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Representative Pelosi Unveils House Democrats’ Health Care Reform Bill; Senator Reid Says Senate Bill Will Include Public Option

On October 29, House Speaker Nancy Pelosi (D–CA) and House Democratic leaders unveiled a house health care reform bill, expected on the House floor the week of November 2. The legislation, which resulted from a merger of bills passed by the House Education and Labor Committee, the House Energy and Commerce Committee, and the House Ways and Means Committee, will be deficit neutral over 10 years, cost $894 billion, and extend health coverage to 96 percent of Americans. Among other provisions, the bill includes an individual health insurance mandate, an employer insurance mandate, and a public plan option with Government-negotiated reimbursement rates. The bill is largely financed by a non-inflation-indexed surtax on individuals with adjusted gross income (AGI) over $500,000 and families with AGIs over $1 million, in addition to more than $400 billion in cuts to Government health care programs. Meanwhile, on October 26, Senate Majority Leader Harry Reid (D–NV) announced that the Senate Democrats’ health reform bill, which combines the Senate Health, Education, Labor and Pensions Committee’s bill and the Senate Finance Committee’s bill, will include a public option. The Senate’s option requires the Government to negotiate reimbursement rates directly with health care providers; however, unlike the House’s option, the Senate’s option includes an “opt-out” for states that are able to provide equal competition and quality through private insurers.

President Obama Signs Military Spending Bill Requiring Mental Health Screenings for Returning Vets; Congressmen Propose Bill To Give Military Personnel Direct Access to Mental Health Treatment

On October 28, President Barack Obama signed H.R. 2647 authorizing Fiscal Year 2010 appropriations for the Department of Defense (DOD). Among the provisions of the new law, the DOD must provide in-person mental health screenings for soldiers returning from the wars in Iraq and Afghanistan. In related news, Representative Michael McMahon (D–NY) introduced legislation (H.R. 1308) to give TRICARE beneficiaries direct access to mental health counseling without a referral from a primary care physician.

Thomson Reuters Estimates U.S. Health Care System Wastes at Least $505 Billion Annually

A report released by Thomson Reuters on October 26 estimates that the U.S. health care system wastes between $505 and $805 billion annually. According to the report, 40 percent of health care waste is attributed to unnecessary care, 19 percent to fraud, 17 percent to administrative inefficiency, 12 percent to provider errors, 6 percent to preventable conditions, and 6 percent to lack of care coordination.

CHCS Report Analyzes High-Cost, High-Need Medicaid Beneficiaries

A Center for Health Care Strategies, Inc. (CHCS), report, funded by Kaiser Permanente, used pharmacy claims to supplement a 2007 report to better analyze Medicaid’s high-cost and high-need populations. The addition of pharmacy data revealed that the proportion of disabled beneficiaries diagnosed with three or more chronic conditions was 45 percent rather than 35 percent, as was previously estimated, and that the frequency of psychiatric illness among disabled beneficiaries was 49 percent rather than 29 percent. The new analysis also found that the costs for beneficiaries with three or more chronic conditions accounted for 75 percent of total spending on disabled beneficiaries, up from the previous estimate of 66 percent.

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