Senators consider women's insurance amendment, Medicare funding issues, with votes likely today

Dec 2 2009

The New York Times: "In a day of desultory debate on sweeping health care legislation, senators appealed to two potent political constituencies ... with Democrats seeking additional medical benefits for women and Republicans vowing to preserve and protect Medicare for older Americans. The Democrats' first amendment, offered by Senator Barbara A. Mikulski of Maryland, would require insurers to cover more screenings and preventive care for women, with no co-payments."

The proposal was partly the result of "the recent furor over new recommendations from a federal task force that breast cancer screenings begin later for many women." Senate Majority Leader Harry Reid "hailed Ms. Mikulski's proposal." Republicans said the proposal would instead interfere with the relationship between doctor and women by allowing the Health Resources and Services administration to develop guidelines on insurance payments (Pear and Herszenhorn, 12/1).

The Wall Street Journal reports that with "their push on women's health, Democrats reached out to another key voter bloc, even as polls show uncertain public support for the White House-backed health-care initiative." The plan would cost $1 billion.

"Looming are several divisive fights, none more so than on abortion. Sen. Ben Nelson (D-Neb.) said Tuesday he planned to introduce an amendment to restrict government funding for abortion in a manner similar to limits in the bill passed by the House last month. Mr. Nelson said he wouldn't vote for the health bill unless the Senate adopts his measure" (Hitt and Adamy, 12/2).

The Washington Post: Meanwhile, the first GOP amendment, sponsored by Sen. John McCain, R-Ariz., "would strip out the bill's primary revenue source, nearly $500 billion in Medicare cost savings. Although AARP and other seniors groups have said otherwise, Republicans are attacking the cuts as a threat that could eventually shorten lives." The Post also details "other flashpoints" likely to be considered as amendments on the Senate floor, including language that "would target provisions in the bill related to abortion and illegal immigrants. Majority Leader Harry M. Reid (D-Nev.) said debate could continue through the weekend" (Murray and Montgomery, 12/2).

Bloomberg: McCain's amendment "took aim at a series of planned changes to projected Medicare spending, including $118 billion in cuts to insurers under Medicare Advantage, a program in which private insurers offer about 11 million enrollees benefits such as dental or vision coverage not provided by the government program. ...   The debate took on a sharper edge when Senator Tom Coburn, an Oklahoma Republican and a doctor, said during debate that the Medicare cuts would restrict doctors' choices in patient care and shift so much power to the government it could endanger the lives of seniors. ... Democrats said the proposed changes would help stabilize rapidly rising Medicare costs that otherwise threaten deep future cuts in the program's benefits. Senate Finance Committee Chairman Max Baucus, a Montana Democrat, said the reductions would hit health-care" (Litvan and Jensen, 12/2).

The Los Angeles Times: "Sen. Olympia J. Snowe (R-Maine), a centrist who objects to portions of the bill, also took issue with allegations that the legislation would hurt Medicare beneficiaries. 'There are going to be a lot of rewards for seniors in this, and no reductions in their benefits,' Snowe said. 'Ultimately, it buoys the system overall in the future'" (Levey, 12/2).

CongressDaily reports that Sen. Nelson also will offer an amendment that "has the potential to shatter the $80 billion cost-cutting deal the pharmaceutical industry worked out with the White House and Senate Finance Chairman Max Baucus." The amendment would "close a coverage gap in the Medicare prescription drug benefit by equipping eligible Medicare beneficiaries with the same drug discounts as those who get prescriptions through Medicaid. The coverage gap, known as the doughnut hole, leaves seniors paying the full price of their prescriptions, though part of the Pharmaceutical Research and Manufacturers of America's deal has the industry providing a 50 percent discount on brand-name drugs to most beneficiaries who fall into the coverage gap. PhRMA forged the deal with the understanding the industry would not get hit with any more cost-cutting proposals" (Edney, 12/2).

Sen. Tom Carper, D-Del., in the meantime, will unveil a new compromise on a proposed government-run public option next week, The Hill reports. "Carper has been working on variations of the public option for months. Recently, he has touted a so-called hammer public option that he believes answers centrists' criticisms that the public option in Reid's bill is government-run and government-funded." It would kick in in states where availability and affordability standards aren't met, but unlike Sen. Olympia Snowe's "trigger" idea, would go into effect the same year as the larger bill.  It would "establish a national public insurance program founded by the government but managed by a non-governmental board. In addition, the plan would be unable to access any taxpayer dollars beyond its initial seed money" (Rushing and Cusack, 12/1).

In a separate story, The Hill reports that Sen. Bob Casey, D-Pa., wants to amend the bill "to ensure" the Children's Health Insurance Program would not be "dissolved into the legislation's proposed health insurance exchange. ... Instead, Casey's measure would fully fund CHIP until 2019, increase the federal government's matching percentage, expand program eligibility and reward states that demonstrate progress in care and coverage" (Romm, 12/1).