CapCon 2010 Day 3

CapCon Day 3

This morning came early as I woke for the final day of CapCon 2010. We had another general session with more representatives on the docket as well as other invited guests including a representative from CMS, a former CBO Director and a current insurance commissioner.

The two representatives who spoke today were Rep. Tom Price (R-GA) and Rep. Charlie Melancon (D-LA). Rep. Price appears to have voted "yes” on the House bill that passed last November, but noted the most important thing we could do is stop the Senate bill from passing. I think it is safe to say Rep. Price will be a no vote. Rep. Melancon voted “no” on the House bill, but completely avoided a question from the audience asking him what kind of pressure was he under to vote “yes” on the Senate bill. Either he does not want to put the House leadership in hot water or he looks like he could be a “yes” vote.

In between the representatives was Danielle Moon who works for CMS. She presented on Medicare Advantage oversight and had some very impressive slides that explained the marketing of Medicare Advantage. She also had some interesting information on the “secret shoppers” being sent out to evaluate the system. I’ll see if NAHU puts her slides out for us to see.

Next up was Doug Holtz-Eakin, President of DHE Consulting and former Director of the CBO. Next to Len Nichols, Doug was my second favorite presenter of the entire conference. Doug’s message was simple. He has serious concerns about the cost of the bills being considered. His message stated that there were several entitlement programs in this legislation, and the country needs entitlement reform in order to reign in cost. He is afraid that if the Senate bill passes, entitlement reform will slip off the table since Congress couldn’t possibly turn around and reform the very legislation they labored so hard to pass. To quote him, “this presents a genuine threat to long term national prosperity”. If you want to see more from Doug, feel free to visit http://www.americanactionforum.org/.

Next was Kim Holland, current Commissioner of Insurance for Oklahoma. Kim is a former Agent and NAHU member so her support for who we are and what we do was very clear. I did not stick around to hear Kim’s presentation as I had to huddle with some of our delegates to see how yesterday’s meetings went.

The opinion of the others was similar to mine. The message from House leadership is we will never be this close again. Some of us met with Rep. Carol Maloney’s folks yesterday. Rep. Maloney was not in our meeting as she was in another meeting. We surmised it was most likely the same meeting that kept Rep. Arcuri away from our meeting yesterday.

Unfortunately the only meeting I could attend today was Sen. Schumer’s Legislative Assistant, Meghan Taira. We’ve met with Meghan before. She is very knowledgeable and friendly. We had a good discussion and I took away a couple of good points. First, I raised the concern that the Senate bill has wellness credits, but only for large employers. With so many smaller employers needing rate relief, why couldn’t we get that expanded? Her answer made some sense. Congress wants to see if wellness has a positive impact on large employer’s rates first, then expand it to the small business sector. She noted that it would be easier to expand something that works, than contract something that does not.

Secondly, she noted that the “Cadillac plan” tax limits were going to be raised, so we may not have the issue of NYC plans tipping the tax penalty. I’ll have to see what the limits are and see if it’s high enough.

Lastly, two parting messages Meghan shared with us are; (1) the challenge to the House is to pass a bill that gets the votes in the House without asking for too many “side car” items that will disrupt the vote in the senate and, (2) there are Senators that have issues with the current Senate bill as it stands, so we could see some changes made on both sides.

There is still a long way to go with many things having to fall into place. Mickey Lyons just e-mailed me about his meeting with Rep. Rangel’s folks, and the message there was that House leadership is confident they can pass the Senate bill and fix their concerns in the “side car” ad on. We need to keep an eye on not only on what happens in the House, but what the Senate is doing as the House moves towards their vote.

That does it for this year’s CapCon Blog. It has been my pleasure to be here on your behalf and share my thoughts and impressions with you. A heartfelt thank you to all the members who came from our state and shared their time and contributed to our efforts.

