From Full Repeal to Slight Tweaking, Congress Focuses on Healthcare

As expected, Senate Democrats quickly quashed the Republican-ruled House of Representatives legislation repealing President Barack Obama's healthcare reform law on Feb. 2.

Ironically, the vote occurred two days after a federal judge in Florida ruled the law—officially known as the Patient Protection and Affordable Care Act of 2010 and the subsequent Health Care and Education Reconciliation Act of 2010— unconstitutional in the case of Florida v. U.S. Department of Health and Human Services filed by the National Federation of Independent Business and 26 states, including five in the South. (See related story below.)

Senate Republicans who bolstered efforts to repeal the highly controversial law took home a parting gift on Groundhog Day with the passage of a bill killing the tax-reporting requirement that would've required business owners to file 1099 tax documents on all cumulative purchases from individual vendors totaling more than $600 annually. Last year, several attempts failed to repeal that provision, with both parties bickering over financial aspects. This particular Democratic amendment garnered broad bipartisan support, passing 81-17 in the Senate. At press time, that bill was headed to the House.

Democrats have remained emphatic about banding together to stop full repeal efforts, while admitting they are open to tweaking the law. Equally passionate about their stance, Republicans believe they hold a trump card, saying that some Democrats who supported the health reform bill and now consider it a mistake will at least vote for positive changes.

"We should repeal this bill and start over," said Sen. Orrin Hatch (R-Utah). "We may not do it today, and we may not do it tomorrow, but we will defeat this bill."

Political pundits considered it a coup for Republicans in the Democrat-controlled Senate to push the repeal bill to the floor for a vote, forcing moderate Democrats facing re-election to go on the record favoring health reform.

"This is just the beginning," vowed Senate Minority Leader Mitch McConnell (R-Ky.). "This issue is still before us, and we're going to go at it in a variety of ways."
Pressure from Americans that voiced displeasure about his signature legislation prompted Obama to state during his State of the Union address that he was open-minded to changes in the law if it made sense economically and didn't affect insurance eligibility for patients with pre-existing conditions.

Sen. Thad Cochran (R-Mississippi), who has served in Congress since 1972, and in the Senate since 1978, is cosponsoring three measures that would repeal certain provisions of the health reform law, including employer and individual mandates regarding health insurance coverage.

"Throughout the long debate on the healthcare reform law, I was wary of its costs and scope. I believe the President and the Democratic Congress overreached and enacted a law that imposes mandatory spending that our nation can ill-afford. It also created federal mandates for individuals and small businesses that are onerous and should be repealed as soon as possible," Cochran said.

Rep. Charles Boustany (R-Louisiana), emphatically said the health reform law needs to be overturned and replaced "with commonsense solutions that actually lower health costs and keep personal medical decisions in the hands of patients and doctors."

Cecil B. Wilson, MD, president of the American Medical Association and an internist from Winter Park, Fla., said he was glad to hear about the Senate voting for the elimination of the burdensome 1099 reporting requirement for small businesses, including physician practices.

"We'll continue to work with members of Congress from both sides of the aisle and the administration during the implementation phase of this new law to ensure the best outcomes for patients and physicians," he added.

Related story

BCBSF Responds to Ruling

When the news broke that Judge Roger Vinson, in a federal court representing the Northern District of Florida, had ruled the entire healthcare law violates the Commerce Clause and is therefore unconstitutional, and as a result must be declared null because of the "individual mandate" requiring people to buy health insurance in 2014 or pay a penalty, Jacksonville-based Blue Cross and Blue Shield of Florida (BCBSF), the state's largest and oldest health insurance provider, weighed in on the response.

"Blue Cross and Blue Shield of Florida continues to support its vision of a comprehensive healthcare reform platform that reduces costs, provides universal access to coverage, and improves the overall quality of care," said Randy Kammer, vice president of public policy for BCBSF, a not-for-profit mutual insurance firm owned by its policyholders.

Health plan coverage for 7 million Floridians enrolled as BCBSF members includes group and individual HMO, PPO, traditional indemnity, and supplemental Medicare policies. BCBSF also provides accident and dismemberment, long-term care, dental, disability, life, and workers' compensation insurance. Other services include the administration of pharmacy programs and health savings accounts.

"While many of the law's provisions, including mandated coverage for all, won't take effect for several years, others have already been implemented," she said. "Blue Cross and Blue Shield of Florida has taken the steps necessary to ensure that we can implement these provisions of the law. We continue to work with key federal agencies to implement practical approaches to reform that are consistent with the law."

Kammer said the Blue Cross and Blue Shield Association licensee continues to focus on the key drivers of healthcare costs and the impact on how some provisions, such as new insurer taxes and narrow age rating bands, will make premiums more expensive for consumers.

"We'll continue to share recommendations," she emphasized, "to make coverage more affordable for individuals, working families, and employers."

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