Federal health care reform legislation cleared the U.S. House with a final vote of 219-212 this weekend.  This vote completed the legislative process on the Senate’s bill, H.R. 3590, and sends the bill to President Obama for his signature.  The House also passed a “side-car” bill, H.R. 4872, containing legislative fixes that will now be sent to the Senate for its consideration.  The Senate will use the procedural reconciliation process which allows the chamber to pass legislation with a simple majority of 51 votes rather than the 60 as required under Senate rules.

IHA’s take on the bills as passed by the House:

Overall: The legislation passed by the House and Senate have addressed many of the concerns that affected hospitals in the original proposals.  The resulting legislation will bring about positive reforms for the health care industry by increasing access to health insurance coverage for citizens while also holding the immediate and long term potential of increasing the historically low payments for Iowa hospitals and physicians.

Insurance Coverage: Having millions more people covered by insurance is good news for hospitals.  Hospitals across the state have seen a notable increase in charity care cases, often because people have lost their jobs and their insurance.  The cost of that care eventually impacts those who do have insurance.  The larger the pool of insured people, the lighter the impact.  And when people have insurance, they are more likely to receive routine care – i.e., check-ups, immunizations, etc. – and avoid serious and expensive illnesses.  This legislation provides access to coverage to 30 million Americans.  Iowa currently enjoys a relatively low uninsured rate, but this legislation seeks to make health insurance more portable, while also making important reforms to the insurance industry.

Cost: We believe the legislation holds the potential to reduce costs by insuring more people (as explained above) and improving the way health care is provided.  The bill emphasizes providing care at the primary level (by providing higher Medicare payments to primary care physicians, for example).  Together with greater numbers of insured, the emphasis on primary care should help establish “medical homes” for more people, a model of care based on the primary care physician that improves quality of care and reduces cost.

Geographic Variation: Iowa’s congressional delegation has made a bi-partisan effort to address geographic inequities in hospital payments across the U.S.  Iowa will benefit from the negotiations as the legislation contains critical reforms that will increase payments to hospitals and physicians that have remained stagnant for decades.  For the first time, the Medicare program will finally recognize value over volume and incent and reward providers that provide the highest-quality of care at the lowest cost like that provided in Iowa hospitals.

IHA will remain actively engaged in the process as the reconciliation bill now moves to the Senate for debate, and applauds the work done thus far by Iowa’s Congressional Delegation that worked to address the issues surrounding geographic variation that negatively impacts payments to hospitals and physicians in Iowa.