11/30/09 HC Reform Update by Mark Sanna: Even if lawmakers do not take a day off until Christmas, the Senate majority leader, Harry Reid of Nevada, has just 25 days to meet his own goal of finishing the Senate version of the bill by the holiday. And then he must iron out differences with the House bill, including some major disagreements over how to pay for the legislation that will almost certainly have to be resolved after New Year’s.

11/28/09 HC Reform Update by Mark Sanna: The fate of healthcare reform in the seems to be resting with these four women: Arkansas Democratic Sen. Blanche Lincoln, Louisiana Democratic Sen. Mary Landrieu, Maine Republican Sen. Susan Collins, and Maine Republican Sen. Olympia Snowe. This new bipartisan gang of four could be key to removing the heavily partisan debate dogging the legislation.

11/26/09 HC Reform Update by Mark Sanna: Two of President Obama’s senior health care advisers said Wednesday that a proposed tax on high-cost insurance plans and a new commission to control Medicare spending were among “four pillars” essential to major health care legislation. Their remarks firmly aligned the White House with the Senate on two major disagreements facing Democratic Congressional leaders trying to pass a bill.

11/25/09 HC Reform Update by Mark Sanna: Democrats are absolutely committed to finishing health reform by the State of the Union address, Sen. Sherrod Brown (D-Ohio) said Monday night. Brown said that Democrats would work overtime to finish a healthcare bill in the Senate by the end of the year and would work to finish the bill before the late-January speech by President Barack Obama.

11/24/09 HC Reform Update by Mark Sanna: Abortion coverage is way down on the list of concerns of those who oppose Democratic-led healthcare reform, a new Pew survey finds. A majority of Americans—55%—oppose abortion coverage as a "guaranteed medical benefit" in a government-run health insurance plan, according to the poll.

11/23/09 HC Reform Update by Mark Sanna: Anxious that Saturday’s party-line Senate vote to open debate on a health care overhaul gives them little maneuvering room, Obama administration officials and their Congressional allies are stepping up overtures to select Senate Republicans in hopes of winning their ultimate support.

11/21/09 HC Reform Update by Mark Sanna: Sen. Bill Nelson (D-Neb.), one of the last public holdouts in last night’s vote, insisted Chairman Reid omit from the Senate bill any change in the insurance industry's protection from federal antitrust law. Before entering politics, Nelson spent his career as an insurance executive, insurance company lawyer and Nebraska’s state insurance regulator.

11/21/09 HC Reform Update by Mark Sanna: Senate Health Care Vote – Senate health care vote results are in. The Senate has voted (by a vote of 60 vote yea to 39 nay) to allow the healthcare reform bill to come to the floor for debate. Majority Leader Harry Reid (D-Nev.) secured the vital 60th vote by persuading Sen. Blanche Lincoln (D-Ark.) with some funds for her state.

11/21/09 HC Reform Update by Mark Sanna: The clock is ticking up to the Senate’s vote scheduled for 8 p.m. Saturday on whether to proceed to debate on the health-care bill. If Reid wins the Saturday vote, the full Senate is set to start debate the bill and take up amendments after the Thanksgiving break, in the week of Nov. 30. If he doesn’t win the vote, it’s back to the drawing board.

11/21/09 HC Reform Update by Mark Sanna: In a show of unity, Senate Democrats sealed a 60-vote majority needed to advance health care legislation Saturday ahead of an evening showdown with Republicans eager to doom the bill and inflict a punishing defeat on President Barack Obama.

11/20/09 HC Reform Update by Mark Sanna The Senate version of sweeping health legislation would cover 5 million fewer people than a companion bill passed by the House, but it would cost less, in part because Senate Democratic leaders felt they had to win support from fiscally conservative members of their party. The Senate is expected to vote Saturday on whether to take up the legislation.

11/18/09 HC Reform Update by Mark Sanna: Three Democrats could block the health bill in the Senate. Senator Ben Nelson, Nebraska, Mary L. Landrieu of Louisiana and Blanche Lincoln of Arkansas are proving tough sells, raising the prospect that one or perhaps all three of them could scuttle the bill before the fight over it even begins on the Senate floor.

11/17/09 HC Reform Update by Mark Sanna: While Congress searches for ways to slow the growth of health care spending, a new study suggests that its efforts may be overwhelmed by the surging prevalence of obesity.

The report, to be issued Tuesday, projects that if current trends continue 103 million American adults will be considered obese by 2018. That would be 43 percent of adults, compared to 31 percent in 2008, according to the research by Kenneth E. Thorpe of Emory University, an authority on the cost of treating chronic disease.

Mr. Thorpe concluded that the prevalence of obesity is growing faster than that of any other public health condition in the country’s history. Health care costs related to obesity — which is associated with conditions like hypertension and diabetes — would total $344 billion in 2018, or more than one in five dollars spent on health care, if the trends continue. If the obesity rate were held to its current level, the country would save nearly $200 billion a year by 2018, according to the study.

Mr. Thorpe said in an interview that the health care bills in Congress limit their attack on obesity to a few community-centered pilot programs with insufficient funding. Congress has steered clear of measures that might have a more direct impact, like taxing sugary sodas and fat-laden snacks.

“If we’re interested in bending the cost curve we’ve got to go back to the source of what’s driving spending,” he said. “And if you go back 5 or 10 years it’s not technology at all. It’s the explosion of chronic disease.”

The study is the first to project obesity levels for individual states, according to Mr. Thorpe. He found that by 2018, Colorado would be the only state where less than 30 percent of adults would be obese. In six states — Kentucky, Maryland, Mississippi, Ohio, Oklahoma and South Dakota — more than 50 percent of adults would be obese.

The research was conducted for the United Health Foundation, the American Public Health Association and the Partnership for Prevention.

