Thursday, September 24, 2009

Baucus ObamaCare Bill Markup Update

SEN CORNYN'S UPDATE ON BAUCUS OBAMACARE BILL - bad news is, the train wreck is advancing down the track:

Rejected: Amendment To Preserve Seniors’ Medicare Advantage Plans

HATCH AMENDMENT: “This Amendment Would Strike The Medicare Advantage
Provisions Of The Chairman’s Mark If CBO Certifies That Beneficiaries
Currently Participating In The Medicare Advantage Program Will Lose
Plan Benefits when the Medicare Part C reductions are implemented by
the Centers of Medicare and Medicaid Services. CBO is required to make
this certification 3 months after the enactment of the health reform
bill.” (“Amendments Submitted To The Chairman's Mark: America's
Healthy Future Act Of 2009,” U.S. Senate, Finance Committee, P. 151)

Amendment Rejected 9-14

(Hatch Amendment #D7, Rejected 9-14; R 9-1; D 0-13, 9/23/09)

SEN. RON WYDEN (D-OR): “[Medicare Advantage Is] Essentially Access.
We’ve Been Hammered Under The Traditional Fee For Service Approach So
Without Good Quality Affordable Medicare Advantage We Simply Don’t
Have Access To Care For Seniors.” “Oregon has the highest percentage
of Medicare Advantage in the country, highest percentage by far. And
one of the things that we have learned over the years is that not all
Medicare Advantage is created equal. Oregon and Washington have good
quality efficient care and in our part of the country it’s a lifeline.
It’s essentially access. We’ve been hammered under the traditional fee
for service approach so without good quality affordable Medicare
Advantage we simply don’t have access to care for seniors.” (Finance
Committee, U.S. Senate, Hearing, 9/23/09)

Rejected: Amendment To Provide Legislative Language And Price Tag
Before Voting

BUNNING AMENDMENT: “This Amendment Requires That Before The Finance
Committee Can Vote On Final Passage Of ‘America’s Healthy Future Act
Of 2009,’ The Legislative Language Must Be Publically Available On The
Finance Committee’s Website For At Least 72 Hours.” (“Amendments
Submitted To The Chairman's Mark: America's Healthy Future Act Of
2009,” U.S. Senate, Finance Committee, P. 279)

Amendment Rejected 11-12

(Bunning Amendment #C4, Rejected 11-12; R 10-0; D 1-12, 9/23/09)

CBO DIRECTOR DOUGLAS ELMENDORF: “A Formal Cost Estimate Would Require,
We Have Said This To People On The House And Senate Side, Would Really
Require Two Weeks Of Work By Us, Once A Package Is Settled. And That
May Seem Like A Long Time, But It - There Are A Lot Of Complications
In Doing This Right, As You Need It To Be Done And It Is The
Interaction Effects Among The Provisions, It Is Reading The
Legislative Language. Our official cost estimates are based on reading
of actual language, very complicated to write this language and to
interpret it correctly, and that often involves a certain amount of
iteration between us and the staff of the relevant committees. We also
need to develop a more complete budget presentation rather than just
the effects on the deficit, which is the way we have been summarizing
for you so far. So we’ve told all the people who’ve asked that it
will take us about two weeks to do a formal cost estimate after we
have a full bill, but as I said we can do a updated preliminary
analysis more quickly than that.” (Finance Committee, U.S. Senate,
Hearing, 9/22/09)

SEN. MAX BAUCUS (D-MT): “CBO Scores Are Really Important.” “‘CBO
scores are really important,’ said Baucus, after members of the
Finance Committee decided to re-craft portions of its legislation
based on the CBO estimate.” (“Baucus To Chop $600 Billion From
Healthcare Bill,” The Hill, 6/17/09)

SEN. KENT CONRAD (D-ND): “With Respect To The Issue Of When Scoring
Might Be Available, Because This Is Obviously A Sensitive Matter, It
Is Critically Important That We Have Scoring Before A Final Vote Is
Cast On The Committee.” (Finance Committee, U.S. Senate, Hearing,

Rejected: Amendment To Stop “Gag Order”

SEN. MAX BAUCUS (D-MT): “Maybe CMS Overstepped.” “I’m not going to get
into that letter, because that’s a whole separate issue. Maybe the law
was not properly executed. Maybe there’s a – maybe CMS overstepped. I
don't know.” (Finance Committee, U.S. Senate, Hearing, 9/23/09)

