10/31/09 HC Reform Update by Mark Sanna: The House health care bill is more costly than the $894 billion reported by House speaker, Nancy Pelosi. The official cost analysis by the Congressional Budget Office suggests that the number that should have reported was $1.055 trillion, which is the gross cost of bill before taking account of certain new revenues, including penalties by individuals and employers who fail to meet new insurance requirements in the bill.

10/29/09 HC Reform Update by Mark Sanna: Speaker Nancy Pelosi’s fallback public option is to have the secretary of health and human services negotiate rates with health care providers as private insurers do. The Congressional Budget Office considers this so weak that it might attract only 6 million of an estimated 30 million people buying insurance on the exchanges in 2019. Its premiums might exceed the average private plan, in part because the sickest people might migrate to the public plan.

10/29/09 HC Reform Update by Mark Sanna: Under pressure from moderate-to-conservative members of the House Democratic caucus, Speaker Nancy Pelosi has decided to propose a government-run insurance plan that would negotiate rates with doctors and hospitals, rather than using prices set by the government, aides said Wednesday.

10/28/09 HC Reform Update by Mark Sanna: Faced with opposition Tuesday from Senators Olympia Snowe, R-Maine, and Joe Lieberman, an independent, over inclusion of a government-run insurance program in the Senate health care bill, Democratic Leader Harry Reid, D-Nev., intensified negotiations with a handful of Democrats whose support is crucial to passing the legislation.

10/26709 HC Reform Update by Mark Sanna: Senate majority leader, Harry Reid’s public option proposal comes with an escape hatch: A state could refuse to participate in the public insurance plan by adopting a law to opt out. The announcement is a turning point in the debate over how much of a role government should play in an overhauled health care system, and it set the stage for a test of Democratic party unity.

10/26/09 HC Reform Update by Mark Sanna: The contentious debate over health care took a new twist Monday as Senate Majority Leader Harry Reid announced his decision to craft legislation including a public insurance option allowing states to opt out. Reid's decision is a major victory for the more liberal wing of the Democratic Party.

10/26/09 HC Reform Update by Mark Sanna: On Page 251 of the Senate Finance Committee’s 1,502-page health care bill is a remarkable provision that would require all hospitals in the US to establish a list of “standard charges for items and services.” What is remarkable is not that hospitals will have to publish their prices, but that researchers think it will do little good and might only highlight the inability of Congress to lower costs.

10/25/09 HC Reform Update by Mark Sanna: As Congress nears votes on legislation that would overhaul the health care system, insurance brokers and benefits consultants say their small business clients are seeing premiums go up an average of about 15 percent for the coming year — double the rate of last year’s increases. That would mean an annual premium that was $4,500 per employee in 2008 and $4,800 this year would rise to $5,500 in 2010.

10/24/09 HC Reform Update by Mark Sanna: Supporters of the public option want it in the bill at the outset, meaning opponents would need 60 votes to pass an amendment stripping it out. Opponents want to leave the government plan out of the bill, so that supporters would need 60 votes to pass an amendment to add it in. The margins are so tight, that neither side seems to be able to muster 60 votes. And that leaves the crucial decision in the hands of the majority leader, Harry Reid.

10/23/09 HC Reform Update by Mark Sanna: In pushing to include a government-run health insurance plan in the health care bill, the Senate majority leader, Harry Reid, is taking a calculated gamble that the 60 members of his caucus could support the plan if it included a way for states to opt out. Mr. Reid met with President Obama at the White House Thursday to inform him of his inclination to add the public option to the bill.

10/21/09 HC Reform Update by Mark Sanna: In the face of solid Republican opposition, Senate Democrats on Tuesday backed down from their effort to increase Medicare payments to doctors without offsetting any of the cost over the next 10 years. It was the first skirmish in a larger partisan battle over President Obama’s effort to remake the health care system in a fiscally responsible way.

10/20/09 HC Reform Update by Mark Sanna: Senate Democrats and White House officials met on Monday evening to discuss how to merge the two versions of the Senate’s health care legislation, and Democratic aides said they were aiming to have a combined bill “mostly baked” by the end of this week. Once the bills are melded, the Congressional Budget Office will be asked to develop a revised cost analysis, which will take several days.

10/19/09 HC Reform Update by Mark Sanna: As she pulls together a health care bill, Speaker Nancy Pelosi has been exceedingly direct, lawmakers say, asking them explicitly Across the Rotunda, Senator Harry Reed, the majority leader, is trying a different tack, acting like what one participant in closed-door sessions described as a coach, urging key chairmen not to get bogged down in pride of authorship and to keep their eyes on the legislative ball.

10/18/09 HC Reform Update by Mark Sanna: President Barack Obama lashed out on Saturday against the "deceptive and dishonest" efforts of health insurance companies, who he said are trying to kill health care reform, no matter the cost to the country. Sharpening his attack on insurers, Obama also signaled support for a congressional review of the insurance industry's long-standing exemption from federal anti-trust laws. Some Democrats want the privilege repealed.

