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The Health Care Reform debate has begun and ASHA is working with Congress to ensure that speech-language pathology and audiology services remain part of the debate. While not taking a position on the overall reshaping of the health care delivery system, ASHA is working to ensure that regardless of what is finally passed into law, speech-language pathology and audiology issues, as identified in ASHA's 2009 Public Policy Agenda, will be addressed.
ASHA is using its 2009 Public Policy Agenda [PDF] as the basis of its lobbying efforts related to health care reform, which includes issues such as therapy caps, direct access to audiologists, fixing the conversion factor of the Medicare fee schedule, and comprehensive coverage of services.
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Both the Senate and House of Representatives have introduced separate health care reform proposals. There has been much debate related to the cost of these programs, which have been scored by the Congressional Budget Office (CBO) to be in excess of a trillion dollars. In complying with President Obama's pledge to pay for health care reform within the budget, the committees are looking at various ways to reduce the cost of the bill while still providing comprehensive coverage.
This is the first step in what will be a long legislative process. The legislation must pass both the House and the Senate, difference in the bills must be reconciled and agreed to before the bill can be sent to the president to be signed into law.
Obama Administration
President Obama has made health care reform a top priority for his administration and has pledged to pass comprehensive reform by October 2009. President Obama's health care agenda can be found on the White House Web site.
Senate Health, Education, Labor and Pensions Committee (HELP)
The HELP committee has finalized its proposal, the Affordable Health Choices Act, which is expected to be combined with the Senate Finance proposal. While many details have yet to be ironed out, the legislation calls for a mandate for all individuals to obtain health care insurance, promote wellness and prevention, establishment of minimum federal requirements for health insurance coverage, and establish reforms in the current markets including the creation of state and regional entities (gateways), by which individuals can compare and purchase insurance coverage. The HELP legislation will also address health care workforce issues by establishing a commission to address shortage issues. The HELP legislation began debate on its health care proposal in early June.
The HELP legislation outlines the basic benefits that must be part of any health care plan, and includes the provision of rehabilitative and habilitative services and stresses the need for better coverage of pediatric services. The HELP Committee proposal does not address Medicare or Medicaid issues as those are under the jurisdiction of the Senate Finance Committee. The HELP Committee proceedings can be followed on their Web site.
The Senate Finance Committee ihas released their legislation as well. Senator Baucus (D-MT), chairman of the Finance committee delayed the introduction and hearings on their legislation due to the projected cost of the legislative proposal. The Chairman has pledged to work on a bi-partisan plan. The Finance Committee actions can be followed on their Web site.
It is anticipated that following consideration of the two bills in their respective committees, the two proposals will be combined before being debated by the full Senate.
The House of Representative has taken a different approach in drafting health care reform legislation. All three committees of jurisdiction—Ways and Means, Energy and Commerce, and Education and Labor—worked together to introduce one comprehensive proposal. Each committee has now reviewed, updated, and reported out of committee their proposed changes to the bill. The changes will be combined again and taken to the floor for vote by full the full House in September.
The House bill is more comprehensive in nature in that it addresses reforms in both the Medicare and Medicaid program. As part of overall health care reform, the bill calls for the development of a National Health Care Exchange. In order to participate in the exchange, the insurance companies would have to provide specific benefits including rehabilitative and would require that insurance companies cover well baby and child care which would include hearing services, equipment, and supplies for children under 21 years of age. An additional provision of the legislation would prohibit insurance companies from imposing any limits unrelated to the clinical appropriateness of coverage.
The legislation includes Medicare provisions that include a two-year extension of the therapy cap exceptions process and makes changes to the current physician fee schedule calculation rate.
No matter what your philosophical position in on the issue of health care reform, speech-language pathologists and audiologists have a vested interested and defined stake in the process. Please take this unique opportunity to speak up and speak out about the needs of your profession and the people you serve.
Congress will take its scheduled recesses to engage in District Work from August 10-September 4, your elected officials will be back in their home states and districts, eager and ready to hear from constituents about their desires and concerns, especially around the topic of health care reform.
Information on your legislators can be found on ASHA's Take Action site. You are encouraged to call your legislators and inquire about any Town Hall Meetings or other public forum being held in your community that provide an opportunity to listen, learn, and speak up about the health care reform debate. In many cases, these forums are held within driving distance to your home or work in the evenings or weekends, making it easy and convenient to attend.
Again, ASHA will work towards advancing its public policy agenda as part of the debate on health care reform and is working to included in any plan signed into law the following principles.
- Comprehensive coverage of speech-language pathology and audiology services for all individuals including children.
- Appropriate reimbursement and access to speech-language pathology and audiology services.
- Recognition of telehealth as a service deliver model
- Repeal of the therapy caps
- Inclusion in workforce provisions to address shortages through loan repayment and forgiveness programs.
Other Web Sites Related to Health Care Reform
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