In a 13-10 vote along party lines, the Senate Health, Education, Labor and Pensions Committee on Wednesday became the first committee to approve a marked up healthcare reform bill. The bill, called the "Affordable Health Choices Act," is expected to be merged with the Senate Finance Committee's bill, which is not completed.
More than 500 amendments were considered, and of those, about 160 Republican amendments were accepted, said Sen. Chris Dodd (D CT), who chaired the committee in the absence of Sen. Edward Kennedy (D MA), who is recovering from a brain tumor. "Although it wasn't a bipartisan vote, it was a bipartisan effort that produced this bill."
Adding to that thought, President Obama—meeting with nurses at the White House Wednesday afternoon—said that the work of both parties in the committee over several weeks, despite the final vote, "showed a hopeful sign of bipartisan support for the final product, if people are serious about bipartisanship."
The bill does have a health insurance exchange, referred to in the bill an "Affordable Health Benefit Gateway," that states would be responsible for establishing. It also includes a government-run, public health insurance option that Dodd said would compete with private insurers to drive costs down.
Under the "shared responsibility" section, all individuals would be required to obtain healthcare coverage, although some exceptions could be made for those who cannot afford coverage. Employers with 25 or fewer employers also would be exempt from penalties. The bill's minimum penalty to accomplish the goal of "enhancing participation" is $750 per individual annually.
The bill also has a greater focus on prevention and wellness efforts than the House bill introduced Tuesday. The bill puts "prevention and public health at the heart" of reform, said Sen. Tom Harkin (D-IA), a committee member. "It replaces our current sick care system with a genuine health care system."
The bill also calls for:
- Prohibiting insurers from denying applicants coverage based on their health status.
- Promoting higher quality of care through health insurance policies that include financial incentives as rewards for providers involved in using, for instance, care coordination, chronic disease management, and medical error reduction.
- Coverage of preventive health services.
- Extending coverage for dependent adults, with all individual and group coverage policies being required to continue offering dependent coverage for children until the child turns age 26.
- No lifetime or annual limits on the dollar value limits of individual or group health insurance policies.
The bill also places emphasis on promoting access to and delivery of care—especially in low income, underserved, minority or rural populations. A variety of grants, student loans, training programs, and recruitment initiatives are emphasized, as well as the role of nurses in providing care—especially in medically underserved areas.
How the bill's provisions will play on the Senate floor later this summer will remain to be seen. Speaking to reporters later, Republican members appeared angry that they could only propose amendments to the bill. Ranking minority member, Sen. Michael Enzi (R-WY), had harsh words—giving the final bill an "F" for failing, he said, to accomplish the President's goals of lowering costs and not driving up the deficit.
The bill would still leave 34 million uninsured, and would add potentially a trillion dollar debt in the U.S., said Sen. Judd Gregg (R-NH). "The president threw out the first pitch (Tuesday) night at the All Star Game but (Wednesday) the Democratic members of the health committee struck out on the issues of the President's initiatives on healthcare."