LAC News
Update From “The Hill” Health Care Amendments
By By David Ferkaluk
October 2009

Last week, the Senate Finance Committee held mark-up sessions on Senator Max Baucus’ (D-Montana) health care reform legislation.  Contrary to Democrats’ claims that Republicans are not offering solutions in the debate, various GOP Senators offered amendments within the hearings.

The following are descriptions and vote results of amendments that were debated and discussed in recent Senate Finance health care mark-up meetings.

Sept. 24, 2009

Amendment #C2[1], Senator Orrin Hatch (R-Utah):  To ensure Americans can keep the coverage they have.  The implementation of America’s Healthy Future Act of 2009 shall be conditioned on the Secretary of Health and Human Services certifying to Congress that this legislation would not cause more than 1,000,000 Americans to lose the current coverage of their choice.

Votes on C2 10 ayes and 13 nays.--The Amendment failed

Amendment #C2, Senator Blanche Lincoln (D-Arkansas):  Chairman’s Mark—Employers whose employees have average annual full-time equivalent wages from the employer of less than $20,000 would qualify for the full credit.  The credit would phase out for an employer for whom the average wages per employee is between $20,000 and $40,000 at a rate of 5% for each $1,000 increase of average wages above $20,000.

Proposed Change—This amendment would modify the Chairman’s Mark so that employers whose employees have average annual full-time equivalent wages from the employer of less than $30,000 would qualify for the full credit.  The credit would phase out for an employer for whom the average wages per employee is between $30,000 and $40,000 at a rate of 5% for each $500 increase of average wages above $30,000.

Amendment needs further work and will come forward later.

Amendment #D1[2], Senator Mike Crapo (R-Idaho):  To preserve choice of plans for seniors under Medicare Advantage.  Chairman and Senator Baucus deemed the amendment to be without germane and going beyond jurisdiction (i.e. in appropriating funds), and therefore, was out of order.  Those on the committee attempted to overrule him, but failed.

Amendment #C3, Senator Michael Enzi (R-Wyoming):  To ensure American workers are protected from lower wages and job loss.  Prior to implementing the employer assessments or fees described in Title 1, Subtitle D, the Secretary of Labor must certify that the implementation of such fees and assessments would not result in a reduction of workers’ wages or an increase in the unemployment.

The amendment was withdrawn due to unclear language, so said Chairman Baucus.

Amendment #C7, Senator Debbie Stabenow (D-Michigan):  Allow stand-alone dental and vision plans to offer the required pediatric dental and vision services to be offered in the individual and small group markets including within the insurance exchanges.

There was no real debate on this amendment, so Chairman Baucus accepted the amendment as it was.

Amendment #C15, Senator Charles Grassley (R-Iowa):  To make the individual mandate in Title I Section D of the Chairman’s Mark a state option.  (Background) Under the Chairman’s Mark, beginning in 2013, all U.S. citizens and legal residents would be required to purchase health insurance or have health coverage from an employer, through a public program (e.g., Medicare, Medicaid or CHIP), or through some other source that meets the minimum creditable coverage standard.  Individuals who kept their current plan would be deemed to have satisfied the requirement.  Those who do not comply with the requirement would be subject to a penalty, which increases with income, up to a maximum of $950 per year for an individual and $3,800 per year for a family.

This amendment would give states the option of pursuing alternative mechanisms to encourage the purchase of health insurance.

Result:  The amendment was withdrawn temporarily due to confusion with another amendment.

Amendment #C7, Senator John Cornyn (R-Texas):  To ensure the accuracy of punitive taxes.

The amendment would amend Title I, Subtitle D of the Chairman’s Mark on required payments for employees receiving premium credits.  The amendment would require the Secretary of Health and Human Services to annually submit to Congress for consideration the flat dollar amount required of employers under subtitle D.  In order to take effect, Congress must enact and the President must sign the penalty into law.  If Congress fails to enact the penalty by September 30^th of each calendar year, the penalty shall not take effect January 1^st of the following year.

