Given the fury of public debate on health care reform (HCR) in town halls around the country, I thought it might be useful to provide our lobbyists' view of where we are at the moment:

• The Senate Finance Committee “gang of six” (Baucus, Grassley, Conrad, Bingaman, Snowe, and Enzi) continue to draft legislation. Despite these efforts, it isn’t clear whether the Republicans will support a bill. Key issues left to address include the public option, an independent MedPAC, expanding Medicaid, and how to pay for the proposal. Some speculate that the Senate Finance bill will include a co-op instead of a public option. Full Senate consideration isn’t likely before October and more likely will be in late October.
• The House Committee on Rules and House leadership must merge the three versions of the House bill. In addition, House Energy & Commerce Chairman Henry Waxman has a list of 58 amendments that he has agreed to consider. It isn’t clear what process will be used to address these amendments because the bill was already marked up.
• The public option remains the top issue in HCR negotiations. Pelosi says she can’t pass a bill in the House without it; the Administration seems to be stepping away from the idea, suggesting that they are open to other ways to expand coverage.
• Congressional leaders and the Administration are strategizing how they might proceed if there is not bipartisan support. One plan would split HCR into two pieces: one dealing with issues with broad support (such as barring insurers from denying coverage based on pre-existing conditions) and the other dealing with the more controversial issues that could be dealt with through the budget reconciliation process (which requires 51 rather than 60 votes).

And, in case you were wondering, the MTM provisions we secured and are now working to protect are still in both House and Senate proposals. The support we've seen from pharmacists has been very good. Keep it up!