BIZ PUSHES FOR CHANGES, reports WSJ’s Neil King Jr.: “Businesses are set to push for modifications to the Senate-approved health bill, while urging lawmakers to steer clear of the version passed by the House. The Senate bill, which passed 60-39 on Christmas Eve with no Republican backing, has drawn tentative support from some large corporations and industry groups, despite containing a range of provisions that they hope to change. By contrast, businesses of all sizes oppose the House bill, which contains more-stringent requirements on employers to offer health coverage to employees. … The support of business leaders isn't critical for passage, but it could help Democrats blunt Republican criticism that their bill is bad for the economy. Many of the country's biggest employers have raised alarms over a provision in the Senate bill that would tax a government subsidy on retiree drug benefits. The move could force an accounting step that would require hundreds of companies to sharply lower their earnings next year. Big businesses also worry that new taxes and fees proposed in both versions of the health legislation could come years before measures meant to contain wasteful spending in the delivery of health care by doctors and hospitals take effect. … Groups representing smaller and medium-sized firms have largely denounced the overall effort, saying it would drive up their costs. The Senate bill ‘implements crippling new taxes, and hurts our ability to create jobs at the worst possible time for the economy,’ said U.S. Chamber of Commerce Executive Vice President Bruce Josten.”

CONFERENCE GROUNDWORK BEING LAID, reports Roll Call’s David Drucker: “Congressional aides began laying the groundwork Monday for Democratic leaders in the House and Senate to negotiate competing health care reform bills into legislation that can be signed by President Barack Obama, a senior Senate aide confirmed. … ‘Everything happening this week is happening behind the scenes,’ the Senate aide said of preparations to reconcile the House and Senate bills. ‘Staff is taking the week to review documents. Informal staff meetings may happen, but nothing is scheduled just yet.’”

STATE LEVEL ACTION — NYT’s David Kirkpatrick reports: “Like about a dozen other states, Florida is debating a proposed amendment to its state constitution that would try to block, at least symbolically, much of the proposed federal health care overhaul on the grounds that it tramples individual liberty. But what unites the proposal’s legislative backers is more than ideology. Its 42 co-sponsors, all Republicans, were almost all recipients of outsized campaign contributions from major health care interests, a total of about $765,000 in 2008, according to a new study by the National Institute on Money in State Politics, a nonpartisan group based in Helena, Mont. It is just one example of how insurance companies, hospitals and other health care interests have been positioning themselves in statehouses across the country to influence the outcome of the proposed health care overhaul. Around the 2008 election, the groups that provide health care contributed about $102 million to state political campaigns across the country, surpassing the $89 million the same donors spent at the federal level, according to the institute. Any federal legislation is likely to supersede state constitutional amendments. But backers of the state measures say they want to send a message to Congress and also lay groundwork for fights about elements of the health care package that are expected to be left up to the states.”

COMPARATIVE EFFECTIVENESS IN SENATE BILL, reports Inside Health Policy: “The Senate’s final health care reform bill would not prevent [the Centers for Medicare and Medicaid Services] from using comparative effectiveness data, but it would impose limits and hurdles for the use of such research in reimbursement and coverage decisions by Medicare and other payers. Senate Majority Leader Harry Reid’s (D-NV) manager’s amendment tweaked the earlier bill’s comparative effectiveness research language but did not alter the overall impact of the legislation on CER. … Even though the legislation does not explicitly direct CMS to use CER data, the legislation provides HHS with a vehicle to incorporate CER data in decisions.” $5:

MEDICARE ADVANTAGE CUTS — AP’s Matt Sedensky reports: “Insurers constantly caution seniors that their Medicare Advantage perks, such as hearing aids, dental payments and even gym memberships will fizzle if Democrats get their way and cut government subsidies for them. But tens of billions of Medicare dollars funneled through insurers also pay for extras that never reach beneficiaries: multimillion-dollar salaries, executive retreats in Hawaii, Scotland and Cancun and massive expenditures on marketing to lure more customers to the privately administered Advantage plans that serve as an alternative to government-provided Medicare. The government-subsidized benefits that seniors on Advantage plans receive — often at premiums lower than Medicare premiums — are real, and are legitimately in danger in some cases if Democrats succeed in their health care overhaul. Medicare Advantage subsidies are on the chopping block to pay for the overhaul. Though there are marked differences between House and Senate versions, both bills would lower payments to private Medicare Advantage plans, which on average cost the government 14 percent more than traditional Medicare. The harshest critics of the Advantage program say patients are exchanging hassle-free coverage for a plan with cheap perks that may ultimately deny them necessary treatment.”

