By Bill Peckham
Tomorrow is the big bipartisan meeting at Blair House which may open a path to passage of a health insurance reform bill. My understanding is if health insurance reform legislation were to pass, that the bulk of the legislative language would come from the Senate bill, which is the Senate's HR 3590, the relevant ESRD Program language was voted through initially in November and then revised with a Managers Amendment in December. For that language to go to the Presidents desk to be signed, all that would have to happen would be for the House of Representatives to vote on the amended Senate bill; this has been true since December.
The problem is that the House passed a health insurance reform bill significantly different from the Senate's and there needs to be a second bill with a package of changes to the Senate Bill, for the House to be willing to pass the Senate's bill. This package of changes will be the subject of tomorrow's meeting. One can imagine that anything could be added to the package but I would think that extending immunosuppressant drug coverage and/or mandating that the dialysis payment include oral drugs (as the House's health insurance reform bill, HR 3962, did) are not big enough issues to enter the discussion. Meaning extending immunosuppressant drug coverage is out.
The a package of changes will be about big things; the ESRD pieces are small in comparison. However, things get slipped into legislation all the time. Illinois Senator Durban, a supporter of extending immunosuppressant drug coverage, is attending tomorrow's meeting. Representative Stark, a proponent of including oral drugs in the dialysis payment bundle to pay for immunosuppressant drug coverage will not be in attendance.
Until changes to the Senate legislation are written into a bill and voted on by both Houses of Congress we can't be sure of the final ESRD provisions, except to say that in the absence of additional language, the Senates HR 3590 ESRD language will become law.