It’s crunch time for health insurance reform, and Senator Tom Harkin and the three Iowa Democrats in the House “announced a major breakthrough today on the issue of Medicare payment reform in the final health care reform bill,” according to a joint press release. Excerpt:

[Representatives Dave] Loebsack, [Senator Tom] Harkin, [Leonard] Boswell and [Bruce] Braley have been outspoken advocates for changing the way Medicare pays health care providers for services, from its current fee-for-service system into a quality and value-based system.

Loebsack, Harkin, Boswell and Braley helped negotiate a compromise adding language to the health care reform bill that provides an immediate $800 million to address geographic disparities for both doctors and hospitals, as well as written guarantees from Health and Human Services Secretary Kathleen Sebelius for further action to reform Medicare reimbursement rates that do not qualify for reconciliation under the Byrd Rule. The Senate bill previously only provided a Medicare reimbursement fix for doctors.

The House reconciliation package maintained automatic implementation of a value index as part of the reimbursement structures for doctors, beginning in 2015.  This language was secured in the Senate bill with the help of Harkin and is based on Braley’s Medicare Payment Improvement Act, introduced in June 2009. Under the fixes secured in the Senate bill and the House reconciliation package, Iowa doctors will see five percent increases in current Medicare reimbursement rates in both 2010 and 2011.

I posted the whole press release, containing more details, after the jump. This deal appears to have secured the vote of Peter DeFazio (OR-04) as well. Yesterday he threatened to vote no because of language on the Medicare payments disparity.

President Barack Obama gave House Democrats a pep-talk today, and his speech (which wasn’t pre-written) got rave reviews from many Democrats. If only the Senate bill were as good as Obama made it sound. (UPDATE: I posted the White House transcript of Obama’s speech after the jump.)

House Democratic leaders have decided to ditch the “deem and pass” method for passing health insurance reform with a single vote, even though the legislative procedure isn’t as rare or controversial as Republicans would have you believe. Instead, the House will hold an hour of flood debate tomorrow on “the rule to allow reconcilation to get to the floor,” then House members will vote on the rule, then they will debate the Senate health insurance reform bill and vote on it. I assume this means that House Speaker Nancy Pelosi is confident she has the 216 votes she needs.

Bart Stupak is now claiming only about half a dozen Democrats are willing to vote against the bill unless it contains major new restrictions on private insurance coverage of abortion. Stupak was supposed to hold a press conference this morning, but he cancelled it, so maybe that means he didn’t get the deal he was hoping for from Pelosi. David Dayen speculates on who is still in the Stupak bloc. David Waldman warns about the prospect that Stupak will use a “motion to recommit” to try to get his anti-abortion language into the reconciliation fix package.

Outside the Capitol, tea party protesters shouted racist insults and held signs threatening gun violence if health care reform passes. Congressional Republicans should disavow this reprehensible behavior, but of course they won’t.

Health Care for America NOW and the American Federation of State, County and Municipal Employees are running television ads this week thanking 20 Democrats in relatively tough districts who voted for the House health care reform bill last Saturday. If you live in the Des Moines viewing area, you may have seen this commercial about Congressman Leonard Boswell:

Corporate-funded conservative groups have targeted Boswell in negative ads this year because of his vote for the climate-change bill in June. Ads attacking the health care reform project (many funded by insurance industry fronts or the Chamber of Commerce) have been plentiful this summer and fall too. It makes sense for reform advocates to thank Boswell, as Iowa Republicans are gearing up to challenge him with State Senator Brad Zaun or some other well-known figure.  

In other health care reform news, Tom Harkin is among the Senate Democrats trying to keep the "Stupak amendment" language on abortion out of the Senate's version of health care reform. He's absolutely right that some people pushing amendments are trying to kill the bill rather than make it better. A lot of questions have been raised about whether defeating the bill was Representative Bart Stupak's main goal. Since 1992, Stupak has been involved with the fundamentalist Christian "Family" group and has lived in their house on C Street in Washington.  

Stupak claims that as many as 40 House Democrats would reject health care reform without his amendment, but yesterday House Whip James Clyburn said the Stupak amendment only gained 10 votes for the bill. Meanwhile, more than 40 House liberals are threatening to vote down the final bill out of conference if it contains the Stupak language.  

Final note: MyDD user Bruce Webb wrote an interesting piece about what he views as "the most important and overlooked sentence" in the House health care reform bill:  

Most of the criticism of HR3962 coming from the left revolves around the belief that the House bill has no premium and so no profit controls, that it in effect delivers millions of Americans into the hands of insurance companies who can continue to raise premiums at will while denying care by managing the risk pool in favor of those unlikely to make claims. This just is not true, not if the provision in this one sentence is properly implemented. In a stroke it guts the entire current business model of the insurance companies, based as it is on predation and selective coverage, and replaces it with a model where you can only make money by extending coverage to the widest range of customers and or delivering that coverage in a more efficient way.

 Like they say, go read the whole thing.
 

As you may have learned last week from LA Times reporting, and from Congressional Hearings, that Insurance companies routinely try to drop your Insurance policy, if you happen to get one of their “Hot List” illnesses.

Getting any of these illnesses, can Trigger the Insurance Company’s “Cancellation Police”, into action.

Denial Specialists scour your medical history, and cross-check that against your application, looking for any reason to Cancel, or rescind, your Insurance policy, thus saving the Insurance Company untold thousands in future payments for your expected Care. Denial Specialists, of course, earn bonuses for each Policy they cancel. What a system!

Those 4 illnesses (out of the 1000+ such Triggers) previously disclosed are:

breast cancer, high blood pressure, lymphoma and pregnancy

Well thanks to the tough questioning of the Oversight and Investigations Sub Committee, at least 2 more Triggering Illnesses have been disclosed, as indicated in the video and transcript of the Hearing:

The 2 other newly disclosed “Drop List” illnesses include:

ovarian cancer, and brain cancer