Senator Kennedy and Impact on Health Reform?

This past week, with the death of Senator Edward Kennedy, Democrats lost not only a champion of healthcare reform, but also someone who was often able to work with Republicans for bipartisan reforms. Some are now focused on passing health reform in his memory while others argue that someone that was key to the potential for bipartisan reforms is now gone. While it may not change the outcome on health reform this fall, he does leave big shoes to fill.

Sen. Chris Dodd (D-CT) vowed to continue the fight for healthcare reform following the death of Senator Kennedy , but he could not say whether he intends to succeed Kennedy as chairman of the Senate health committee. Dodd, who chairs the Senate banking committee but spearheaded the health panel's five-week markup of health reform legislation, said he would take time to weigh his options and confer with Democratic leaders before making a decision.

The chairmanship of the Senate Health, Education, Labor and Pensions (HELP) Committee is one of many holes that Kennedy's death has left in the Senate. Dodd is now the panel's most senior Democrat, and could become its new chairman, if he is willing to give up the chairmanship of the Senate banking committee. If Dodd does not take the HELP position, the next senators in line would be Tom Harkin (IA) and Barbara Mikulski (MD). Harkin, like Dodd, would have to surrender his chairmanship of the Agriculture Committee in order to lead HELP.

HELP along with the Senate Finance Committee are the key committes for the Senate focused on health reform.

With Congress now in recess, what is the outlook for health reform?

With both the House and now the Senate going out on recess -- this is a perfect opportunity to assess the outlook for health reform. The Senate is the continues to have the best chance of moving forward with bipartisan health reform this year. In fact yesterday, President Obama met with the group of six Senators (being referred to as the Gang of Six) that are leading the charge on health care reform in the Senate which includes Senate Finance Chair Max Baucus (MT-D), Chuck Grassley (IA-R), Kent Conrad (ND-D), Jeff Bingaman (NM-D), Olympia Snowe (ME-R) and Mike Enzi (WY-R). The meeting did not resolve any key issues but the Senators are reported to have committed to continue negotiations over the recess with a goal of reaching some form of consensus by mid-September. This means that the earliest the Senate Finance would move to mark-up would be the week of September 14th. Key health reform issues that remain unresolved that are key to bipartisan support include:

• Public plan option and related details
• Independent MedPAC or expanded role for MedPAC as a rate setting authority
• Expansion of Medicaid and related budget impact for states
• Level of insurance subsidies for lower income families
• Mechanisms to fund health reform and other cuts or "pay fors"

Most experts are still projecting some form of health reform legislation will emerge this year but it is not likely until mid or late October based on the differences in bringing together the work from the various committees in both the Senate and House.

The House Energy & Commerce Committee staff will be working over the recess to identify the remaining amendments and determine which are noncontroversial and can be agreed upon by both sides to be made a part of the base bill to be marked up in September starting after the recess. Our understanding is that only the amendments submitted during the last mark-up will be considered and then those would be added as additional recommendations from the committee.

The House Democratic Leadership and the Chairman of the three Committees will then reconcile changes for a final bill for consideration on the House Floor potentially in early October. This means that both the House and Senate could finalize some form of health reform as early as late October.