11/16/09 HC Reform Update by Mark Sanna: Even as drug makers promise to support health care overhaul by shaving $8 b a year off the nation’s drug costs after the legislation takes effect, the industry has been raising its prices at the fastest rate in years. According to analysts, the industry has raised the wholesale prices of brand-name prescription drugs by about 9% in the last year.

11/15/09 HC Reform Update by Mark Sanna: Some House Democrats have vowed that if the final bill contains an anti-abortion measure, they will oppose it. More than 40 members have attached their names to a letter to Speaker Nancy Pelosi, warning that they would not vote for a final bill if it restricts women’s right to choose any further than current law.

11/14/09 HC Reform Update by Mark Sanna: President Barack Obama probably never intended to do it, but his push for healthcare reform has reopened debate on one of America's most polarizing issues – abortion. "This is a healthcare bill, not an abortion bill," Obama told ABC News. But that aspect of the healthcare overhaul is dividing his Democratic party and may threaten the entire effort.

11/13/09 HC Reform Update by Mark Sanna: The Senate majority leader, Harry Reid, is considering a proposal to increase the Medicare payroll tax on high-income workers to help offset the costs of providing health insurance to millions of Americans, Senate aides said Thursday. The proposal is part of a legislative package that Mr. Reid has put together in secrecy and submitted to the Congressional Budget Office for analysis.

11/11/09 HC Reform Update by Mark Sanna: The Senate majority leader, Harry Reid of Nevada, said Tuesday that he expected to bring major health care legislation to the floor next week and to complete work on the bill before Christmas. But other Democratic leaders said it was unlikely that a bill could reach President Obama’s desk by year’s end. The House approved its version of the health care legislation late Saturday by a vote of 220 to 215. In a first procedural step toward Senate debate, Mr. Reid on Tuesday night moved to put the House bill on the Senator calendar, from which he could call it up any time after Tuesday.

11/10/09 HC Reform Update by Mark Sanna: As health care legislation moves toward a crucial airing in the Senate, the White House is facing a growing revolt from some Democrats and analysts who say the bills Congress is considering do not fulfill President Obama’s promise to slow the runaway rise in health care spending.

11/9/09 HC Reform Update by Mark Sanna: The White House, growing concerned that the Congressional timetable for passing a health care overhaul could slip into next year, is stepping up pressure on the Senate for quick action. In the Senate the bill is stalled while budget analysts assess its overall costs. Unlike the House bill, which pays to extend coverage by taxing individuals who earn more than $500,000 a year and couples who earn more than $1 million, the Senate bill imposes a 40 % excise tax on so-called Cadillac plans that cost more than $8,000 a year for an individual or $21,000 for a family. And unlike the House bill, which includes a national public plan, the Senate measure would allow states to opt out.

11/8/09 HC Reform Update by Mark Sanna: After a daylong clash with Republicans over what has been a Democratic goal for decades, lawmakers voted 220 to 215 to approve a plan that would cost $1.1 trillion over 10 years. Democrats were forced to make major concessions on insurance coverage for abortions to attract the final votes to secure passage. Democrats say the House measure paid for through new fees and taxes, along with cuts in Medicare would extend coverage to 36 million people now without insurance while creating a government health insurance program. It would end insurance company practices like not covering pre-existing conditions or dropping people when they become ill.

11/7/09 HC Reform Update by Mark Sanna: House Democrats put the finishing touches on their health care legislation on Friday, but failed to bridge an internal divide over the issue of insurance coverage for abortions, as party leaders and the White House pushed to lock in votes on the eve of a historic floor debate. Democratic leaders said they were confident that they would have the 218 votes needed to pass the bill. A planned visit to the Capitol by President Obama was postponed until Saturday so that a face-to-face appeal would have greater impact on wavering lawmakers just before the vote

11/6/09 HC Reform Update by Mark Sanna: President Obama made a surprise appearance at the daily White House press briefing on Thursday afternoon to announce that the AARP and the AMA have endorsed the current health care plan being considered in Congress. “We are closer to passing this reform than ever before,” Mr. Obama said, adding that he was “extraordinarily pleased and grateful.”

11/5/09 HC Reform Update by Mark Sanna: House Democratic leaders struggled Wednesday to strike a deal that would restrict the use of federal money to pay for abortions under health care legislation. The haggling over abortion was part of a frenetic effort by House Democratic leaders to lock in the 218 votes needed to pass the legislation, and it highlighted the political land mines on the path to a vote tentatively set for Saturday.

11/4/09 HC Reform Update by Mark Sanna: House Republicans have come up with an answer to Speaker Nancy Pelosi, drafting an alternative health care bill that would reward states for reducing the number of uninsured, limit damages in medical malpractice lawsuits and allow small businesses to band together and buy insurance exempt from most state regulation.

11/3/09 HC Reform Update by Mark Sanna: As the House moved toward climactic votes on legislation to remake the health care system, the Congressional Budget Office said Monday that middle-income families might be required to pay 15 - 18 % of their income on insurance premiums and co-payments under the proposal. House Republicans were drafting an alternative, which they said would be much less costly.

11/2/09 HC Reform Update by Mark Sanna: After months of plodding work by five Congressional committees and weeks of back-room bargaining by Democratic leaders, President Obama’s arms-length strategy on health care appears to be paying dividends, with the House and the Senate poised to take up legislation to insure nearly all Americans. Debate in the House is expected to begin this week, and the Senate will soon take up its version.

11/1/09 HC Reform Update by Mark Sanna: Of all the elements of a health care bill that the Senate and House will have to reconcile, one of the thorniest is the issue of the so-called employer mandate. To what degree will Congress require employers to provide health insurance for their employees? The three operative bills in Congress — one unveiled in the House on Thursday, and two in the Senate that are being merged into one — take different approaches.