Expert discusses the next steps for health care reform in the U.S.

Major milestone in the health care debate

With health care legislation now up for debate in both the House and the Senate, comprehensive health care reform is closer than ever, says Timothy McBride, Ph.D., health economist and associate dean of public health at the George Warren Brown School of Social Work at Washington University in St. Louis.

Congressional leadership is working to consolidate the legislation so it can be brought to the floors for a vote.

“If both chambers pass the legislation, which looks increasingly possible at this point, the legislation that is passed will still be quite different in the House compared to the Senate,” McBride says. “It will take a conference committee to work on compromise legislation.”


Health policy analysts expect the conference committee to complete its work, have the legislation sent back to each chamber for passage, and have legislation passed for the President’s signature by the end of the year.

“The legislation passed out of the Senate Finance committee is significantly different from the proposal brought to the committee by Sen. Max Baucus, chairman of the Senate Finance Committee,” McBride says.

Estimates are that about 94% of the population will be covered by health insurance if the legislation proposed by Senate Finance passes, and that it will cost about $829 billion over ten years to achieve this.

“It is much more likely the legislation will be acceptable now to the majority of Democrats, but some work still needs to be done before that can happen,” McBride says. “It is unlikely that Republicans will support the legislation, other than perhaps Senator Snowe from Maine, who voted in favor of the bill in the Senate Finance Committee.”

McBride has been active in testifying before Congress and consulting with important policy constituencies on Medicare, insurance and health policy issues. He is a member of the Rural Policy Research Institute Health Panel that provides expert advice on rural health issues to the U.S. Congress and other policymakers.

McBride says that there is still much work to be done with health care reform and contentious issues remain. Among those are the public option, how the legislation will be financed, the generosity of the coverage, Medicare Advantage reforms and whether there will be mandates for employers to offer coverage.