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Three Amendments that Could Slow Down Senate Debate

Janice Simmons, for HealthLeaders Media, November 12, 2009

Before the Senate adjourned earlier this week, Majority Leader Harry Reid (D-NV) announced plans that he would bring Senate's version of healthcare reform legislation to the floor next week.

Time will be short as the Senate attempts to unveil the bill and aim for passage and eventually reconciliation with the House bill (HR 3962) within a few weeks. "Our goal is to make sure we get it out of the Senate this year," Sen. Dick Durbin (D-IL), the number two Senate Democrat, said earlier this week.

But any fast actions on the bill may likely run into legislative amendments introduced from the floor that may slow the process as they are debated.

Here's a look at three of the amendments:

Public insurance option. Not surprisingly, the public option will be front and center of the debate. Under the current Senate proposal, the option where states can opt-out of the process appears to be the top version under consideration. And the House bill has a different version requiring the Health and Human Services secretary to negotiate rates with healthcare providers as private insurers.

In this debate, attention has focused on senators, such as Joseph Lieberman (I-CT), who usually votes with the Democrats and has said he won't support any public option, or others such as Sen. Blanche Lincoln (D-AR), a Finance Committee member who has remained quiet on the issue. Their support is needed to reach the magic number (60) needed to pass legislation in the Senate. But attention also needs to be paid to moderates, such as Sen. Jay Rockefeller (D-WV) or Sen. Sherrod Brown (D-OH), who say they would not vote for a bill without the option.

Again, the "trigger plan" suggested earlier by Sen. Olympia Snowe (R ME)—which would feature nonprofit agencies offering health insurance in instances in which private insurers could not cover 95% of the people in their regions—could make an appearance. But it may be hard to appease that core of senators who are demanding an actual option.

"Pay or play." In July, the Senate Health, Education, Labor and Pensions Committee passed a package that included a "play or pay amendment," in which employers would pay an annual fee for individuals not covered by a health insurance plan.

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