Pause on Health Reform Paves Way for Work on HME Agenda

ATLANTA — The Beltway is still buzzing after Republican
Scott Brown’s January 19 win in a special election to fill the
Massachusetts Senate seat of the late Ted Kennedy. With the
Democrats’ filibuster-proof majority gone, the stunning upset puts
health reform — and its proposed HME cuts — on
hold.

“If Congress decides to scale back its health reform agenda in
order to win over Republicans, that less-ambitious approach may
benefit the HME sector, which is the target of several onerous
provisions,” the American Association for Homecare wrote in a
message to its members Jan. 20. “For instance, the health reform
bills include an acceleration of Round 2 of the competitive bidding program,
elimination of the first-month purchase option for power
wheelchairs, an excise tax on medical devices, and productivity
adjustments, which would reduce the annual Consumer Price Index
(CPI) updates for HME.”

The momentary pause in the reform juggernaut, said Wayne
Stanfield, could be the perfect opportunity to push the industry
agenda. “By having these bills die, the bad things for DME also
die, and that’s a good thing,” said Stanfield, president and CEO of
the National Association of Independent Medical Equipment
Suppliers, Halifax, Va. “We won’t have to pay for the bad things
with cuts. When the health care bills come back, we may fair better
if we do a good job of selling Congress that we don’t need to be
cut to pay for other things.”

Cara Bachenheimer, senior vice president of government relations
for Elyria, Ohio-based Invacare, said it is really difficult now to
predict how health reform — including its DME-specific issues
— will move forward. “The one thing that is clear is there is
no clear path for Obama and the Democrats,” said Bachenheimer.
“There are several procedural, as well as substantive, options for
the Democrats to move forward, but none is clear-cut. We expect to
learn more over the next few days as the Democrats consider various
options.”

However, she cautioned, “I don’t think we should be changing our
message to legislators.”

The MED Group’s Wayne Grau, vice president of supplier relations
and government affairs for the Lubbock, Texas-based member services
group, agreed that the election’s effects still amount to “a very
big we don’t know.”

On the topic of procedural options, Grau pointed out that the
House of Representatives could use budget reconciliation to force
through a reform bill by voting on and approving the Senate version
and delivering this to the president to sign. Grau said that option
“is looking more unlikely at this point, but it could happen.”

On Jan. 21, House Speaker Nancy Pelosi, D- Calif., told
reporters she doesn’t see the votes to pass the Senate bill. But
Roll Call reported that day some Democratic senators and aides
don’t believe that House passage of the Senate bill is completely
off the table. “They said the Speaker has told them privately that,
in order to secure enough votes for the Senate bill, she would need
a promise of Senate action on the House’s concerns,” wrote
reporters Steven Dennis and Emily Pierce.

Reconciliation would limit the scope of the reform legislation,
but could allow the bill to pass with a 51-vote simple
majority.

Other current options Democrats are considering include passage
of a scaled-back health care bill. Another idea would be for the
House to pass a “corrections” bill that would make changes to the
Senate version, but such a bill would also require Senate
passage.

In the more likely scenario that health care reform gets put off
until later, perhaps with a scaled-back bill, Pride Mobility
Products’ Seth Johnson said that pressing HME industry issues is
still firmly on the agenda.

“Speaker Pelosi has already indicated she does not have the
votes in the House of Representatives to pass the Senate bill
without changes, which was one strategy initially considered by the
Democrats,” said Johnson, vice president of government affairs for
the Exeter, Pa.-based manufacturer. “Regardless of what happens,
the industry will need to remain vigilant throughout 2010 to make
sure the threats discussed in the health care reform debate do not
reappear. The good news is it’s an election year, and legislators
seem to be more attentive to the industry’s concerns in those
years.”

From a national perspective, it’s clear Massachusetts voters
were sending a message that both political parties are desperately
trying to decipher. Provider Tom Ryan, president and CEO of
Homecare Concepts, Farmingdale, N.Y., believes the election was a
wake-up call for Democrats.

“Health care reform cannot be rammed down the throat of
Americans in a partisan wheeling-dealing process,” said Ryan. “As
far as the industry is concerned, I will be breathing a sigh of
relief that provisions like the face-to-face requirements for all
DME, the manufacturer tax and studies to have manufacturers sell
direct to patients can be taken off the fast track. We can use the
additional time to lobby against them.”