Lawmakers Say Health Care Reform Bill May Lose Negotiated Payments

By Staff Report

Aug. 28, 2009

Two key lawmakers said that a provision in the House health care reform bill that would allow a public health plan to negotiate payments with providers could be dropped from a bill passed by a crucial House panel.

Rep. Pete Stark, D-California, chairman of the Ways and Means Health Subcommittee and a principal author of the America’s Affordable Health Choices Act, said he wants payments based on Medicare’s rate schedule—a measure that puts him at odds with the provider community as well as the more conservative wing of his party.

“I think most of us agree that we pay too much to providers now,” Stark told reporters on a conference call.

At issue is a provision included in a House bill that allows the Health and Human Services secretary to negotiate pay rates with hospitals and doctors. The measure was added after a bloc of fiscally conservative Democrats, known as Blue Dogs, threatened to stall the bill.

Providers have long contended that Medicare payments don’t cover the cost of care. Neither Stark nor Rep. Xavier Becerra, D-California, who helped shape negotiations between three different committees, suggested the provision would be a deal breaker, but each warned that it could drive up costs rather than lower them.

“To have negotiated rates would cost American taxpayers money,” Becerra said, citing a report by congressional budgeters. “If one of your principles is to really drive costs down, well, there’s tens of billions of dollars on the table right now in how you structure the public option.”

Stark, who is critical of the Blue Dog wing of the party, said lawmakers will continue to negotiate when they return to Washington in September.

Filed by Matthew DoBias of Modern Healthcare, a sister publication of Workforce Management. To comment, e-mail

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