Senators plunged into a massive overhaul of the US healthcare system this week with a chairman’s draft proposal and 564 potential amendments. After a week of marathon sessions, the Senate Finance Committee whittled the pile down to a still-whopping 503.
At first glance, it’s a fiercely partisan process. With a 13 to 10 edge on the panel, Democrats are rolling over most Republican amendments.
Of the 61 amendments taken up this week, the panel accepted only four proposed by Republicans. Another 17 GOP amendments were defeated on near party-line votes, and 11 – including four signature GOP proposals to cap jury awards in medical malpractice cases – were dismissed on procedural grounds.
By contrast, Democrats have won 20 of their amendments and lost one, but that one loss was huge.
In a rare move, the chairman and two other Democrats sided with Republicans to defeat an amendment by Sen. Bill Nelson (D) of Florida that would have required drug companies to provide rebates to seniors to close a controversial coverage gap in the 2003 Medicare Prescription Drug bill, dubbed the “donut hole.” Those rebates would save taxpayers $86 billion over 10 years, Nelson had said.
But the Nelson amendment would also have unraveled a deal between President Obama and the Pharmaceutical Research and Manufacturers of America (PhRMA) that commits drug companies to $80 billion in cost cuts -- but no more. The amendment failed by a vote of 10-13 on Thursday, with Sens. Baucus, Thomas Carper of Delaware and Robert Menendez of New Jersey breaking ranks to vote with Republicans.
Other tough votes are expected next week, including amendments by Sens. Charles Schumer (D) of New York and John Rockefeller (D) of West Virginia to offer a public alternative. Chairman Baucus says that a public option can never win the 60 votes needed to pass the Senate.
Baucus was the only one of five committee chairs who tried to draft a bill that would win bipartisan support. After more than 60 sessions to work out a bipartisan deal, the so-called Group of Six within the panel gave up negotiations last week. But elements of their work, including a rejection of a public option, are still reflected in the chairman’s mark.
“We have debated, we have questioned, we have prodded at times, and we have discussed and discussed. Most important, we continue to move forward,” said Senator Baucus in a statement after today’s markup.
It the Congress does nothing, the federal government will go broke over the next several decades, Medicare will be insolvent in less than 10 years, and healthcare premiums will increase 84 percent in the next seven years, he said.
After the finance panel completes its markup, Senate Democratic leaders expect to merge this bill with the more liberal draft approved by the Senate Health, Education, Labor and Pensions (HELP) Committee. Liberals aim to move proposals rejected in the Finance Committee into the leadership package that goes to the floor of the Senate.
With an eye to the melding of bills with the HELP panel, Sen. John Kerry (D) of Massachusetts withdrew an amendment today that would have required insurers to charge people over 60 no more than two times what they charge younger people, or “the young immortals.” In the current Finance panel draft, that ratio is 4:1.
Republicans countered that that proposal would increase costs to younger Americans.
“What on earth leads us to believe we have the perspicacity, the wisdom to make all these decisions? This is one of the reasons why we are very skeptical of the degree of detailed meddling in the marketplace that this bill represents,” he said.
“What the people are going to learn from this markup session and our product is that they are being done over -- had for lunch -- by the insurance companies,” countered Senator Rockefeller.
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