Federal Healthcare Update

December 8, 2009

Pardon Our Dust

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During this past weekend’s session, the Senate considered several amendments to the health care bill. The Senate rejected 66-32 an amendment offered by Senator John Ensign (R-NV) to limit the amount of fees that attorneys representing a plaintiff in a medical malpractice liability action could receive. An amendment from Senator Blanche Lincoln (D-AR) to limit tax deductions for insurance executives’ salaries was defeated 56-42. The Senate defeated 41-53 a motion from Senator Mike Johanns (R-NE) to send the bill back to the Finance Committee with instructions to return it without cuts in payments to home health agencies, which provide health care support and services within qualified patients’ homes. This marks the third occasion that the Senate has defeated an attempt from a Republican Senator to remove savings from Medicare from the bill. Earlier in the week, the Senate rejected 58-42 an amendment from Senator John McCain (R-AZ) that would have restored all the planned reductions in Medicare payments.  The Senate also rejected a motion from Senator Orrin Hatch (R-UT) that would have restored the cuts to Medicare Advantage.
Majority Leader Harry Reid (D-NV) reported that the weekend session was also productive off the Senate floor, as Senators continue to work on a compromise for the public option. Although details are still being finalized, it appears that the public option in the bill will be vastly different from both the original version in the Senate and the House version. A working group of ten Senators, five moderate and five liberal Democrats, have been discussing several compromise proposals for the public option. Under a leading proposal, the federal Office of Personnel Management (OPM) would negotiate with insurers to offer one or more national health plans to individuals, families and small businesses. The OPM is the office that oversees the federal health care plan for Members of Congress and includes not-for-profit insurance options offered by private companies. Senator Joe Lieberman (I-CT), one of the negotiators, is the only member of the Democratic Caucus who has pledged to oppose legislation that includes a public option, but has not yet ruled out support for the OPM plan currently under discussion.
President Obama’s visit to the Democratic Caucus on Sunday served as a pep rally for the Democrats. The President focused on the importance of the issue, and did not address specific proposals or the public option. Reports say that the President told the Caucus that health care is the biggest issue for a Democratic-led Congress since the enactment of Social Security during the Depression, and would be immeasurably important to Democrats’ political fortunes in 2010 and beyond.
Yesterday, Senator Ben Nelson (D-NE) unveiled final language for his amendment to limit federal funding for abortions, mirroring the language included in the House bill by Congressman Bart Stupak (D-MI).  The amendment would prohibit the public option insurance plan from covering elective abortion at all, and would limit abortion coverage for low-income people using federal subsidies to purchase insurance. Sen. Nelson reiterated his pledge to filibuster the bill if the final version does not include his language or an acceptable alternative.
As time is rapidly running out before the end of the year, Sen. Reid has indicated that he will begin to cut off debate on aspects of the health care plan by filing for cloture on a manager’s amendment or on the health care bill this week.  Senate Republicans are expected to force Reid to reach 60 votes on each step of this process, setting up cloture votes and up to 30 hours of post-cloture debate on a manager’s amendment, the final proposal, and on the underlying House bill that is serving as the Senate’s legislative vehicle for the overhaul. Sen. Reid is expected to try to complete Senate action on the bill this year.