Cath Lab Digest

With Legislation Stalled, Reformers Regroup

Confronted with public opposition, a unified minority party, and an election loss that changed the balance of power in the US Senate, healthcare reform efforts have entered a new phase featuring talk of bipartisan cooperation and a healthcare summit at the White House. Democrats continue to hold majorities in the House of Representatives and the Senate, but after months of debate and several narrowly won votes, their voluminous healthcare bills may no longer be viable. The opposition is calling for reformers to toss out the current House and Senate bills and start with a clean slate, but majority leaders say they will work to enact the most widely supported aspects of existing proposals.

This winter, the reform debate has revolved around the Senate healthcare bill, titled the Patient Protection and Affordable Care for America Act (S.AMDT.2786 an amendment in the nature of a substitute to HR 3590), and the House bill, titled the Affordable Health Care for America Act (HR 3962). Earlier versions of reform legislation that made headlines in 2009 include S 1796, the America’s Healthy Future Act of 2009, and HR 3200, the America’s Affordable Health Choices Act of 2009.

A copy of HR 3962 downloaded from Senate.gov is just over 2000 pages, and the bill narrowly passed the US House of Representatives by a vote of 220 to 215 on November 8. HR 3590 as amended by the Senate is more than 2400 pages, and the last major action for this vehicle for healthcare reform legislation occurred on December 24 when the bill passed with a vote of 60 in favor and 39 opposed. Since the Christmas Eve vote, a process that appeared to be nearing completion has stalled as the House majority decides whether to pass the Senate bill in its current form or proceed with an amendment process that would necessitate another Senate vote.

Public opinion polls released at the beginning of the year reported varying degrees of opposition to the House and Senate bills. A CNN/Opinion Research poll conducted by telephone from January 8 to 10 found 57% of the 1000+ respondents generally opposed to the House and Senate bills with 47% generally in favor. By January 22, only 38% of respondents polled by the same group were in favor of the bills while 58% were opposed. The same poll, conducted December 2-3, 2009, had 61% opposed to the Senate bill and 36% in favor. At press time, a RealClearPolitics Poll average of 7 major polls reported 38.6% in favor of the Democrats’ healthcare plan and 53.1% opposed.

Democrats were forced to address opposition to their healthcare proposals after losing the Senate seat formerly held by the late Senator Edward M. Kennedy (D, Massachusetts) in a special election. Regardless of whether or not Massachusetts voters were specifically rejecting Democrats’ handling of healthcare reform, they awarded Republicans a key vote allowing them to filibuster Senate legislation. After winning the election, Republican Scott Brown, who campaigned against the current bills, called for a fresh start. “One thing is clear, voters do not want the trillion-dollar healthcare bill that is being forced on the American people,” he said.

A Rasmussen Reports survey of 1000 Massachusetts voters in the special election, conducted on election night, found that healthcare was a top issue. Among those who voted for Senator Brown, 52% said healthcare was the most important issue in determining their vote compared with 63% of those who voted for Massachusetts Attorney General Martha Coakley, the Democrat candidate. In addition, 78% of voters who selected Senator Brown said they strongly oppose the healthcare legislation before Congress.