Senate Continues To Work on Health Care Reform Over Weekend
The Senate over the weekend convened for a rare session, during which lawmakers discussed several outstanding issues that "threaten to derail" the chamber's health reform bill (HR 3590), the Los Angeles Times reports (Levey, Los Angeles Times, 12/6).
On Friday and over the weekend, senators voted on GOP-led proposals aimed at stripping from the bill more than $118 billion in proposed cuts to Medicare Advantage, eliminating a plan for a voluntary government-administered insurance plan for long-term care and restoring proposed cuts to home health care agencies.
CLASS Program for Seniors and Disabled Prevails
On Friday, an amendment by Sen. John Thune (R-S.D.) to eliminate the Community Living Assistance Services and Supports Act failed by a 51-47 vote, the AP/San Francisco Chronicle reports. CLASS would create a new long-term care insurance plan aimed at helping seniors and people with disabilities live independently at home.
Under the floor rules negotiated by Democrats and Republicans prior to the start of debate, all amendments to the reform bill require 60 votes to be approved (Alonso-Zaldivar, AP/San Francisco Chronicle, 12/5).
Thune said the CLASS program would be another excessive cost burden on the government that already is overwhelmed with debt. President Obama has voiced his support for the program, a version of which also is included in the House reformÂ bill (HR 3962) (Pear/Herszenhorn, New York Times, 12/5).
Eleven Democrats, including Senate Finance Committee Chair Max Baucus (D-Mont.) and Senate Budget Committee Chair Kent Conrad (D-N.D.), voted with Republicans to support the amendment (AP/San Francisco Chronicle, 12/5).
According to Thune, seven of the Democrats sent a letter to Senate Majority Leader Harry Reid (D-Nev.), asking him to drop the program from the bill because it would create long-term spending that would exceed its revenue.
Before voting on Thune's amendment, the Senate voted 98-0 to adopt an amendment by Sen. Sheldon Whitehouse (D-R.I.) to add language to the bill stating that the net savings from the CLASS program and any additional money in the Social Security trust fund should be saved for those programs.
Whitehouse defended CLASS' financial stability, noting the Congressional Budget Office projected that it would save $1.6 billion for Medicaid in the four years after it is implemented (Ethridge , CQ Today, 12/4).
Democrats Block Reversal of MA Plan Cuts
Also on Friday, the SenateÂ voted 41-57 to reject an amendment by Sen. Orrin Hatch (R-Utah) that would have sent the Senate bill back to the Senate Finance Committee with an order to eliminate $118 billion in proposed cuts to Medicare Advantage plans over 10 years, the New York Times reports.
Hatch said that seniors, particularly those who receiveÂ coverage for vision and dental care, would be affected by the cuts (Pear/Herszenhorn, New York Times, 12/5).
Sens. Ben Nelson (Neb.) and Jim Webb (Va.) were the only Democrats to back the amendment.
Baucus defended the proposed cuts, noting that MA plans are administered through private insurance, unlike traditional Medicare. He said, "We've reached the point now where Medicare Advantage is, by everyone's estimate, quite dramatically overpaid," adding, "I hear all these senators crying crocodile tears, how seniors are going to get cut and this and that and so forth, but frankly, the changes made, I think, are very fair" (Ethridge , CQ Today, 12/4).
Funding Cut to Home Care Program Remains in Bill
On Saturday, the Senate in a 41-53 vote rejected an amendment by Sen. Mike Johanns (R-Neb.) that would have eliminated about $42 billion in cuts over 10 years to a MedicareÂ home health care program, The Hill reports.
Johanns said the programs would end because of the cuts (Alarkon, The Hill, 12/5).
The New York TimesÂ reports that the cutbacks in payments, which primarily would affect health agencies that provide nursing care and therapy to homebound Medicare patients, would help cover part of the cost of providing subsidies to the uninsured.
Four centrist Democrats -- Evan Bayh (Ind.), Blanche Lincoln (Ark.), Nelson and Webb -- supported the amendment (Pear, New York Times, 12/6).
All 53 opponents of the amendment were Democrats, while three Republicans, two Democrats and one Independent did not vote (Los Angeles Times, 12/6).
Before Johanns' amendment proceeded to a vote, the Senate voted 96-0 to adopt an alternative amendment by Sen. John Kerry (D-Mass.) that would ensure that the Senate bill would not cut guaranteed home health benefits (Vadala/Ethridge, CQ Today, 12/5).
Amendments on Medical Malpractice, Tax Deduction Limits Fail
The Senate also voted on several other amendments over the weekend. Details are below.
- Medicare coverage language: On Friday, the Senate voted 97-1 to approve an amendment by Sen. Debbie Stabenow (D-Mich.) that would ensure that language in the bill states clearly that the benefits already promised to seniors in MA plans under current law would not be reduced or affected by the legislation, the Detroit Free Press reports. Sen. Tom Coburn (R-Okla.) was the only senator to vote against the proposal (Spangler, Detroit Free Press, 12/4).
- Medical malpractice: The Senate on Sunday voted 32-66 to reject an amendment by Sen. John Ensign (R-Nev.) that would have restricted the amount of fees that plaintiffs' attorneys in medical malpractice liability cases would be eligible to receive, CQ Today reports. Four Democrats -- Sens. Kay Hagan (N.C.), Herb Kohl (Wis.), Lincoln and Mark Warner (Va.) -- voted for the amendment, while 12 Republicans voted against it. Ensign argued that his proposal would discourage unnecessary malpractice lawsuits that damage patient care and raise health care costs, adding, "The estimates are as high as $100 billion to $250 billion in unnecessary tests by doctors annually. Most of those are because of fear of lawsuits" (Davidson/Ethridge, CQ Today, 12/6).
- Tax deduction limits: Also on Sunday, the Senate voted 56-42, four votes shy of passage, to block an amendment by Lincoln that would have lowered the amount health insurers could deduct from their taxes for executive pay, CQ Today reports. The limit would have been lowered from $1 million annually to $400,000 annually, or whatever the U.S. president's income was in that year. Lincoln said her proposal would save about $650 million over 10 years, which could have been directed into the Medicare trust fund. She also said her amendment would have "put premium dollars toward lower rates and more affordable coverage, not in the pocketbooks of" insurance company executives (Vadala/Ethridge, CQ Today, 12/6).