Insurers, Doctor-Owned Hospitals Get Late Help

Tucked into President Barack Obama's health care bill are several 11th-hour changes that help major insurance companies and doctor-owned hospitals.

Among the beneficiaries, according to lobbyists and congressional aides, are Kaiser Permanente, the giant California-based insurance company; Geisinger Health Plan based in Pennsylvania; and doctor-owned health facilities in about a dozen states, including Ohio, Pennsylvania and Tennessee.

House leaders hoped to approve the revisions Sunday when lawmakers vote on the health care legislation. They were included in a 153-page bill revising the giant Senate-passed overhaul package, and in separate language that Democrats plan to add.

Some of the special deals in the health care bill have been widely derided by Republicans and Democrats, and a few have been dropped.

Last year, to help win the vote of Sen. Ben Nelson, D-Neb., the massive Senate measure had included $100 million that only Nebraska would get in added federal Medicaid assistance. Dubbed the Cornhusker Kickback, it was eliminated in the revisions bill.

The latest changes to the bill include:

—Tax-exempt insurers would have to pay a new fee levied on insurers on only half their premiums. Kaiser Permanente and Geisinger are both tax-exempt.

—An Aug. 1, 2010, deadline on new doctor-owned hospitals to apply to the government for eligibility to serve — and get paid for — Medicare patients would be extended to Dec. 31. Aides and lobbyists said this would help roughly 13 facilities. These include Mercy Hospital in Monclova, Ohio; Scranton Orthopedic Specialists in Dickson City, Pa.; and Paragon Rehabilitation in Goodlettsville, Tenn.

The three facilities are represented, respectively, by Democratic Reps. Marcy Kaptur of Ohio, Paul Kanjorski of Pennsylvania, and Bart Gordon of Tennessee. Gordon has switched to support the health legislation after opposing an earlier version and Kaptur said Sunday she would stick to her "yes" vote. Kanjorski hasn't indicated how he would vote. Aides to all three said the lawmakers had nothing to do with the provisions and their votes would not be affected by inclusion of the language.

—A new 2.9 percent excise tax on medical devices would be lowered to 2.3 percent. But it will be broadened to apply to some lower-cost devices it hadn't initially covered, though hearing aids, contact lenses and other items consumers buy retail would be excluded. According to one medical industry official, the changes were made at the insistence of Reps. Baron Hill and Brad Ellsworth, both Indiana Democrats, and Scott Murphy, D-N.Y., who are all now supporting the legislation.

—The 153-page bill would have allowed the state-owned Bank of North Dakota to continue making federally financed student loans to students, even though the health care overhaul ends that system nationally in favor of direct government lending. Sen. Kent Conrad, D-N.D., who initially supported the exemption for the bank, decided to seek its removal when it was criticized, and revisions to the 153-page bill would delete that provision.