10/17/09 HC Reform Update by Mark Sanna: The Obama administration on Friday backed away from an order that had prohibited insurance companies from warning Medicare recipients about the possible loss of benefits under pending legislation to overhaul the health care system. Medicare officials set off a political storm when they tried to stop such communications last month. Under new guidelines, insurance companies can communicate with Medicare beneficiaries on pending legislation, provided they do not use federal money to do so. In addition, insurers must get permission from beneficiaries before sending them information about legislation or asking them to join grass-roots advocacy efforts.

10/16/09 HC Reform Update by Mark Sanna: Deep fissures among Senate Democrats became evident on Thursday as lawmakers moved closer to a floor debate on legislation to remake the health care system. The divisions involved two issues: whether the government should sell health insurance, in competition with private insurers, and whether Congress should offset any of the cost of legislation to increase Medicare payments to doctors.

10/15/09 HC Reform Update by Mark Sanna: Lobbyists for the American Medical Association and other physician groups met with Senate Democratic leaders on Wednesday to discuss a long-term fix to the health care crisis. Under current law, doctors face cuts of 21.5 percent in January and about 5.5 percent in each of the next four years.

10/14/09 HC Reform Update by Mark Sanna: After months of relentless courting and suspense, Senator Olympia Snowe, Republican of Maine, cast her vote with Democrats on Tuesday as the Senate Finance Committee approved legislation to remake the health care system and provide coverage to millions of the uninsured. With Ms. Snowe’s support, the committee backed the $829 billion measure on a vote of 14 to 9, with all the other Republicans opposed.

10/13/09 HC Reform Update by Mark Sanna: A proposed tax on high-cost, or “Cadillac,” health insurance plans has touched off a fierce clash between the Senate and the House as they wrestle over how to pay for legislation that would provide health benefits to millions of uninsured Americans. Whether it remains in the bill is emerging as a test of the commitment by President Obama and his party to slowing the steep rise of medical expenses.

10/12/09 HC Reform Update from Mark Sanna: The latest battle between the Obama administration and the health insurance industry escalated quickly on Monday, as the White House and Congressional Democrats fired back at an industry report prepared by Price Waterhouse Coopers suggesting that health premiums would rise sharply as a result of the proposed heath care legislation.

10/10/09 HC Reform Update by Mark Sanna: As the drama over health care legislation builds, the uncertain intentions of Ms. Snowe, Maine’s senior senator, have made her one of the foremost Scrum Queens on Capitol Hill. A vote by the Senate Finance Committee next Tuesday on its version of the health overhaul has set off a particularly intensive round of “What Will Olympia Do?”

10/9/09 HC Reform Update by Mark Sanna: Democrats are looking at the possibility of a windfall profits tax on insurance companies as part of healthcare reform, House of Representatives Speaker Nancy Pelosi said on Thursday. She added that insurance companies would get some 50 million new consumers, many subsidized by taxpayers, under reforms Democrats are planning and "we think they can put more on the table."

10/8/09 HC Reform Update by Mark Sanna and Breakthrough Coaching: According to the new Congressional Budget Office analysis, the Senate Finance Committee’s health care legislation would cost $829 billion to provide insurance coverage to millions of Americans. But over 10 years, it would also reduce federal deficits by $81 billion. Besides providing insurance coverage, the other main goal of the legislation is to slow the steep rise in federal spending on health care, particularly on Medicare, which covers Americans over age 65 and the disabled. The analysis by the nonpartisan budget office shows that the savings generated by slowing Medicare growth, combined with revenues from new taxes, would more than cover the cost of providing health benefits to roughly 29 million people.

10/7/09 HC Reform Update by Mark Sanna: A group of centrist Democratic senators, who could determine the fate of the major health care legislation, sent a letter Tuesday to the majority leader, Harry Reid, Democrat of Nevada, urging that the public be given at least 72 hours to review the legislation before debate begins on the Senate floor. White House officials and the committee chairman expect the Democrats to support the bill, if only to advance it to the next stage of the legislative process, the Senate floor, for what is likely to be a raucous, riveting and unpredictable debate.

10/6/09 HC Reform Update by Mark Sanna: As Democrats prepare to take up health care legislation on the floor of the Senate and the House, they are facing tough choices about two competing priorities. They want people to pay affordable prices for health insurance policies, but they want those policies to offer comprehensive health benefits. These goals collide in the bills moving through Congress.

10/3/09 HC Reform Update: It wasn’t pretty at times, but at 2:15 a.m. Friday, the Senate Finance Committee finished debating amendments to its sweeping health care legislation. The bill will now be delivered to the Congressional Budget Office for a crucial cost estimate. A final vote on the measure is expected next week.

9/30/09 HC Reform Update: The Senate poses the main hurdle to President Obama’s effort to overhaul the health care system. But passing so far-reaching a bill in the House is not going to be easy either. Few Democrats doubt that ultimately the House will approve its version of a program to expand insurance coverage and restrain long-term health care spending, given the party’s sizable majority.