Republicans Amend Baucus Bill To Lower Affordability Standards, Stop Funding For ACORN

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"Republicans Amend Baucus Bill To Lower Affordability Standards, Stop Funding For ACORN"

Members of the Senate Finance committee have submitted 534 amendments to Sen. Max Baucus’ (D-MT) health care mark. Democrats introduced several amendments re-instating the public insurance option, expanding Medicare to Americans 54 to 65, striking the network of consumer driven cooperatives, and improving affordability standards. Multiple amendments lowered the threshold for subsidies, limited out-of-pocket expenses, increased subsidies for individuals making 300-400% of poverty and narrowed the so-called ‘age-band’ (the variation that allows insurers to charge older beneficiaries higher rates).

Democrats exempt workers in high risk professions from the excise tax on insurers, replaced the free rider provision with an employer mandate, and even proposed tax equity for domestic partnerships.

And while Republicans have proposed several compromise amendments — Sen. Olympia Snowe (R-ME) offered an amendment to ‘trigger’ the public option if affordable coverage was not available to at least 95 percent of state residents — most of their provisions seek to delay the mark-up process and undermine the bill.

Republicans offered two separate amendments prohibiting funding for ACORN, reduced affordability credits, and eliminatedall industry fees.” Here are some of the most outrageous:


Amendment/Sponsor Provision Offset
Kyl 371 Prohibit the federal government’s takeover of health care. None required.
Ensign 409 Transparency in Czars. None required.
Hatch 511 Prohibits authorized or appropriated federal funds under the Mark from being distributed to or used by ACORN. No offset.
Ensign 543 Strike the word “fee” everywhere it appears in the bill and replace with the word “tax” . No offset.
Roberts 137 To prevent Medicare payment policies which discourage physicians from fulfilling their Hippocratic Oath to maintain the good of their patients as their highest priority, and instead encourage the rationing of health care. none.
Roberts 144 To ensure that if people like the hometown hospital they have, they can keep it. To be determined.
Ensign 156 To ensure that the financial well-being of future generations is not compromised by the activities of the current generation. none.
Cornyn 163 Ensuring seniors have access to physicians beyond 2010. Strike the premium tax credit for individuals between 300-400 percent of FPL under Title I, Subtitle C of the Chairman’s Mark.

The Senate Finance Committee begins mark-up this week. Below are some of the most important amendments, categorized into Coverage, Financing, and Delivery reforms. To see the complete list, click here.

Helpful Coverage Amendments


Amendment/Sponsor Provision Offset
Rockerfeller 182 Immediately require a prohibition on pre-existing condition exclusions for children. Capping itemized deductions at 35%
Rockefeller 185 Strike state exchanges, multiple competing exchanges, and regional exchanges, and create one national exchange. This amendment should save money
Rockefeller 186 Consumers Health Care Act (S.1278), as modified (a public option amendment). None required.
Rockefeller 187 Establishment and administration of a public health insurance option as an exchange-qualified health benefits plan None required.
Rockerfeller 191 Strike health care cooperatives None required.
Rockerfeller 196 Increase Medicaid eligibility to 150% of poverty This amendment should save money
Rockerfeller/Hatch 201 Remove the Children’s Health Insurance Program (CHIP) from the exchange Elimination of Title I, Subtitle E.
Rockerfeller 206 Allow early retirees between ages 55 and 64 to buy into Medicare Capping itemized deductions at 35%.
Rockefeller 210 Allowing patients to have more control over their own care (would add advance care planning to the Medicare prevention and wellness risk assessment.) This amendment should save money.
Bingaman 222 Strikes “Section 1937″ provision, which would permit states to discriminate in providing benefits to new Medicaid expansion populations Commensurate increase in annual fee on health insurance providers.
Bingaman 225 Limits the value of the scope of benefits that may receive subsidized coverage within the health insurance exchanges Potential to reduce spending.
Kerry/Schumer 226 Replace the Free Rider provision with an employer mandate. None required.
Kerry 240 Narrow the age rating band. None required.
Wyden 249 To increase low-income subsidies to 400% of the Federal Poverty Level and lower cost-sharing. Tax revenue related to Internet gaming authorized to be collected under the Internet Gambling Regulation, Consumer Protection and Enforcement Act.
Wyden 256 To limit insurance rating based on age in the individual and group markets. Allow increased the limit on variation of premiums for tobacco use to be increased as necessary.
Schumer/Cantwell 261 Public option as passed by HELP Committee None required.
Schumer 262 Hardship waiver at 7% No cost anticipated, any savings should be directed to improving affordability in the exchange.
Schumer 263 Hardship waiver at 5% No cost anticipated, any savings should be directed to improving affordability in the exchange.
Schumer 264/strong> Hardship waiver at 3% No cost anticipated, any savings should be directed to improving affordability in the exchange.
Stabenow/Manendez 281 Requires that the more than 13 million children enrolled I the CHIP in 2013 are not moved to the exchanges unless it is clear that they will secure coverage that it at least comparable or better to what they have in CHIP so that they are not left worse off by health reform To the extent necessary, the insurers’ fee will be increased.
Nelson 297 Strike interstate sale of insurance None required.
Menendez/Bingaman 301 To allow citizen and lawfully present immigrant children to get affordable health coverage while ensuring that undocumented immigrants do not benefit from the tax credit subsidy None required.
Menendez/Bingaman 301 To allow citizen and lawfully present immigrant children to get affordable health coverage while ensuring that undocumented immigrants do not benefit from the tax credit subsidy None required.
Menendez 312 Providing a reduction in the out-of-pocket maximum for those between 300%-400% of poverty. No cost anticipated.
Snowe 356 Provision of safety net fallback plan to ensure access to affordable coverage. (Trigger public option) To be provided.
Snowe 362 Expedite insurance market reforms in small group market None required.

