Senate Finance Committee passes Baucus healthcare bill

WASHINGTON The Senate Finance Committee passed a long-awaited $829 billion healthcare bill Tuesday by a 14-9 vote.

Sen. Olympia Snowe, R-Maine, whose vote was crucial to Democrats, was the only Republican to support the Democratic legislation.

The total cost of the Senate proposal – aimed at overhauling the nation’s health system and broadening health coverage – would be $829 billion over the next 10 years, according to a CBO report issued Oct. 7. That cost includes $345 billion in additional spending for Medicaid and the Children’s Health Insurance Program, as well as federal outlays of $461 billion to help lower-income Americans buy insurance if they can’t afford it under the mandatory coverage plan advanced in the Senate and Obama health proposals.

Despite those costs, the Congressional Budget Office projected the Senate plan will cut long-term health costs. The reform bill, hammered out over the summer with the strong support of Finance Committee chairman Max Baucus, D-Mont., would lower the federal deficit by $81 billion while extending insurance benefits to another 29 million Americans, congressional budgeters predicted. The savings would come largely by slowing the projected rise in Medicare spending – in particular by shaving $117 billion in payments to privately run Medicaid Advantage plans – and by taxing high-cost insurance policies.

The advance of the so-called America’s Healthy Future Act out of committee drew praise – and a hopeful reaction – from the independent pharmacy lobby. The bill, noted the National Community Pharmacists Association this afternoon, “includes several provisions ensuring the ability of community pharmacies to continue providing critical services to patients.”

In a statement, NCPA EVP and CEO Bruce Roberts commended the Finance Committee and the leadership of its chairman, Montana Democrat Max Baucus. “Chairman Baucus understands the significant role community pharmacies play, and we appreciate his support,” said Roberts.

Among the bill’s pharmacy-friendly elements, he noted, was language that gives pharmacies a somewhat more generous reimbursement for dispensing generic drugs to patients covered by Medicaid. Under a formula supported by Baucus, Medicaid would pay pharmacies 175% of the weighted average of the average manufacturer’s price of the generic.

Roberts called that provision “a very good start to protecting beneficiary access to community pharmacies while avoiding severe cuts that would do the opposite.

“We want to continue to work with the Senate and the Congress to assure that the level remains high enough for community pharmacies to continue to keep their doors open and provide pharmacy services to Medicaid patients,” added NCPA’s top manager.

Roberts also lauded the bill’s exemption of small-scale pharmacies from Medicare’s durable medical equipment accreditation regulation, which pharmacy leaders have long opposed as an unwarranted burden on their business and professional practice. “Pharmacists are already state-licensed and other health care providers are exempted,” he argued, adding that the Baucus bill “preserves seniors’ access to diabetes testing supplies and other essential goods.”

NCPA also strongly supports an amendment from Senator Maria Cantwell, D-Wash., that was added to the legislation before its passage by the Finance Committee. That amendment, Roberts said, “will lead to transparency regarding the deals pharmacy benefit managers…reach with drug manufacturers.”

The PBM industry strongly opposes the Cantwell amendment. Other provisions, including a plan to tax premium, high-cost insurance benefits provided by employers, have also drawn opposition from the insurance industry and other interest groups.

That opposition promises to make the road to passage of any health reform bill, including the Baucus plan, a rocky one in the coming weeks. “Now our attention turns to the melding of the separate Senate Finance and HELP committee bills into one bill that will be considered by the full Senate,” said Roberts. “While some portions of the bill do raise concerns for community pharmacies, we urge the Senate leadership to keep these and other pharmacy-friendly provisions in that bill, because they are also patient-friendly, and that’s what everyone should be striving for if America’s health care system is truly going to be reformed for the better.”