Members of the Senate Finance Committee today voted 14-9 to pass the “chairman’s mark” of the America’s Healthy Future Act bill.
All Democrats on the panel voted for the bill, and Sen. Olympia Snowe, R-Maine, was the only Republican to cross party lines to vote for it.
“Is this bill all that I want?” Snowe asked. “Far from it. But when history calls, history calls.”
Snowe said she was voting to continue the process of working on the health reform issue; that she has grave concerns about what might happen when the AHFA bill is merged with the HELP bill, and when a health bill goes to the Senate floor; and that she might not vote for the health bill that emerges on the Senate floor.
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The vote came after another long AHFA bill markup session.
The chairman’s mark of the AHFA bill, an alternative to a health bill developed by the Senate’s Health, Education, Labor and Pensions Committee, was developed by the Finance Committee staff under the direction of Senate Finance Committee Chairman Max Baucus, D-Mont. The committee sent a heavily revised version to the Congressional Budget Office and the Joint Committee on Taxation for review Oct. 2. The CBO released an analysis of the possible effects of the proposal on the federal budget deficit Oct. 7. The bill returned to the Finance Committee today for a final committee vote.
Now that the committee has approved the AHFA proposal, Senate leaders plan to combine it with the HELP bill, then bring a combined bill to the Senate floor for debate.
Baucus noted that the committee had spent more time on marking up the bill draft than it had spent on any single piece of legislation in decades.
He led the Finance Committee in singing “Happy Birthday” to Sen. Maria Cantwell, D-Wash., who responded by joking that she thought the process of drafting the AHFA bill would go on so long that the committee would end up celebrating the birthday anniversaries of all of its members.
Republicans on the committee blasted the draft and the process that produced it.
“We tried to take the chairman’s mark in a different direction,” said Sen. Charles Grassley, R-Iowa, the highest-ranking Republican on the committee. “We were rebuffed at every step.”
Sen. Jim Bunning, R-Ky., complained that the committee had not sent the Congressional Budget Office analysts – who were in charge of estimating the effects of the bill on the federal budget deficit – the final statutory language.
Sen. Jon Kyl, R-Ariz., said that, in some cases, the CBO used assumptions that appear to be different than those included in the bill draft summary. The CBO, for example, assumed that a proposed fine that would be imposed on people who fail to buy health coverage would increase along with inflation, but the AHFA summary shows that the fines would not be indexed.
Because of the omissions, “the estimated cost of the bill is incorrect,” Kyl said.
Sen. Orrin Hatch, R-Utah, said the process of reviewing the bill has been too rushed for the CBO to prepare an analysis of how the bill might affect insurance premiums.
Hatch also pointed to a prediction in a Joint Committee on Taxation analysis that the combined effects of various components of the bill might increase the marginal tax rate for a family of 4 with $34,200 in annual wage income to 59%, meaning that, after subtracting federal taxes and health costs, the family would get to keep only 31 cents of every dollar earned over $34,200.
Sen. Pat Roberts, R-Kan., questioned the credibility of AHFA proposal provisions that call for the government to hold down the rate of increase in Medicare provider payments each year. In reality, whenever Congress has tried to impose similar provider payment increase slowdown in the past, it always has come back and voted for a funding supplemental, he said.
“I think this is where the big shell game comes in,” Roberts said.
On paper, Medicare funding may hold steady, and benefits may remain roughly the same, but providers will be dropping out of the program, Roberts said.
Sen. John Ensign, R-Nev., complained about the lack of a CBO estimate of the effects of the AHFA proposal on overall health care costs. “We haven’t brought health care costs down with this bill,” he said.
Sen. Michael Enzi, R-Wyo., praised Baucus’s work on the bill but noted that many of his constituents find the bill confusing, partly because detailed legislative language is not yet available.