While the ink was drying on the historic healthcare reform bill signed into law by President Obama on Tuesday, the latest—and possibly the last—major debate on reform was gearing up across town on the Senate floor.
Under discussion was the 153-page reconciliation bill (HR 4872) approved by the House Sunday night that contains "fixes" to provisions contained in the bill passed by the House on Sunday.
"While the Senate still has a last round of improvements to make on this historic legislation and these are improvements I'm confident they will make swiftly the bill I'm signing will set in motion reforms that generations of Americans have fought for, and marched for, and hungered to see," Obama said at the bill-signing ceremony.
With a vote of 56-40, the Senate voted on Tuesday afternoon to begin the debate. Under Senate rules, discussion of the reconciliation bill will be limited to 20 hours. However, senators are permitted to offer as many amendments as they want, which don't count on the time.
Democrats, though, will likely try to prevent any amendment from being approved because that would mean the bill would have to go back to the House for a new vote. On Tuesday, the Senate met until 10:30 p.m., using more than seven hours of debate time. Democrats are hoping to have a vote on the reconciliation measure by the week's end.
"We do not have before us the whole healthcare reform bill. We do not have to reopen every argument that we had over the last two years. We do not have to say everything that we said about healthcare, one more time," said Sen. Max Baucus (D-MT), chairman of the Senate Finance Committee, in opening floor debate.
However, Sen. Judd Gregg (R-NH), the ranking member of the Senate Budget Committee, was first to offer one of the numerous GOP reconciliation bill amendments. His amendment called for requiring that any Medicare savings from the new healthcare law and the reconciliation bill be used to "shore up the already insolvent Medicare program—not expand or create new entitlements at the expense of Medicare beneficiaries."
Gregg, the designated GOP strategist for Senate debate this week, called the reconciliation bill an "atrocity" and "an attempt to purchase votes in the House." He said most of the reconciliation bill's hospital insurance trust fund savings "would be used to pay for other spending and therefore would not enhance the ability of the government to pay for future Medicare benefits.
"Democrats are trying to have it both ways, but they can't," Gregg said. "The end result is that more money will have to be borrowed from our children to cover the difference."
Among the GOP amendments offered on Tuesday were:
- From Sen. Charles Grassley (R-IA): To make sure the president, cabinet members, White House senior staff, and congressional committee and leadership staff purchase health insurance through the health insurance exchanges established by the new law.
- From Sen. Charles Inhofe (R-OK): A provision to exclude devices for persons with disabilities from the medical device tax.
- From Sen. John McCain (R-AZ): A measure to eliminate financial "sweetheart deals" for Tennessee, Hawaii, Louisiana, Montana, Connecticut, and frontier states.
- From Sen. Tom Coburn (R-OK): An amendment that would both enact recommendations from a Government Accountability Office to stop fraudulent payments for prescription drugs prescribed by dead providers, plus prohibit coverage of Viagra and other erectile dysfunction medications to convicted child molesters, rapists, and sex offenders.
The debate on the reconciliation bill will continue on Wednesday morning.
Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.