HR 1077/ S 343 The Medicare Respiratory Therapy Initiative:
Where
do We Go From Here?
AARC’s Virtual Lobby Day is a huge success with thousands of emails having been sent by respiratory therapists, patients, friends, and supporters of the respiratory community soliciting co-sponsorship of HR 1077 and
S 343. What does this
mean and how will we know if our efforts had an impact?
Background and What’s Next
Making changes to the Medicare
Program or to any legislation is a lengthy and complex process which
has been equated to a three-legged stool. What are the 3 legs of the
legislative stool?
Leg #1: Sponsorship
The issue first must be drafted into legislative language and then introduced as a bill by a supportive Representative or Senator known as a Sponsor, ideally in both houses of Congress.
Secondly, support in the form of co-sponsorship must be garnered from other legislators: the more co-sponsors, the greater chance a bill will pass. Members of Congress are asked over time to support and co-sponsor thousands of bills circulating on the Hill. Only if they hear from their constituents, their voters back home will legislators agree to co-sponsor a bill. Bills such as HR 1077/S 343 have the best chance of passing as they are not considered controversial.
Increasing the number of co-sponsors
is extremely important, and was of course the primary goal of the Virtual
Lobby Day.
Leg #2 Cost Determination
The Congressional Budget Office (CBO) is a non partisan agency tasked with analyzing the cost of legislation under consideration by Congress.
CBO analysts work in somewhat mysterious ways using hard data, and in the case of our legislation, Medicare data to project the cost to the Federal Government.
In 2009 the CBO estimated the
cost of enactment and implementation of our legislation to be about
$100 million over a ten year period, which actually is a relatively
low number by Congressional standards.
The new health care reform
legislation bill initiated a re-evaluation by the CBO of all cost components
which resulted in a revision of the cost of our program to several billion
dollars. This second analysis was based on erroneous assumptions and
comingling of our provisions with other types of Medicare services.
Our key sponsors on the Hill have requested, and the CBO is currently
in the process of performing a third cost analysis based on more targeted
data.
Leg # 3 Passage “Vehicle”
Traditionally, no single piece of legislation passes Congress on its own. The provisions of one bill are taken as a whole and attached to many other individual bills which are tied to what is viewed by Congress as “must pass” legislation. What will be the next “must pass” bill is hard to predict and could include most anything.
There is speculation amongst health care advocates that a “Technical Corrections Bill” may be introduced to tweak the massive new health care reform law. It’s unlikely for many political reasons that Congress will undertake a health care reform technical corrections bill prior to the November mid-term elections. Furthermore, after the November elections, Congress may be called back to Washington, D.C. for a Lame Duck session if the results of the elections turn control of the House and/or the Senate over to the Republicans.
Traditionally Congress produces
some form of Medicare legislation every year, so if the appropriate
vehicle is not identified in 2010, it may still come along soon.
Conclusion
While Legs #1 and #2 are well
underway we need to continue to search for and to identify Leg # 3 the
“Vehicle”. In the meantime, please keep the emails going, and call
your members of Congress asking for their support as co-sponsors.
See Who’s Co-sponsoring Our Bill