Pete

CapCon Day 2

I left you all feeling that day two had many expectations. The day started flat but the afternoon on “The Hill” gave us some interesting insight that had our group arguing most of the way back to the hotel. Here’s how it went down;
I was firmly in my seat at 8 a.m. and ready for the Senators to show up and give us all sorts of great info based upon what had happened just yesterday. The first speaker, Sen. Ben Nelson was late. NAHU did its best “soft shoe” to keep several hundred of us entertained and engaged as the time ticked away. Sen. Scott Brown arrived and went on ahead of Mr. Nelson. I have to say I had high expectations. All I can say after his speech is that he wants to create jobs, supports state’s rights and drives a truck. In my opinion, very disappointing. His speech was very middle of the road. Not what we expected from a “long shot” candidate.
Ben Nelson finally showed and, after last year’s informative speech, I felt that Sen. Brown was new and maybe doesn’t want to go too far out on limb, but Ben will tell us like it is. Wrong. Sen. Nelson was just as distant and hard to read as Sen. Brown. Bad start to the day. And I had already sat for over an hour. I’ve got things to do. This wasn’t a productive use of my time. It was at that time I started to think why. Then it became clear. The Senate has nothing to do at this moment and nothing to go out there for. The House is where the action is. The House is where all the info and influence is at this point. I re-focused, as Rep. Mike Pence was next. Surely he could give us some insight. But I was fearful that the newness of the information about the Senate bill would have him dodging like Ben Stiller in Dodgeball.
But Mike Pence (R-IL) did not disappoint. He was straightforward and gave great advice. He encouraged us to “talk from the heart” in our meetings on the hill and understood that cost was as much an issue, if not more, than access and coverage. He also understood that we represented our clients and not the carriers and reminded us that we are not representative of and industry, but representatives of a way of life. He mentioned that in his home town, he is not approached by folks asking for healthcare reform. He is approached by folks asking for jobs. He feels the focus of this administration should be on jobs at this moment, and not healthcare. I was glad to see someone from Congress giving us some useful information.
Sen. Tom Coburn, who shined so brightly in the Healthcare Summit, was a no-show and we had to end the a.m. session. Our state contingent gathered for lunch to coordinate our meetings on the hill.
My first meeting on the hill was with Rep. Paul Tonko’s Leg. Director. I did not expect him to share a while lot since the news about the House vote and the mandatory House Dem’s meetings was announced just yesterday. I really wanted to get a feel for how he felt the house would vote and see if Rep. Tonko had any questions or concerns about the Senate bill they were being asked to vote on. His initial indication was that there was a lot of “arm twisting” going on and that he thought the Senate bill would pass the house. Tonko voted “yes” on the House bill last November and it is my opinion that he will vote “yes” on the senate bill too.
After our Tonko meeting it was off the Rep. Scott Murphy’s office. We had no meeting set, but we thought we would try to see if we could get a meeting. No go here, but they said they would call with a possible meeting tomorrow. Rep. Murphy voted “no” on the House bill last November, so it would be good to hear what the concerns are now.
Next it was a meeting with Rep. Michael Arcuri. He was in, but was running behind and asked us to wait until he finished up. After some time, an aide came in and noted she would meet with us until Rep. Arcuri finished. We stated our case, but a got a very neutral response from the aide. It was apparent that she was not going to tip which way Mr. Arcuri was leaning. Arcuri voted “yes” on the House bill in November and had just been quoted in a newspaper as being opposed to the Senate bill. We finished our meeting without having met with Mr. Arcuri and headed out.
As we went down the hall Rep. Arcuri came towards us. We stopped and he spent a moment with us in the hall. He was extremely friendly and gracious, but gave us the indication that he was leaning towards a “yes” vote. In his words, “we may never be this close”. We thanked him, made our case for our concerns, shook his hand and headed out.
On the walk back, all of us (Norm Michaels, Chris Koetzle, Kishan Perera and I) could not help but come to the conclusion that a “yes” vote is very much a reality. It seems the House is going to place its trust in the Senate to fix the bill (through reconciliation) and pass health care reform.
Tomorrows appointments include both our Senators (Schumer & Gillibrand) as well as another try for Murphy, a meeting with Rep. Hall, Rep. Rangel and Rep. Maloney.
I will try to ascertain the outcomes of the meetings I was not involved with. In the meantime, the over-arching message is health care reform seems to be pouring like and avalanche coming down the mountain.
Good night all.
Pete

CapCon 2010 Day 1

CapCon Day 1

Wow. All I can say is wow.

What an amazing first day here at CapCon. What serendipitous timing that we are all here as health care reform is taking leaps. Wow. No time for casual gatherings or for photos and back slaps. I had barely enough time to scarf down a chicken salad sandwich and return one call before launching myself into the next session. The day flew by and I was energized by it.
Today started with the Pledge of Allegiance, followed by the National Anthem and then introductions of the NAHU Board, various committee heads and NAHU staff. Then Janet Trautwein did a very god job of laying out the reasons why we are here and how NAHU is prepared to address the questions raised in the proposed legislation. She did an excellent job of preparing us for what we need to do on “The Hill” over the next couple of days. She also described the path by which the Senate Bill, passed on Christmas Eve, would most like go through the House. I’ll expand more on that in a minute.

Next, we heard from Stuart Rothenberg, Editor and Publisher of the Rothenberg Political Report, who gave us an overview of health care reform and the political election cycle. I must admit, I’m more of a “policy junkie” than a “political junkie” so his political insights were welcomed. Stuart made many references to polling numbers. In an election, polls mean quite a bit. This is an election year and many legislators want reform, but also want to get re-elected too. He gave us two good resources if you want to keep your finger on the “pulse” of the polls- www.realclearpolitics.com & www.pollster.com . The biggest poll he felt mattered was the one that measured the public’s confidence in the leadership of the country. That approval rating currently sits around the mid-30’s. Not very good and is a sure tell-tale sign as to the public’s waning tolerance for “spend and spend some more” government. He referred to it as “Big Government Fatigue”.

The next topic was the importance of political involvement. I had felt that message had already been received, and they were running late, so I snuck out to check e-mails and return a call (I still have a business to run).

After my work, it was a quick sandwich and then off to our regional meeting where, Norm Michaels, our regional VP, headed up a session that gave an update from our region (our region includes most of the northeastern states). Here we introduced ourselves, talked about membership, heard tips on board development and coordinated our legislative appointments.
I know I’m going on too much, but I haven’t even gotten to the most important part of the day yet. I hope you keep reading.