Political Coverage Amendments


Amendment/Sponsor Provision Offset
Grassley 328 Require that elected officials and all federal employees purchase coverage through exchanges. None required.
Hatch 349 Automatic enrollment of Members of Congress voting for the Federal government-funded Health Care Cooperative. None required.
Kyl 371 Prohibit the federal government’s takeover of health care. None required.
Ensign 409 Transparency in Czars. None required.
Enzi 421 Congressional enrollment in Medicaid. None required.
Cornyn 460 Protecting competition and fighting monopoly in health care. None required.

Dubious Coverage Amendments


Amendment/Sponsor Provision Offset
Grassley 332 Promoting coverage without the use of a government requirement to purchase insurance. Any savings achieved through this amendment are redirected towards other provisions in the Chairman’s Mark
Hatch 345 Strike the new federally imposed individual mandate and replace it with a state option. Proportionate reduction as needed in spending in the Chairman’s Mark.
Hatch 352 Strike Medicaid Expansion. Proportionate reduction as needed in spending in the Chairman’s Mark.
Snowe 359 Medicaid expansion phase in option. None required.
Kyl 381 Clarification that legal immigrants must reside in the U.S. for at least five years in order to be eligible for the tax credit available through the state exchanges. None required.
Kyl 383 Allowing the purchase of health insurance across state lines. None required.
Ensign 401 Ensure that illegal immigrants do not fraudulently receive federal health care tax credits. None required.
Enzi 422 Ensure that Medicaid expansions will not take effect until state Medicaid programs can guarantee that enough physicians in the state will actually accept and treat Medicaid patients. None required.
Ensign 425 Terminates Medicaid expansions that results in increased costs for a state. None required.

Helpful Financing Amendments


Amendment/Sponsor Provision Offset
Rockefeller 466 Eliminate health savings accounts (HSAs). None required.
Rockefeller/Kerry/Schumer/Menendez Exempt workers in high-risk professions from the excise tax on high cost insurance. capping itemized deductions at 35 percent .
Lincoln 472 Executive compensation limits on health insurance providers. None required.
Schumer/Kerry/Cantwell/Menendez Tax equity for Domestic Partners. Offset will be determined when the amendment is offered for consideration
Menendez 479 Create a credit that would encourage investments in new therapies to prevent, diagnose, and treat acute and chronic disease. increase annual fees on health insurance providers to offset increase in spending.
Ensign 546 Ensure the high cost of insurance tax shall apply to FEHB plans of Members of Congress and staff, the President of the United States, all Administration Czars, and other federal employees. proportionate decrease in certain spending provisions in the Chairman’s bill except for Medicare spending.
Ensign 550 Exempt products sold to Medicare beneficiaries and veterans from the excise tax on medical devices. reduce subsidies to make amendment budget neutral with subsidies awarded to individuals earning 400% of poverty.

Political Financing Amendments


Amendment/Sponsor Provision Offset
Hatch 491 Exempt middle-income families from tax increases in the bill . proportionate reduction as needed in spending in the Chairman’s Mark .
Hatch 511 Prohibits authorized or appropriated federal funds under the Mark from being distributed to or used by ACORN. No offset.
Hatch 512 Surcharge on attorney’s fees for malpractice lawsuits . No offset
Ensign 543 Strike the word “fee” everywhere it appears in the bill and replace with the word “tax” . No offset.

Dubious Financing Amendments


Amendment/Sponsor Provision Offset
Grassley 483 Strike fee on health insurance providers. corresponding reduction in unspent and unallocated mandatory spending that falls within Finance Committee jurisdiction from the American Recovery and Reinvestment Act of 2009.
Grassley 484 Strike fee on medical device manufactures. corresponding reduction in unspent and unallocated mandatory spending that falls within Finance Committee jurisdiction from the American Recovery and Reinvestment Act of 2009.
Grassley 485 Strike fee on clinical laboratories. corresponding reduction in unspent and unallocated mandatory spending that falls within Finance Committee jurisdiction from the American Recovery and Reinvestment Act of 2009.
Grassley 486 Strike fee on manufactures and importers of branded drugs. corresponding reduction in unspent and unallocated mandatory spending that falls within Finance Committee jurisdiction from the American Recovery and Reinvestment Act of 2009.
Grassley 489 Clarifying IRS governance reporting requirements for tax-exempt organizations negligible revenue effect.
Hatch 492 Allow small business tax credits for those purchasing insurance outside the state insurance exchange proportionate reduction as needed in spending in the Chairman’s Mark.
Hatch 505 Provide that the annual fees assessed on the four health industry segments are deductible for U.S. income tax purposes proportionate reduction as needed in spending in the Chairman’s Mark.
Hatch 510 Exemption of annual fee for manufactures and importers of medical devices that furnish products that are used to combat H1N1 proportionate reduction as needed in spending in the Chairman’s Mark.
Snowe 517 Replace individual mandate with a defined minimum contribution. No formal score available. Offset will be provided at a later date.
Kyl 522 Eliminate all industry fees. tie tax credit to the lowest cost bronze plan

