1/31/10 HC Reform Update by Mark Sanna: Lobbying has been a major factor in the fate of the health care overhaul. Health care and insurance lobbyists spent more than $648 million in 2009, according to the Center for Responsive Politics, which tracks the influence of money on elections and policy.

1/30/10 HC Reform Update by Mark Sanna: If Democrats break down their major health care legislation into components that could be approved separately, the first bill up for consideration could be a proposal to end the exemption from federal antitrust laws that insurers have enjoyed since 1945. Private insurers strongly oppose a repeal of the antitrust exemption.

1/29/10 HC Reform Update by Mark Sanna: Speaker Nancy Pelosi, at a news conference in the Capitol, said House Democrats had begun exploring the possibility of breaking out pieces of the comprehensive bill they passed in November. “It means, we will move on many fronts, any front we can,” Ms. Pelosi said. “We’ll go through the gate. If the gate’s closed, we’ll go over the fence. If the fence is too high, we’ll pole-vault in. If that doesn’t work, we’ll parachute in.

1/28/10 HC Reform Update by Mark Sanna: President Obama drew sustained laughter from Congress, especially Democrats, on Wednesday when he declared in his State of the Union speech that “by now it should be fairly obvious that I didn’t take on health care because it was good politics.” Mr. Obama’s speech did nothing to resolve differences between the House and the Senate or to clarify the way forward.

1/27/10 HC Reform Update by Mark Sanna: With no clear path forward on major health care legislation, Democratic leaders in Congress effectively slammed the brakes on President Obama’s top domestic priority on Tuesday, saying they no longer felt pressure to move quickly on a health bill after eight months of setting deadlines and missing them. The Senate majority leader, Harry Reid, said “We’re not on health care now.”

1/25/10 HC Reform Update by Mark Sanna: In the wake of a political setback for national health care legislation, Senator John McCain, advised President Obama on Sunday that the way to get meaningful changes passed is to “start from the beginning” by meeting with Republicans. “We’d be willing to sit down and start over from the beginning with genuine negotiations,” he replied. “There are things we can agree on.”

1/24/10 HC Reform Update by Mark Sanna: One provision that most likely will be included in the healthcare reform bill is the insurance exchange—an entity that initially lets individuals and small businesses purchase health insurance at reasonable prices. But getting there may not be so simple since the House and Senate bills remain divided on what type of exchange—state or federal?

1/23/10 HC Reform Update by Mark Sanna: During a town hall meeting in Ohio on Friday, President Obama made an impassioned pitch for a broad overhaul of the American health care system. He acknowledged that the legislative process on Capitol Hill was ugly “it starts looking like just this monstrosity,” he said, but also said he was resolved to finish the job.

1/22/10 HC Reform Update by Mark Sanna: Members of Congress began Thursday to deal with the reality that a less ambitious than the bills approved last year is needed. It would extend insurance coverage to perhaps 12 million to 15 million people — and provide political cover to Democrats, who said they could not simply drop the issue after spending so much time and effort on it.

1/21/10 HC Reform Update by Mark Sanna: President Obama signaled on Wednesday that he might be willing to scale back his proposed health care overhaul to a version that could attract bipartisan support. In the interview with ABC, he cited two specific goals: cracking down on insurance industry practices that hurt consumers and reining in health costs.

1/20/10 HC Reform Update by Mark Sanna: House Democratic leaders appear to be backing away from a plan to ask their rank-and-file to approve the Senate version of major health care legislation and send the measure directly to President Obama for his signature. House leaders gathered at the Capitol late on Tuesday to chart their strategy in the wake of the Republican victory in the Massachusetts special election.

1/19/10 HC Reform Update by Mark Sanna: In a victory few thought possible just a month ago, Republican Scott Brown defeated Democrat Martha Coakley Tuesday in the race for the U.S. Senate seat formerly held by Ted Kennedy -- a win that could grind President Obama's agenda to a halt and portend unexpected losses for Democrats in the November midterms.

1/19/10 HC Reform Update by Mark Sanna: With Democrats anxious about the special election in Massachusetts on Tuesday and what it will mean for health care legislation, the House speaker, Nancy Pelosi, told reporters in California Monday that the legislation would move forward not matter what. “Let’s remove all doubt,” she said. “We will have health care one way or another.”

1/18/10 HC Reform Update by Mark Sanna: With the Massachusetts special election for the US Senate increasingly unpredictable, Democrats are forming backup plans should a Republican upset on Tuesday deprive them of the 60th vote they need to pass health care legislation. The favored fallback is to try to convince House Democrats to approve the Senate bill obviating the need for an additional Senate vote.

11/17/09 HC Reform Update by Mark Sanna: Even as Democrats nail down the final details of their health care bill, Republicans are devising ways to convert it into political capital. Their greatest hope is to defeat the bill outright, rebuffing President Obama and weakening the Democrats heading into the midterm elections. Republicans now think they can persuade some conservative and moderate Democrats in the House to vote against the final bill.

