Capitol Hill Report: Senate Finance Committee Weighs Options for Health Care Reform

May 18, 2009


By Mike Amery, Legislative Counsel, Federal Affairs, (202) 349-4299,

The mission of the Academy is to be "indispensable to its members." One way the Academy fulfills this mission is by representing of neurology in the halls of Congress. Capitol Hill Report presents regular updates on legislative action and how the AAN ensures that the voice of neurology is heard on Capitol Hill. The Academy's legislative counsel in Washington, DC, Mike Amery, offers weekly updates on advocacy for neurology and neurologic concerns.

If you visit the Senate Finance Committee, one of the first things you will see is a quote from former Republican Majority Leader and presidential candidate Bob Dole:

One of the highest honors that can come to a member of the U.S. Senate is to serve on the Committee on Finance. The Committee on Finance has since its creation been associated with some of the most significant and most controversial issues in U.S. history.
—Robert J. Dole

The quote is certainly true today as the Congress debates health reform: the Finance Committee has taken the clear lead in the debate.

Last Friday the committee took comments on a paper it released, "Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs." The Academy's Health Reform Task Force worked to submit comments and included a unique idea to provide incentives to providers of health care for patients who fall into one of 15 categories of special needs, including many neurologic disorders. The idea here is that paying for the management and coordination of care for these patients will improve the quality of care and lower costs through the elimination of unnecessary and duplicative care.

Because the Finance Committee has taken the lead, it has been vital to the Academy to make sure that we are in contact with the committee's members. I met with two key committee members this week: Sen. Charles Grassley (R-IA), who is the ranking member (i.e., lead Republican), and Ron Wyden (D-OR).

As ranking member, Sen. Grassley is the Republicans' point person on health care. In my conversation with him it was clear he understands that physicians are in a precarious position due to the failed Medicare formula that calls for cuts each year. He vowed to fix that. But for the rest of reform, he is very concerned about the "public option," which would provide a government-sponsored insurance option. Grassley said there was "an awful lot of conflict," but held out hope they could reach compromise on a public insurance option.

Sen. Wyden discussed his Healthy Americans Act (S. 391), which he has been pushing for several years. He brought this issue to the Academy's attention when he addressed the 2006 Neurology on the Hill event in Washington. The Healthy Americans Act is budget-neutral and provides private coverage for all Americans. However, detractors complain that it eliminates the tax deduction for health care, which represents a large tax increase.

Wyden's bill has 14 cosponsors, seven from each party. He is promoting his bill throughout the Congress as the only bill that is "on paper, paid for, and bipartisan."

The Finance Committee is getting closer to writing legislation, but for now, Wyden is correct on each of those points.

Read all of Mike Amery's reports on the Capitol Hill Report page.