HEART DOCS SUE HHS, reports USA Today’s Steve Sternberg: “Heart specialists on Monday filed suit against Secretary of Health and Human Services Kathleen Sebelius in an effort to stave off steep Medicare fee cuts for routine office-based procedures such as nuclear stress tests and echocardiograms. The lawsuit, filed in U.S. District Court for the Southern District of Florida, charges that the government's planned cutbacks will deal a major blow to medical care in the USA, forcing thousands of cardiologists to shutter their offices, sell diagnostic equipment and work for hospitals, which charge more for the same procedures. … The issues raised in the lawsuit are not related to the health reform legislation being hammered out on Capitol Hill. But the dispute offers a revealing case study of the impact of payment reform on one specialty — cardiologists — and, ultimately, their patients."

LONG TERM CARE – AP’s Carla K. Johnson takes a look: “Most people don't buy long-term care insurance. They simply don't want to think about moving into an assisted living center or hiring a stranger to bathe them. … A program tucked into the health care overhaul legislation emerging from Congress … would create a voluntary long-term care insurance program to be run by the government. Voluntary, yes. But workers at participating companies would be automatically enrolled — critics say ‘tricked into’ enrolling — unless they opted out. People would see a deduction for the program from their paychecks — estimates range from $160 to $240 a month — unless they signed a form or clicked a box saying they wanted to keep the money. The proposed program would help shift the financial burden of an aging population from Medicaid, now the largest funder of long-term care, to individuals. The federal-state health insurance program for the poor is straining state budgets.”

Fred Barnes WSJ Op-Ed: “Democrats in Washington do have large majorities in Congress. But instead of reflecting popular opinion, they are pursuing wideranging initiatives in defiance of the views of the majority of Americans. This stands de Tocqueville's concept on its head. The most striking example is health-care reform. It is intensely unpopular but was approved by the House in November and the Senate on Christmas Eve. Asked in a Rasmussen poll in mid-December if they'd prefer no bill to ObamaCare, 57% said they would. Only 34% said they'd rather ObamaCare be enacted. Yet Democrats are forging ahead as if the public actually approves of their health-care reform. Why, when Republicans are preparing to hammer them on the issue in next year's elections, would they do that? Democrats offer different explanations — besides their obsessive attachment to national health care — which suggests that they aren't quite sure of the political fallout. After Senate Democrats locked up the 60th vote to assure Senate passage of ObamaCare, Mr. Obama sounded worry-free. Risk? What risk? … The president didn't mention the public's disapproval as expressed in countless polls. … David Axelrod, a senior adviser to the president, is more realistic. While acknowledging bad poll numbers, he suggested recently on ABC's ‘This Week’ that enactment of sweeping health-care legislation will melt public misgivings. … Ms. Pelosi, too, is brimming with wishful thinking. ‘Now we will have the attention placed on the truly great things that are in the bill that we have in common,’ she declared recently. And Sen. Chuck Schumer (D-N.Y.) told Politico, ‘When people see what is in this bill and when people see what it does, they will come around.’ … ‘I regard as impious and detestable the maxim that in matters of government the majority of a people has the right to do everything,’ de Tocqueville wrote roughly 175 years ago. But what about a congressional majority — which lacks a mandate from a majority of Americans — seeking to do everything? The Frenchman might have dubbed that the ‘tyranny of the minority.’”

WHO’S HIRING WHOM? POLITICO’S Kendra Marr reports on the lobbying contracts since Dec. 21: 
— McLeod Regional Health System hired Strategic Health Care. 
— Hall of Fame Foundation, Ltd., hired Hengen Group, LLC. 
— Lake Erie College of Osteopathic Medicine hired Arent Fox LLP. 
— Physician Sales & Service, Inc. hired The Fiorentino Group, LLC.
— North Colorado Medical Center Foundation hired Strategic Health Care. 
— Westview Hospital hired The Winston Terrell Group.

EDITED BY MICHAEL FALCONE

** Reform should have three goals — cover everyone, fix care, and make care affordable. Any plan that does all three is a winner. The debate should be about helping people and fixing care. Reform is needed now. View the video http://tiny.cc/1aXVx and visit http://kp.org/reform for thoughts on health care reform. **