Result:  Chairman Baucus found the amendment not germane and ruled it out of order.

Sept. 25, 2009

Amendment C#10, Senator John Ensign (R-Nevada):  To have transparency in Czars.  Any czar handling health care issues shall be subject to the Senate confirmation process.

Vote 10 Ayes, 13 Nays, The amendment failed.

Amendment #C15, Senator John Kerry (D-Massachusetts):  This amendment would replace the 4:1 age rating band in the Chairman’s Mark with a 2:1 age rating band.  Taking together all permissible risk factors, premiums within a family category could not vary by more than a 3:1 composite ratio.

Senator Kerry eventually withdrew the bill, but he may have it come back later.

Essentially, what this bill does it gets rid of the supposed discrimination against seniors who are charged higher costs by insurance companies as opposed to young people because that is not “fair”.  In other words, Senator Kerry wants to create a disincentive for young people to buy health insurance so that we can end “age discrimination” from the insurance companies.  Seniors are charged more because they are a higher risk than are young people, not to mention many young people do not think they need health insurance.  Thankfully, Senator Kerry withdrew the amendment, and hopefully it will not come back.

Senator Cornyn (R-Texas) brought up another amendment on transparency that would make CBO and the Senate recheck all of the amendments it puts forth to make sure that nothing is rushed through and that it is done right; however, Chairman Baucus thought that this would set up an unworkable amount of delays and again urged all of his like-minded Democratic colleagues to oppose this amendment.  In the end, with his colleagues falling perfectly into line, Chairman Baucus managed to see Senator Cornyn’s amendment fail.

Senator Maria Cantwell’s (D-Washington) amendment passed very quickly.  She proposed an amendment that strikes Title I, Subtitle E, Health Care Cooperatives and replaces it with a public option included in the Senate Health, Education, Labor, and Pensions (HELP) Committee.

Amendment #C10, introduced by Senator Jon Kyl (R-Arizona), would prohibit the federal government from limiting consumer choice by defining the health care benefits offered through private insurance.  However, this amendment did not pass.

September 29, 2009

Amendment #D8, the “Preserving Access to Targeted, Individualized, and Effective New Treatments and Services Act” (PATIENTS) was introduced by Senators Jon Kyl (R-Arizona), John Cornyn (R-Texas), Pat Roberts (R-Kansas), and Mike Crapo (R-Idaho), and would have addressed concerns about “comparative effectiveness research” (CER) and accounted for personalized medicine and differences in patient response to treatments.  In other words, the amendment would have protected the ability of doctors to prescribe personalized treatments to individuals without facing government insistence on prescribing only “cost-effective” treatments (also known as “rationing”).  The PATIENTS amendment failed 13-10.

On a somewhat encouraging note, the Finance Committee voted to restore $50 million for abstinence funding.  As well, the two “public option” amendments introduced by Senator John Rockefeller (D-West Virginia) and Senator Chuck Schumer (D-New York) were voted down in committee.  The Rockefeller amendment failed by a vote of 15-8, and the Schumer amendment failed 13-10.  Chairman Baucus stated that although he wanted to see a “public option” included in the legislation, he recognized that it seemed unlikely to procure a 60-vote majority.  The battle now begins in committee mark-up sessions over a “trigger option”, or a type of “public option” to be tested at the state level over several years.  Conservatives still oppose the “trigger”, as it would establish what is seen as a slippery slope to a national “public option” and then “single-payer option”.

Sadly, the Democrat members of the Senate Finance committee are not listening to the millions of Americans who openly oppose their health care reform bill.  Instead, there is a sense of urgency to pass this legislation, even with 56% of Americans currently against the health care reform package they are championing.  In essence, the amendments brought up in the Finance Committee hearings (except for the ones that were rejected) allow the federal government to force its tentacles even further down the throats of Americans.