Thursday, 28 January 2010

USA - What are the US healthcare reform options after the Democrats have lost the supermajority in the Congress?

Options exist but it is not clear that a stripped-down healthcare reform bill can be approved soon.

A key aspect of President Obama’s policies has been to overhaul the healthcare system. In January 2010, the Democrats lost the Senate’s seat in Massachusetts to the Republican candidate Scott Brown. For decades, this seat had been held by Ted Kennedy who had pushed the healthcare reform bill. The loss brought an end to the Democrats’ 60-seat supermajority in the Senate. This is a blow to Barack Obama’s agenda and the healthcare reform is now in doubt. Mr Brown has already expressed his opposition to the healthcare reform bill. Ironically, he has supported a similar bill in Massachusetts.

There are several options left for passing the healthcare reform bill, but none of them are clear. One option would be for Democrats to press the House to pass the Senate’s version of the healthcare reform; the Senate’s version was approved on 24th December 2009, without any support from the Republicans, whilst the House bill was approved on 7th November 2009 with one Republican’s backing. However, House Speaker Nancy Pelosi has said that she does not think that this version could pass the House without changes, particularly regarding the tax on high-insurance plans and the less-restrictive use of federal funds to cover abortions.

Another option would be to put together a scaled-back healthcare bill and take it through the reconciliation process, but such a move seems unlikely too. This would require a 51-vote majority in the Senate but is limited to issues with a budgetary impact. Both options would require more time just when Democrats need to address other major issues, especially the overhaul of banking regulations, an energy bill for limiting emissions of greenhouse gases and the immigration reform that would regularise the status of illegal immigrants. President Obama has indicated that he might be willing to scale back his proposed healthcare overhaul in order to attract bipartisan support but it is not clear that a stripped-down bill can be approved soon.

Further reading - A detailed analysis of the US pharmaceutical market is available from Espicom: The Pharmaceutical Market: USA (published January 2010)

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