Hill Staff Memo

The Senate Republican staff of the Republican Policy Committee sent around a briefing memo today explaining the contents and implications of a letter the President sent to the Senate on Healthcare reform. The briefing memo follows:
LAH

June 3, 2009

To: Republican Health Policy Staff
Fr: Andy Chasin

Re: Obama Letter to the Senate on Health Reform

President Obama sent a public letter to Senators Kennedy and Baucus on health care reform today. The letter says that the President “strongly believes” in including a public plan option in health care reform legislation. He also talks about his support for a pay-or-play mandate with an exemption for small businesses (though it is unclear how that would be defined). The President continues to talk about bipartisanship and a plan that will be “at least deficit neutral.” However, there still has been no real demonstration as to how the President intends to pay for $1.5 trillion in new health spending. It might also strike readers as ironic that the President talks about bipartisanship while at the same time highlighting his support for a public plan—which is strongly opposed by Republicans.

Below are some of the highlights:

· On the Public Plan: “I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.”

· On the Pay or Play Mandate: “In addition, while I believe that employers have a responsibility to support health insurance for their employees, small businesses face a number of special challenges in affording health benefits and should be exempted.”

· Using MedPAC as a new BRAC: “To identify and achieve additional savings, I am also open to your ideas about giving special consideration to the recommendations of the Medicare Payment Advisory Commission (MedPAC), a commission created by a Republican Congress. Under this approach, MedPAC's recommendations on cost reductions would be adopted unless opposed by a joint resolution of the Congress.”

· On an Individual Mandate: “I understand the Committees are moving towards a principle of shared responsibility -- making every American responsible for having health insurance coverage, and asking that employers share in the cost. I share the goal of ending lapses and gaps in coverage that make us less healthy and drive up everyone's costs, and I am open to your ideas on shared responsibility. But I believe if we are going to make people responsible for owning health insurance, we must make health care affordable. If we do end up with a system where people are responsible for their own insurance, we need to provide a hardship waiver to exempt Americans who cannot afford it.”

· On New Spending: “Health care reform must not add to our deficits over the next 10 years -- it must be at least deficit neutral and put America on a path to reducing its deficit over time.”

· On Working with Republicans: “I know that you have reached out to Republican colleagues, as I have, and that you have worked hard to reach a bipartisan consensus about many of these issues. I remain hopeful that many Republicans will join us in enacting this historic legislation that will lower health care costs for families, businesses, and governments, and improve the lives of millions of Americans.”

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