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Senate leaders face opposition, scrape for votes as reform debate rages

BY Jim Frederick

WASHINGTON —With the health-reform debate raging in the Senate as of press time, the fate of President Obama’s top domestic priority—overhauling the U.S. health system and extending coverage to uninsured Americans—rests with a handful of undecided lawmakers weighing the pros and cons of the massive $848 billion health-overhaul plan.

Democratic leaders in the Senate are faced with a difficult balancing act. They’re racing to muster the votes needed to pass what would be one of the most sweeping, expensive and far-reaching efforts to re-engineer a major part of the U.S. economy that has ever been attempted by federal legislation. But given almost unanimous opposition from Senate Republicans and the misgivings of their own party members over various elements of the bill, dubbed the Patient Protection and Affordable Care Act, they face what could be a long and rancorous battle to keep the bill’s most controversial elements from being stripped away in a gauntlet of compromises.

After months of wrangling in committee meetings and weeks spent rounding up support from his Democratic colleagues, Senate majority leader Harry Reid, D-Nev., was able to put together the fragile, 60-vote coalition needed to bring his health-reform package to the full Senate for debate at the end of November.

The Reid bill would overhaul the U.S. health system by providing coverage to millions of uninsured Americans, mandating that all Americans have coverage, creating a publicly funded insurance option to compete with private insurance plans and setting up new incentives and processes to promote healthier lifestyles and disease prevention. Pharmacy advocates support some aspects of the proposal, including its plan to boost funding for medication therapy management initiatives, its easing of restrictions on the sale of Medicare Part B durable medical equipment and supplies by pharmacies, and—perhaps most importantly—its somewhat more generous plan to compensate pharmacies for dispensing generic drugs to Medicaid patients.

To help defray the expected cost of the overhaul—estimated to be $848 billion over 10 years—the Senate plan would levy a tax on the highest-value insurance plans dispensed by employers. In line with White House goals, the Reid proposal also would create a professional review board to seek out the most cost-effective treatments and reduce waste and unneeded medical procedures in government-funded health programs.

Republicans remain strongly opposed to the Patient Protection and Affordable Care Act. Among the hot-button issues that could delay or derail its passage: federal funding for abortions, the public insurance plan option, the mandate that all Americans must buy insurance or face fines if they don’t and the taxation of premium health plans.

Nevertheless, the chances for passage of the Senate bill got a major boost early this month from the nonpartisan Congressional Budget Office. Reporting on its analysis of the bill’s expected costs over the next decade, the CBO concluded that most Americans would see their health insurance rates either hold steady or decline if the bill becomes law.

The majority of Americans who get their health coverage from their employers will see either no increase or a modest drop in their premiums under the Senate plan, according to the budget office. For large employers, premiums would drop as much as 3%. Small employers could see either a slight drop or a modest uptick in premium costs, while the smallest employers could use tax credits under the Senate plan to lower their premium costs by as much as 11%, the CBO predicted.

However, those changes wouldn’t become fully effective until the full implementation of the health overhaul bill in 2016. In addition, some of the estimated 32 million Americans expected to buy their own health coverage in 2016 would see an increase in their out-of-pocket costs of 10% or more, the CBO predicted, though many of those self-insured people would qualify for subsidies that would substantially cut their premiums.

Predictably, Senate Democrats and Republicans responded to the CBO analysis in strikingly different ways. Senate Finance Committee chairman Max Baucus, D-Mont., noted in a statement, “The vast majority of Americans will see lower premiums than they would if we don’t pass health reform.” Senate minority leader Mitch Mc- Connell, R-Ky., on the other hand, said the findings pointed out the fact that “most people will end up paying more or seeing no significant savings,” despite the high cost of the health overhaul plan.

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Hy-Vee names new president

BY Alaric DeArment

WEST DES MOINES, Iowa A 28-year employee of Hy-Vee has become its new president, according to published reports.

The company appointed Randall Edeker as president of the supermarket chain Thursday at the company’s annual meeting, succeeding Ric Jurgens, who had served as president since 2001 and will maintain his position as chairman and CEO.

Edeker had previously served as EVP and COO.

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Tricare expands vaccination coverage to pharmacies, clinics

BY DSN STAFF

NEW YORK Convenience and value. That’s what community pharmacy and their retail clinic partners deliver to their patients. And that’s what the Department of Defense is counting on in covering immunizations at local pharmacies and identifying convenient care clinics as network providers — two separate pieces of news issued within the past month that really underscore the importance of pharmacies and retail clinics in the delivery of health care today.

Prior to these announcements, military personnel interested in getting their flu shots had to schedule an appointment with their doctor, as Tricare only covered the cost of shots delivered in a doctor’s office.

“As a convenient and accessible healthcare provider, pharmacy is uniquely positioned to offer services for patients, such as vaccinations,” stated Steve Anderson, president and CEO for the National Association of Chain Drug Stores. Anderson noted that as of earlier this year, pharmacists have the ability to immunize patients in all 50 states. “[This] presents an important opportunity for pharmacists to counsel patients during their visit, and an additional healthcare provider from which to obtain these vaccinations.”

It’s also quite a bit of opportunity for pharmacy — Tricare provides healthcare coverage for 9.5 million eligible beneficiaries. Those beneficiaries pick up almost 2.3 million prescriptions every week, and 1.2 million of those at retail pharmacies, according to Tricare .

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