In Washington...
Power Shift...In the House of Representatives it appears that Rep. Nancy Pelosi (D-California) is poised to assume the post of House Democratic replacing Rep. Richard Gephardt, who stepped down following the November 5 election. Pelosi would be the first female to serve as House Minority Leader. In the Senate, Republicans regained control of key committees. Sen. Judd Gregg of New Hampshire will assume the chairmanship of the Health, Education, Labor and Pensions Committee formerly chaired by Massachusetts Sen.Ted Kennedy. The Appropriations Committee will be chaired by Sen. Ted Stevens (R-Alaska) and the Budget Committee, which will have a significant voice in the Medicare prescription plan, will be chaired by Sen. Don Nickles (R-Oklahoma).

Sign the Pledge...The American Hospital Association (AHA) has launched a “sign the pledge” campaign designed to get a majority of both Houses to commit to provider relief before they adjourn. Partners HealthCare is working to get the fully committed Massachusetts delegation to sign on. That’s the easy part. Meanwhile, Sen. Ted Kennedy (D-MA) recently expressed his optimism about action during the lame duck session, but urged continual educational efforts. The White House continues to oppose more than a fix in the physician and Medicare+Choice payments. With Republicans back in control of the Senate as well as the House, legislators will return in mid-November but aren't expected to get to work in earnest until early December.

On Beacon Hill...
Uncompensated care pool Senator Travaglini to lead the Senate...Sen. Robert “Trav” Travaglini (D-Boston) will likely serve as the Massachusetts Senate’s next President, starting in January 2003. Hailing from a district that includes Massachusetts General Hospital, Spaulding Rehabilitation Hospital, and the MGH-Revere Health Center, Sen. Travaglini has been a longtime advocate on issues of concern to the entire health care community. Other leadership changes are in the works.

UCP commission meets again...Members of the UCP special commission met recently to discuss the future of the state’s free care pool. The commission grappled with fundamental questions regarding the nature and scope of health care services provided through the pool, as well as pool costs, management and financing. The Massachusetts Health Policy Forum also released an issue brief on the pool, and sponsored a discussion that included several commission participants. The forum’s recommendations include: (1) preserving MassHealth basic coverage slated to end on April 1, 2003; (2) broadening and increasing the financing of the pool; (3) creating and expanding care management programs; and (4) improving accountability and reporting of pool expenditures. The commission hopes to complete its work by December 16, 2002. A copy
of the brief may be obtained at www.sihp.brandeis.edu/mhpf/pool_ issue_brief.pdf.

Worth noting... In comments at a breakfast forum recently, House Speaker Tom Finneran defended the legislature’s decision to curtail MassHealth benefits and predicted a $2 billion hole in the upcoming FY 04 budget. Finneran noted that the Medicaid program will need at least a 10 percent increase just to sustain current commitments and that inadequate provider payments continue to be a serious roblem.