In my first breakout session, the speaker announced that there was breaking news. It had just been announced that the House was calling for a vote on the Christmas Eve-passed Senate bill in just 10 days and that a mandatory meeting of all the House Democrats is scheduled for Wednesday morning. The session was about NAHU’s plan for reform, and I took some notes, but I kept thinking about this House meeting, the Senate bill and how reconciliation tied all this together. I skipped the next session and found our Director of State Affairs, Adam Brackemyre, and asked him to explain it all to me. He was all too happy to help. Here’s what it all means;

Apparently the President is asking the House to vote (and pass) the Senate bill that was passed on Christmas Eve. Then send that bill, along with a list of things the House wants to see changed in the bill (almost akin to a “wish list”) and the Senate will “fix” it through a voting process called “Reconciliation”. To the best of my knowledge, reconciliation is a process by which a simple majority vote will approve legislation and there is shorter time for debate than during the “regular” process. There are two problems here; (1) the House must trust the Senate to implement their “fixes” into the final bill. The Senate could not change anything and pass the bill onto the President for a signature (since now the same bill passed both the House and the Senate) and then it will become a law. This is a huge extension of faith on the part of the House. (2) In the past, the reconciliation process has only been used for items that relate directly to the budget. There are two major, non-budget, issues in the Senate bill- Abortion and Immigration. These are moral issues and it is unclear if the Senate can even use reconciliation if the Senate Parliamentarian cries “foul” on non-budget issues. There are theories that the Vice President can override the Parliamentarian, but we are getting way ahead of ourselves. The message here is that we are entering uncharted waters and we can’t afford any mistakes.

The House vote now takes center stage and finding out what Representative’s support this and who does not is “mission critical”.

Lastly, but certainly not the least was our final speaker of the day, Len Nichols, the Director of Health Policy Program at the New America Foundation. In my opinion, Len was nothing short of amazing. I’ve been to many conferences and have had the pleasure of seeing many speakers, but Len was about the best I’ve ever seen. I am not kidding. Len is an economist and you might be thinking his presentation was similar to CPA lecture, but he put together a presentation that was interesting and inspiring. While pulling together statistics and numbers that gave validity to his statements, he had us captivated. He was not compromising. Some of his statements cut us to the quick, however, the manner in which he delivered them did not allow us the ability to deny them. It was truly something to be experienced. You could have heard a pin drop during his pauses. I recommend you find him on some social outlet and follow him.

Once more, wow what a day. Tomorrow has some big shoes to fill. I am honored to be here on your behalf. Thank you and stay tuned for my tweets.

Pete

The Day Healthcare Reform Stood Still

Greetings from our Nation’s Capitol,

It is the eve of CapCon and I am anxious to get started. These are historic times for our industry as we stand at the very precipice of health care reform. As I thought about how I would “kick off” CapCon, I was reminded of a scene from the 2008 re-make of the 1950’s sci-fi film, The Day the Earth Stood Still, where Keanu Reeves plays Klaatu, an alien sent to monitor how humans have treated the earth and all its resources. Klaatu is on earth to decide if humans should be allowed to continue to occupy the planet.

In one particular scene a human begs Klaatu not to allow the destruction of the human race by explaining how human crisis need to be taken to the very edge before change can truly occur. The person goes on to say that it is sometimes necessary to teeter at the very precipice of annihilation in order to create the kind of change that results in better things. It is at that critical point where we come together. This is where we forget petty differences and individual agendas. This is where only one thing matters and everyone can see it.

No one doubts that these are historic times. No one doubts that we need health care reform. No one doubts that we need change. I believe we stand at the precipice of health care reform today. Health care presents some interesting challenges to us. One the one hand we have the moral issue that everyone deserves some form of care when they are sick and/or ailing. On the other hand we have the economic challenges that force the concept of rationing. Wrap all this around an industry that employs millions, involves both the public and private sectors, is sometimes driven by the demands of stockholders and is 1/6th of our nation's economy and it is not too hard to see there may be no “easy fix”.

I wonder if we, unfortunately, somehow need this crisis in health care in order to bring us all together with the narrowed purpose that is only clearly visible at the precipice of annihilation.

Last year we were successful at stopping a “hurried” fix of the system. I did not believe then, nor do I now, that the hurried fixes would have worked. We have a moment now. A moment where we have the attention of Washington and the hopes of our clients and customers. We only have a moment. We need to make it count and suggest changes and reforms that will create a better health care system. If not, I fear we, as workers in the health care industry, will suffer the same suggested fate the humans faced in the Day the Earth Stood Still. I believe this is a huge challenge. I hope we are up for it.

Keep this concept in mind as you read the blog over the next few days. I know I will.

Pete

Welcome to the 2010 NYSAHU Capitol Conference Blog!

Peter Andrew, Council of Community Services, has agreed again this year to provide up to the minute insights on Capitol Conference 2010! Check back daily to learn about Peter's activities during Capitol Conference! THANK YOU PETER.