Annals of Long Term Care

In a major step forward for healthcare reform advocates, House Democratic leaders unveiled a reform bill, financed in large part by proposed tax increases for the wealthiest 1.2 % of U.S. households, that includes a public plan and would cover an additional 37 million Americans. After months of setbacks, House Democrats proposed the plan July 14, as this issue of Annals of Long-Term Care went to press.

The three House committees that drafted the proposal—the committees on Ways and Means, Energy and Commerce, and Education and Labor—were to begin considering amendments to the bill on July 16. While the proposal is expected to win support of most Democrats, it faces opposition from Republicans, the insurance industry, and business groups, which object to a provision in the proposal that would require companies with payrolls exceeding $250,000 to pay a fee equal to 2-8% of wages if they don’t provide their workers with coverage.

In the Senate, the Senate Health Education Labor and Pensions (HELP) Committee was on the brink of approving comprehensive health legislation on July 14, but the Senate Finance Committee was still struggling to find a way to finance the legislation.

Whether Congress would meet President Obama’s deadline and enact reform legislation before leaving for its August recess remained to be seen.

The American Geriatrics Society (AGS)—both independently and in coalition with like-minded organizations—has been advocating and continues to advocate for reform legislation that ensures older adults access to appropriate, high-quality care. In visits, calls, and letters to key lawmakers and their staff, AGS has urged and continues to urge inclusion of provisions that support quality, cost-effective healthcare for older persons.

In June, AGS Deputy Executive Vice President Nancy Lundebjerg, MPH, and AGS Board Chair John Murphy, MD, met with staff of several Congressional offices to advocate for inclusion of measures supporting eldercare in the House reform proposal. Later, in a letter to House Energy and Commerce Committee Chair Henry Waxman commenting on a draft of the House reform plan, AGS lauded the draft for including some of these measures and reiterated calls for others. Among other things, AGS called for the inclusion of provisions from two bills: “The Retooling the Healthcare Workforce for an Aging America Act,” and the “Health Professions and Primary Care Reinvestment Act.” The “Retooling” bill, proposed by Rep. Jan Schakowsky (D-IL) and Senate Aging Committee Chair Herb Kohl (D-WI), would implement recommendations from the Institute of Medicine’s groundbreaking Retooling for an Aging America: Building the Health Care Workforce. And the “Health Professions” bill, which Rep. Diana DeGette (D-CO) and then-Sen. Hilary Clinton proposed last year, would expand access to care to the underserved, improve the training of primary care physicians and other health professionals, and train more health professions faculty.

Because these provisions were not included in the House reform bill unveiled July 14, AGS and the Eldercare Workforce Alliance (EWA)—a coalition that includes the AGS and other organizations representing older adults and the health professionals, direct-care workers, and family caregivers who care for them—was working with key House staff on an amendment that would add these measures as this issue of Annals went to press.

Ms. Lundebjerg and Dr. Murphy also met with staff of several Congressional offices in June to advocate for inclusion of provisions supporting quality elder healthcare in Senate reform plans.