Stakeholders Sign On – In the waiting room in anticipation of legislative proposals that will establish the outline of how health system reform will become reality, there still are efforts underway to bring the principle parties together in agreement for action. This week, a joint letter was sent to President Obama setting out that "as stakeholder representatives, (we) are committed to doing our part to make reform a reality in order to make the system more affordable and effective for patients and purchasers. We stand ready to work with you to accomplish this goal." The stakeholders who submitted the letter were the Advanced Medical Technology Association, America’s Health Insurance Plans, the American Hospital Association, the American Medical Association, the Pharmaceutical Research and Manufacturers of America, and the Service Employees International Union. On the very deep concern over the growing cost of health care in America, the letter states: "As restructuring takes hold and the population’s health improves over the coming decade, we will do our part to achieve your Administration’s goal of decreasing by 1.5 percentage points the annual health care spending growth rate-saving $2 trillion or more. This represents more than a 20% reduction in the projected rate of growth." CQ HealthBeat reports that HHS Secretary Sibelius said that the President has given the health care industry groups until June 1 to submit specific recommendations on how they plan to reduce health care spending.

Policy Options to Expand Health Care Coverage – The Senate Finance Committee released a 63-page paper that sets out potential policy directions on eight coverage aspects: insurance market reforms; coverage affordability; a public insurance plan; the role of existing government programs; individual and employer responsibilities; prevention and wellness; long term care; and health disparities. Politico reports that the paper presents three public plan options: a "Medicare-like" plan; regional third-party administrators outside of HHS overseeing and regulating the plan; and state administered plans. A related option calls for a mandate for individuals to elect coverage, enforced through a tax on a percentage of the premium for the cheapest coverage offered through an insurance exchange. The introduction carries an interesting caveat: "While these proposed options are jointly offered for discussion, not all the options in this document have the support of Chairman Baucus or Ranking Member Grassley."

Republicans – Representative Blunt, chair of the 21-member House Republican Health Care Solutions Group, said that the Group will issue health system reform proposals before Congress’ Memorial Day recess. The Hill quotes Representative Blunt as saying "We hope to have a set of solutions outlined that we think Republicans can rally around for our members to take home with them when they leave here at the end of the month."

Funding – One of the contentious issues pertaining to health system reform funding is the possibility of taxing the value of employee health benefits. This was raised again at a Senate Finance Committee hearing as reported by the Wall Street Journal. Estimates of lost revenue from this tax emption were set at $246 billion in 2007 and $297 billion in 2010. USA Today reports Chairman Baucus as saying: "We are not going to eliminate that exclusion," but "we should look at ways to modify the current tax exclusion so that it provides the right incentives." Another potential funding source, as reported by the Wall Street Journal and supported by the Center for Science in the Public Interest (CSPI), would be a federal excise tax on soda and other high-calorie beverages. Beverage tax supporters say that such a tax could yield a decrease in health problems and spending. The Congressional Budget Office estimates that adding a three-cent tax per 12-ounce serving of these drinks would bring in about $24 billion over the next four years. although lawmakers have not indicated how large of a tax they would consider. The CSPI also supports tax increases on alcohol, bans on trans-fat, and reductions in sodium content in packaged and restaurant-served food.