11/16/09 HC Reform Update by Mark Sanna: The pharmaceutical industry’s trade group, Pharmaceutical Research and Manufacturers of America, announced that they will oppose health care legislation if the White House and Congress reduce a proposed 12-year monopoly on biologic drugs. The group includes the CEOs of Pfizer, Merck, Bristol-Myers Squibb and other pharmaceutical companies

11/15/09 HC Reform Update by Mark Sanna: White House and Congressional officials worked into the wee hours of Friday as they continued to press for a final accord on health care legislation. The White House issued a statement saying: “They made solid progress toward a final package, including common-sense adjustments that strengthen the legislation and make sure it works for middle-class families while bringing down costs and expanding coverage to millions of Americans.”

1/13/10 HC Reform Update by Mark Sanna: Almost a year after taking office, President Obama has not yet nominated anybody to run Medicare. Health reform is not merely a matter of passing a bill, hard as that has been (and may still be); its success will also depend on how that bill is put into action. And the lack of a Medicare nomination suggests that the White House is not giving enough attention to what will happen once Mr. Obama signs a bill.

1/12/10 HC Reform Update by Mark Sanna: President Obama told union leaders at a private White House meeting on Monday that he remained committed to taxing high-cost insurance policies as a way to drive down health costs. But he also signaled that he was willing to amend the proposal to “make this work for working families,” a senior administration official said.

1/11/10 HC Reform Update by Mark Sanna: As White House and Congressional negotiators work toward an agreement on a final version of sweeping health care legislation, they seem likely to push the 10-year price tag closer to the $1.05 trillion cost of the House-passed bill while relying on new taxes proposed by the Senate, probably including a bigger increase in the Medicare payroll tax than currently proposed.

1/10/10 HC Reform Update by Mark Sanna: Democrats have long maintained that they must pass their health care legislation in part because failure to do so would be a political disaster. The midterm elections are 10 months away, and anything can happen between now and then. But even as Democratic leaders wrangle in a high-stakes endgame — behind closed doors — to produce a final health care bill, they are bracing for losses in November, when the entire House and a third of the Senate are up for re-election.

1/9/10 HC Reform Update by Mark Sanna: Labor leaders are fuming that President Obama has endorsed a tax on high-priced, employer-sponsored health insurance policies as a way to help cover the cost of health care reform. And as Senate and House leaders seek to negotiate a final health care bill, unions are pushing mightily to have that tax dropped from the legislation.

1/8/10 HC Reform Update by Mark Sanna: Several House Democrats on Thursday chafed at President Obama’s insistence that the final version of major health care legislation include a Senate proposal for a new tax on high-cost, employer-sponsored insurance policies. The proposed tax would be a 40 percent levy on the cost of individual insurance policies above $8,500 annually and family policies above $23,000.

1/7/10 HC Reform Update by Mark Sanna: With final negotiations on a health care overhaul beginning this week, complaints about the Stupak amendment are likely to grow even louder. The amendment prevents women who receive federal insurance subsidies from buying abortion coverage — but critics assert it could cause women who buy their own insurance difficulty in obtaining coverage. Representative Stupak insists that the final bill include his terms.

1/6/10 HC Reform Update by Mark Sanna: Senator Christopher Dodd, the embattled Connecticut Democrat has decided not to seek re-election this year. Mr. Dodd, 65, is a pivotal figure in the major debates now confronting Congress. The decision came hours after Democratic senator, Byron Dorgan of North Dakota, announced that he would not seek re-election. The developments underscored the fragility of the Democrats’ 60-vote Senate majority.

1/5/10 HC Reform Update by Mark Sanna: House and Senate Democratic leaders announced that there are no plans for a formal Conference Committee to reconcile their two bills. Party leaders will negotiate and then each chamber will adopt updated versions in a “ping-pong,” process until they have adopted identical bills. There may be just one volley, thus avoiding a Republican filibuster.

1/4/10 HC Reform Update by Mark Sanna: Early versions of the Senate’s health care bill said that small businesses with fewer than 50 workers would not be penalized if they failed to provide insurance. That was before labor unions in the construction industry went to work and persuaded Senate leaders to insert a provision that singles out the construction industry for special treatment, in a way that benefits union members and contractors who use union labor.

1/3/10 HC Reform Update by Mark Sanna: Health shares have seen a sudden boost in recent weeks, with stocks including Cigna, Humana, United Health and Wellpoint all experiencing rises in their stock prices. The positive trading is due in part to the healthcare reform bill being passed at the end of December. In particular, all versions of a government-backed health insurance plan have largely been eliminated, which was a major concern for US private healthcare companies.

1/2/10 HC Reform Update by Mark Sanna: Some immediate benefits from the health care legislation advancing on Capitol Hill will ease the minds of parents, Within 6 months, the Senate bill would allow dependent, unmarried children to remain on their parents’ policies until their 26th birthday; the House bill would allow an additional year of dependent coverage, until the 27th birthday. Right now it varies from state to state.