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Fine Print In Health Overhaul Reveals Also-Rans

Even now, after all these months of legislating and jawboning, there's a lot of detail to pick over in the revisions by House Democrats to the health overhaul package passed by the Senate.

What's included in the fixes House Democrats are looking to pass? The New York Times produced a nifty interactive graphic that hits some of the biggest issues. Kaiser Health News covers some of the high points in this roundup.

But what got left out? For comparison, rewind to late February when President Obama finally released his proposal for what the administration really, really wanted to be part of health overhaul and some things it thought should be scratched.

Medicaid Deals: The administration wanted to jettison the $100 million Medicaid deal branded the "Cornhusker Kickback" to land the vote of Nebraska Sen. Ben Nelson, and, sure enough, that's out. Still, extra money for other states, including Louisiana, remain.

Medicare Advantage: Also gone, protection against cuts to Medicare Advantage that would have helped about 800,000 Floridians and not seniors in other states. The administration has targeted government subsidies to the privately run Medicare plans for cost savings.

Insurance Rate Commission: In case you somehow missed it, the administration has been making a lot of its case for health overhaul on the basis of runaway increases in insurance premiums. The administration proposed to establish a federal commission to review rates and reject unreasonable ones. But the provision didn't make it off the drawing board because parliamentary rules don't allow items without a direct effect on the federal budget to be handled in reconciliation.

Delays In Generic Drugs: The Federal Trade Commission has been fighting -- and often losing -- court battles to prevent deals that brand-name drugmakers cut with generics companies to delay the launches of cheaper medicines. Obama had looked to overhaul legislation as a way to beef up the FTC's powers, but those provisions haven't survived.

Malpractice Reform: For all the talk about the administration embracing additional changes in the system of medical malpractice, including some Republican ideas, you won't find evidence of that in the reconciliation package.

Copyright 2020 NPR. To see more, visit https://www.npr.org.

Scott Hensley edits stories about health, biomedical research and pharmaceuticals for NPR's Science desk. During the COVID-19 pandemic, he has led the desk's reporting on the development of vaccines against the coronavirus.