Helpful Delivery System Amendments


Amendment/Sponsor Provision Offset
Rockefeller 9 Eliminate all overpayments to Medicare Advantage private plans. none.
Bingaman 23 Protection for low-income Seniors and other Medicare beneficiaries Proportionately increase the annual fees on health insurance providers; manufacturers and importers of branded drugs; manufacturers and importers of medical devices; and clinical laboratories in the Chairman’s Mark by an amount commensurate with the cost associated with this amendment.
Bingaman 25 National Health Care Workforce Commission Budget Neutral.
Stabenow 71 To establish guidelines to ensure patient access for our nation’s emergency rooms None
Stabenow/Snowe 83 To help solve our nation’s physician workforce shortage Given the small number of hospitals potentially affected by this amendment, it is unlikely to score. However, if this amendment does score, the annual fee on manufacturers and importers of branded drugs would be increased an equivalent amount.
Nelson/Rockefeller 88 Eliminate the Part D Coverage Gap and Require Drug Maker Rebates for Full-Benefit Dual Eligible Individuals Require Part D Drug Rebates for Dual Eligible Individuals.
Carper 106 To establish a state demonstration program to develop, test, and evaluate the “Safe Harbor” model as an alternative to the current civil litigation system. No offset required.

Political Delivery System Amendments


Amendment/Sponsor Provision Offset
Wyden 44 Ensuring People in Hospice Do not Have to Give Up the Prospect of a Cure. This amendment will not result in increased cost.
Kyl/Roberts/ Crapo/Cornyn 131 The PATIENTS Act. None.
Roberts 137 To prevent Medicare payment policies which discourage physicians from fulfilling their Hippocratic Oath to maintain the good of their patients as their highest priority, and instead encourage the rationing of health care. none.
Roberts 143 To prevent health care reform from being paid for on the backs of our most vulnerable and frail seniors in nursing homes. To be determined.
Roberts 144 To ensure that if people like the hometown hospital they have, they can keep it. To be determined.
Roberts 145 To prevent health care reform from being paid for on the backs of our seniors. To be determined.
Ensign 155 An amendment to prohibit funding under this bill for ACORN. This amendment has no cost.
Ensign 156 To ensure that the financial well-being of future generations is not compromised by the activities of the current generation. none.
Cornyn 163 Ensuring seniors have access to physicians beyond 2010. Strike the premium tax credit for individuals between 300-400 percent of FPL under Title I, Subtitle C of the Chairman’s Mark.
Ensign 156 To ensure that the financial well-being of future generations is not compromised by the activities of the current generation. none.
Kyl 126 Limiting the Number of New Federal Health Care Bureaucrats & Preventing the Rationing of Seniors’ Care. Strike federal funding for the CO-OP program.

Dubious Delivery System Amendments


Amendment/Sponsor Provision Offset
Hatch 118 Provide a uniform system of awarding noneconomic damages in health care lawsuits. none.
Hatch 119 Provide a uniform system of awarding noneconomic damages in health care lawsuits. none.
Hatch 120 Provide a uniform system of awarding noneconomic damages in health care lawsuits. none.
Kyl Limiting the Number of New Federal Health Care Bureaucrats & Preventing the Rationing of Seniors’ Care. Strike federal funding for the CO-OP program..
Kyl 130 Prohibiting a Federal Rationing Board. none.
Cornyn 172 Limiting Non-Economic Damages in Medical Liability Lawsuits. none.
Cornyn 173 Eliminating Junk Science in Medical Liability Lawsuits. none.
Cornyn 174 Protecting Generic Drug Manufacturers from Liability for Label Language That They Did Not Write.. none.
Cornyn 175 Encouraging Amicable Settlement of Medical Liability Lawsuits. none.
Cornyn 176 Encouraging Compliance with the Institute’s Recommendations . none.
Cornyn 177 Limiting Punitive Damages. none.
Cornyn 178 Protecting Doctors from Frivolous Lawsuits. none.
Cornyn 179 Protecting Doctors from Excessive Damage Awards. . none.


Update

Sen. Orrin Hatch (R-UT), introduced an amendment (Hatch F7) to “add transition relief for the excise tax on high cost insurance plans for any State with a name the begins with the letter ‘U.’” The amendment would increase the threshold at which high-cost insurance plans could be taxed.

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