SEN. JON KYL (R-AZ): “[A]n Example Of One Of The Most Heavy Handed,
Unconstitutional Actions That I Can Think Of That Our Federal
Government Has Ever Attempted to take against private citizens,
private organizations in this country because they disagree with the
administration with respect to its ideas on health care
reform.” (Finance Committee, U.S. Senate, Hearing, 9/23/09)

SEN. PAT ROBERTS (R-KS): “This Is Not Right. This Is, Quite Frankly It
Smells Exactly Like Tough Hardball Chicago Politics Abridging The
First Amendment. If We’re Not Able To Pass This Amendment We Have
Reached A Very Dark Day Here On This Committee.” (Finance Committee,
U.S. Senate, Hearing, 9/23/09)

KYL AMENDMENT: “Amendment That Would Clarify That A Health Plan May,
Pursuant To Constitutional Rights Guaranteed By The First Amendment,
Express Its Views About Legislation Or Legislative
Proposals.” (Amendment To The Chairman’s Mark, “America’s Health
Future Act Of 2009,” U.S. Senate, Finance Committee, 9/23/09)

Amendment Rejected 10-13

(Kyl Amendment, Rejected 10-13; R 10-0; D 0-13, 9/23/09)


SEN. MAX BAUCUS (D-MT): “At The Urging Of Senate Finance Committee
Chairman Max Baucus (D‐Mont.) The Centers For Medicare & Medicaid
Services (CMS) Has Cracked Down On Insurance Compan[ies] … The CMS
Investigation Into The Beneficiary Letter Was Prompted By A Baucus
Request.” “At the urging of Senate Finance Committee Chairman Max
Baucus (D‐Mont.) the Centers for Medicare & Medicaid Services (CMS)
has cracked down on insurance company attempts to mislead and confuse
beneficiaries about how they would be affected by health care reform
legislation being crafted in the Finance Committee and other
congressional committees. The CMS investigation into the beneficiary
letter was prompted by a Baucus request for the agency to review the
insurance company’s tactics last week. Baucus condemned insurance
industry scare tactics and stressed that health reform legislation
will include significant improvements to the Medicare program that
will benefit seniors.” (Sen. Baucus, “At Baucus’ Urging, CMS Cracks
Down On Insurance Company Scare Tactics,” Press Release, 9/21/09)

Rejected: Amendment Prohibiting A Federal Rationing Board

KYL AMENDMENT: “The amendment would strike the following language from
the Medicare Commission in subtitle E of Title III: ‘By April 1,
2014, the Senate Finance Committee, along with the relevant House
committees, would be required to report out either the Commission’s
(or Secretary’s) proposal or an amended proposal that achieves the
same level of reductions in excess cost growth.’” (“Amendments
Submitted To The Chairman's Mark: America's Healthy Future Act Of
2009,” U.S. Senate, Finance Committee, P. 203)

Amendment Rejected 8-8

(Kyl Amendment D7, Appeal Ruling of the Chair Failed 8-8; R 8-0; D
0-8, 9/23/09)

Ruled Out Of Order: Medical Liability Reform Amendments

ENSIGN AMENDMENT: “The amendment will insert language in Title III,
Subtitle H of the Chairman‘s Mark to improve patient access to health
care services and provide improved medical care by reducing the
excessive burden the liability system places on the health care
delivery system.” (“Amendments Submitted To The Chairman's Mark:
America's Healthy Future Act Of 2009,” U.S. Senate, Finance Committee,
P. 184)

CORNYN AMENDMENT: “Any state receiving funding under Medicaid shall
enact a limit on total noneconomic damages against doctors and health
care facilities of one million dollars or less.” (“Amendments
Submitted To The Chairman's Mark: America's Healthy Future Act Of
2009,” U.S. Senate, Finance Committee, P. 210)

KYL AMENDMENT: “This amendment would limit noneconomic damages in a
civil medical liability lawsuit to $250,000 from any provider or
health care institution, not to exceed $500,000 from all providers and
health care institutions. It would also make each party liable only
for the amount of damages directly proportional to such party's
percentage of responsibility.” (“Amendments Submitted To The
Chairman's Mark: America's Healthy Future Act Of 2009,” U.S. Senate,
Finance Committee, P. 273)

Ruled Out Of Order


Anonymous said...

This is an alternative universe. No common sense, not regard for clear thinking or deliberation. God help us!

MichaelApolskis said...

The provisions associated with the Medicare Commission were amended by Senator Rockefeller's Amendment #D10. See my blog post, titled Medicare Commission Survives First Week of Senate Finance Committee Mark-Up, at