxman said there would not necessarily be added provider cuts. Asked about deficit financing, he said, "that's a big issue. I think we're going to have to pay for it," he said of overhaul provisions.

Waxman got a warm introduction from Federation of American Hospitals President Chip Kahn. "He's a man who cares about those most in need," Kahn said of Waxman. And Kahn expressed confidence that Waxman can lead the nation to an overhaul "we all can be proud of."

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