During today’s mark-up of the Senate Finance Committee health bill, Sen. Chuck Grassley (R-IA) offered an amendment requiring Medicaid enrollees to submit a government issued photo ID (“identification must be authenticated with the issuing agency,” the amendment states) with the application for coverage. Democrats defended the current birth certificate requirement, claiming that the amendment created an additional obstacle to coverage for lower-income enrollees who lack a photo ID. Some studies estimated that as many as 21 million American citizens don’t have such identification.

Sen. Jeff Bingaman (D-NM) called the amendment “a solution looking for a problem.” Binagman reminded Grassley that the majority of Medicaid fraud “is provider fraud,” not applicant fraud. “It is providers who are charging for services they are not providing,” Bingaman explained. Grassley responded by suggesting that his photo ID amendment would weed claims for people who are dead, leading Bingaman to point out that dead people can’t apply for coverage:

GRASSLEY: Medicaid is paying claims for people that are dead. So you know, photo ID and ‘are you alive?’ and all that is pretty darn important, it seems to me. [...]

BINGAMAN: To the extent Medicaid is paying for people who are dead to get health care services, it’s not because people are applying for those services. It’s because providers are billing for services for people who are dead, and that’s the fraud we ought to stop.

Watch it:

Sen. Robert Menendez (D-NJ) reminded the committee that stringent verification requirements often do more harm than good, turning some citizens “into second class citizens.” The Wisconsin Department of Health and Human Services, for instance, reported that “nearly 33,000 individuals had their Medicaid denied or terminated because of the documentation requirement,” Menendez said. “In 62 percent of those cases, the sole reason for denial or loss of coverage was lack of identification. All of these individuals had provided documentation showing that they were citizens.”

The Baucus bill already includes verification requirements. Under the legislation, to obtain coverage within the Exchange, an applicant’s “name, social security number, and date of birth will be verified with Social Security Administration (SSA) data.” “For individuals who do not claim to be U.S. citizens but claim to be lawfully present in the United States, if the claim of lawful presence is consistent with Department of Homeland Security (DHS) data then the claim will be considered substantiated.”

Grassley’s amendment failed in a vote of 10-13.

The Baucus health bill maintains federal restrictions on abortion funding by preventing federal money from funding any abortions beyond reasons of life-endangerment, rape or incest. Under the mark, women wouldn’t be able to use subsidy dollars for the procedure and would finance the operation only with private premiums.

This morning, Sen. Orrin Hatch (R-UT) introduced amendment Hatch C14, requiring that “no funds authorized or appropriated under this Mark may be used to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion.” Under Hatch’s amendment, women who purchase comprehensive private insurance packages — that include abortion services — would have to pay for the entire cost of the package (even if they qualify for subsidies) and obtain a separate rider for abortion coverage.

Responding to Hatch’s amendment, which ultimately failed in a vote of 10-13, Sen. Debbie Stabenow (D-MI) said, “with all respect to my friend, as a woman, I find it offensive”:

In fact, with all respect to my friend, as a woman, I find it offensive that in here– any woman, any family purchasing through the exchange, if they did not receive any tax credit, would be prohibited from having the full range of health care options that they may need covered….This is an unprecedented restriction on people who paid for their own health care insurance…the assumption that somehow a woman or family would say, ‘you know some did we may have an unintended pregnancy, so we’ll get a separate rider or maybe my pregnancy is going to have a crisis, many, many crises, and so we’re going to find some other rider.’ In my judgment, I don’t even know how that would work.

Stabenow explained that Hatch’s ‘extreme’ amendment would drastically change existing law and levy an undue burden on women who want access to abortion services. Watch it:

While the Baucus amendment establishes a firewall between public dollars and private dollars for abortion services, some advocates believe that the existing language would jeopardize the abortion coverage for women moving from employer sponsored plans (the majority of which cover abortion services) to insurance within the Exchange. They point to present federal policy which subsidizes employer-sponsored plans without restricting abortion coverage.

The mark requires each state-based exchange to contain at least one plan that does not cover abortion and a separate policy that does.

Last night, in a controversial speech on the House floor, Rep. Alan Grayson (D-FL) announced that the Republican alternative health care proposals would force sick Americans to “die quickly”:

It’s my duty and pride tonight to be able to announce exactly what the Republicans plan to do for health care in America… It’s a very simple plan. Here it is. The Republican health care plan for America: “don’t get sick.” If you have insurance don’t get sick, if you don’t have insurance, don’t get sick; if you’re sick, don’t get sick. Just don’t get sick. … If you do get sick America, the Republican health care plan is this: “die quickly.”

Watch it:

No Republican wants Americans to die, but the party’s efforts to stonewall meaningful health care reform perpetuate a status quo in which 45,000 Americans die every year because they lack health care coverage and thousands more see their policies canceled or denied by private insurers that are beholden to Wall Street’s profit expectations and not patient health.

Grayson intentionally over-stated his case. It’s not that Republicans want to kill people; it’s that their opposition to meaningful health care reform and their “free market” alternatives would further deregulate insurers and allow companies to continue pushing individuals into high deductible policies that don’t provide adequate coverage and actually harm Americans who can’t afford their medical bills:

“Don’t get sick.” Under the Republican alternatives, private insurers will deny coverage to Americans who suffer from chronic illnesses like cancers or asthma and lure healthier applicants into high deductible policies that provide limited coverage once they become sick.

“Die quickly.” If Americans in these policies do fall ill, they will go bankrupt paying off their medical bills and join the 78 percent of bankruptcy filers burdened by health care expenses who had health insurance but “still were overwhelmed by their medical debt.” Grayson is facetiously suggesting that Americans would be urged to skip the “bankruptcy” part, avoid being a financial burden on their family, and simply pass away.

In other words, the Republican alternatives harm Americans by placing our fate in the hands of the very same private for-profit corporations that have created the health care crisis in the first place.