Capitol Hill Report: Blue Dog Card Game

June 30, 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.

With the release of the Tri-Committee health care plan, even without cost details, the health care debate moved to the House last week. As I mentioned last week, the Senate delayed its public discussion after its first draft came in at a "cool" $1.6 trillion. Rumor has it that the Senate has reduced their cost to $1 trillion and that they will take up a bill after the July 4 recess, which begins this week.

The House plan—written by the Democratic chairs of the Ways & Means, Energy & Commerce, and Education & Labor Committees—eliminates the physician reimbursement plan known as the "Sustainable Growth Rate" (SGR), provides a positive update for 2010, and then reverts to a two-tiered SGR that will provide most CPT codes with an annual increase of one or two percent. It also provides a five or ten percent increase reserved for primary care physicians.

Academy members worked this week to provide comments on the House bill. The Academy's plan to focus on patient needs is included in the comments.

Without a cost number on the House bill, it still leaves the process in the dark, though much of the final result will depend on where the congressional "Blue Dogs"—a group of 58 fiscally conservative Democrats—will come down on the bill.

I met with the chair of the Blue Dog Health Task Force, Mike Ross (D-AR), on Wednesday. Ross detailed the Blue Dogs' concerns with a public plan, as well as their hopes for a complete offset of any new spending.

I asked him what his health care reform plan would look like if he were the Speaker of the House and the Blue Dogs were the majority. He paused, then said in a clearly joking manner, "Well, it would be common sense, of course." Then I asked in a fun manner, "What does common sense mean?" After another pause, Ross, with a smile on his face, responded, "The values we all share."

The Blue Dogs may hold the cards, but, like almost everyone else, they don't have a plan either.

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