More Amendments Go Up for Vote in Senate Finance Panel Markup

In its sixth day of debate on its draft health reform bill, the Senate Finance Committee on Wednesday discussed amendments regarding taxes on medical expenses, abortion and undocumented immigrants, the Washington Times reports (Haberkorn, Washington Times, 10/1).

Taxes on Medical Expenses

The committee's bill contains a provision that beginning in 2013 would raise the threshold at which U.S. residents can claim deductions on their personal taxes for medical expenses from 7.5% of their annual adjusted gross income to 10% of their annual AGI.

However, the panel voted 14-9 to approve an amendment from Sen. Bill Nelson (D-Fla.) that would exempt people ages 65 and older from the threshold increase until 2017.

The committee later voted 9-14 to reject a related amendment from Sen. Jon Kyl (R-Ariz.) that would have maintained the threshold at 7.5% for all U.S. residents (Rubin, CQ Today, 9/30).

Abortion Restrictions

The committee also rejected two abortion-related amendments introduced by Sen. Orrin Hatch (R-Utah).

One amendment would have prohibited any money provided under the reform bill from being used to pay "any part of the costs of any health plan that includes coverage of abortion," with a few limited exceptions. Under the amendment, insurers could have offered "a separate supplemental policy" to cover abortion services, which would be financed "solely by supplemental premiums paid by individuals choosing to purchase the policy."

The proposal was defeated in a 10-13 vote (Pear, New York Times, 10/1).

Hatch's second amendment -- which would have banned any local government, agency or health providers from discriminating against health care providers who chose not to provide abortion services -- also was rejected on a 10-13 vote.

The amendment also would have mandated that the HHS Office for Civil Rights collect and investigate discrimination claims (Washington Times, 10/1).

Undocumented Immigrants

A pair of amendments by Sens. Chuck Grassley (R-Iowa) and Kyl intended to prevent undocumented immigrants from signing up for new programs under the reform legislation were defeated 10-13 along party lines, CQ Today reports.

Grassley's amendment would have required applicants for Medicaid, or their parents in the case of children, to present a photo ID.

Kyl's amendment would have mandated that the Social Security Administration, the Department of Homeland Security and IRS set up "real-time" communications systems between them to verify identification (Wayne [1], CQ Today, 9/30).

Panel Opts Against Lowering Minimum Average Coverage Amount

The Finance Committee also voted 11-12 to reject an amendment by Sen. Mike Enzi (R-Wyo.) that would have lowered the average minimum percentage insurers must pay for covered services from 65% to 60%, CQ HealthBeat reports (Reichard, CQ HealthBeat, 9/30).

Carper, Cantwell Devise Alternatives

Senate Finance Committee members Tom Carper (D-Del.) and Maria Cantwell (D-Wash.) currently are developing proposals that could drastically change the current reform legislation, CQ Today reports.

Carper's proposal would allow states to create new government-run insurance programs as an alternative to a public plan run by the federal government.

Cantwell's proposal would change the way working low-income residents acquire insurance by redirecting to states subsidies intended to help such residents purchase coverage.

Cantwell's proposal would affect residents whose annual incomes are less than twice the federal poverty level and who are not eligible for Medicaid subsidies in the state in which they live.

The state would use the redirected funds to purchase insurance on those residents' behalf (Wayne [2], CQ Today, 9/30).

CBO Estimate of Finance Committee Draft Bill Inaccurate

The Congressional Budget Office's original savings estimate for the Finance Committee's reform bill could be significantly off because the agency did not factor in that hospitals would be exempt from a Medicare cost-cutting measure.

CBO originally estimated that the bill would reduce the federal deficit by $23 billion over 10 years.

However, CBO officials recently wrote in an e-mail, "We have not estimated the effect of the commission based on language in the mark, but it is likely that the savings would be reduced by at least half" (Edney, CongressDaily, 10/1).

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