Voting for health reform before voting against it

[Bradley in DC]

I'm sorry if this isn't going to transcribe well, but it's from a spreadsheet showing the list of amendments from Senate Finance Cmte.

Sheet1
A B C D E
1 Senate Finance Committee Amendments 2009
2 Wednesday (9/23/2009)
3 Amendment Sponsor Amdt # (SFC #) Pass/Fail? Description of Amdt Comments about votes

4 Bunning C4 (397) Fail (11-12) Transparency Amdt: would have required that actual legislative text (not the conceptual draft) and a final CBO score be posted for a nominal 72 hours on the Committee website for fair public review before the Senate Finance Committee could vote on final passage. Party line except for B. Lincoln

5 Baucus modification of Bunning C4 Pass (13-10) Baucus modification of Bunning C4: to just post the “conceptual language” and a “complete cost analysis from CBO” ahead of the Committee vote on final passage.
Party line

6 Kyl D1 (124) Fail (not germane) Protecting Seniors' Access to Medicare Benefits and HC Providers With 2/3 of Committee not agreeing, amendment is ruled out of order due to not being germane.

7 Roberts D9 (145) Thrown out (Nays - 11
Ayes - 10) To prevent health care reform from being paid for on the backs of our most vulnerable and frail seniors in nursing homes. Roberts D9 as modified: Strikes provisions that reduce or have the effect of reducing financing for Medicare. Amendment failed on a point of order. Party line: Without 2/3 of those present voting in the affirmative, the Chairman's ruling is sustained. The amendment is thrown out.

8 Hatch D7 (117) Fail (9-14) This amendment would strike the Medicare Advantage provisions of the Chairman’s mark if it the Chief Actuary of CMS certifies that beneficiaries currently participating in the Medicare Advantage program will lose Medicare-covered plan benefits when the Medicare Part C reductions are implemented by the Centers of Medicare and Medicaid Services. The Chief Actuary of CMS is required to make this certification 3 months after the enactment of the health reform bill. Party line and Snowe voted w/dems

9 Baucus alternative to Hatch Pass (14-9) Chairman's Alternative to Hatch Amdt Party line and Snowe voted w/dems

10 Kyl C4 (371) Fail (PoO) Prohibit the federal government's takeover of health care Kyl C4 as modified: Strikes provisions in Title III (with the exception of provisions which impact delivery system reforms, the SGR, and rural health) which would have the effect of eliminating the cuts to Medicare. Baucus raised a point of order because it was not offset, even though the offset is needed to fund a new health care entitlement. Amendment failed on the point of order.

11 Menendez D2 (99) Agreed to by Voice Vote Designation of Urban Medicare-Dependent Hospitals (UMDH): Provide a special Medicare add-on payment for hospitals receiving the designation of urban Medicare-dependent hospitals. To qualify as an UMDH, a hospital would have to: (1) be located in an urban area; (2) have over 60 percent of its inpatient days or discharges covered by Medicare; and (3) not receive another type of mitigating payment, such as IME, DSH, RRC, CAH, SCH, and MDH payments.

The payment would be similar to the existing payment for rural MDHs – i.e., PPS payments plus 75 percent of the difference between those payments and a hospital-specific rate based on each hospital‘s costs in a previous year, trended forward for inflation. The methodology would use the higher of 2002 or 2006 costs as the base year costs for those hospitals. In addition, this amendment would be budget neutral because it would require the Secretary to ensure that aggregate payments to PPS hospitals are not, as a result of this provision, greater than would have otherwise been paid.

12 Kyl D6 (129) Fail (10-13) Ensuring Seniors Can Keep Their Coverage if They Like It: No provision to HIPAA or any other entity to discourage health insurance companies to inform their beneficiaries about legislation that will affect them. This amendment also includes safe harbor provisions

13 Ensign D6 (151) Pass (21 Ayes, 2 Passes) Medicare Savings Should be Kept within Medicare:The Amendment would require all of the Medicare savings achieved under the Chairman‘s Mark to be used to restore the solvency of the Medicare program Pass: Conrad and John Kerry

14 Cornyn D6 (165) Fail Ensuring Spending Accuracy: Description: Strike the Medicare Commission in Title II, Subtitle D of the Chairman‘s Mark.Offset: Reduction in spending under the Mark Party line and Snowe voted w/dems

15 Kyl D7 (130) Thrown out Prohibiting a Federal Rationing Board-amdt thrown out! With 2/3 of the Committee not voting in the affirmative, the Chairman's ruling is sustained. The amendment is throw out.

16 Grassley D4 (110) Agreed to by Voice Vote Short Title: Improve Governance of Patient-Centered Outcomes Research Institute
Purpose: To remove cabinet secretaries and other high-ranking government officials from the PCORIs board
Background: The Chairmans Mark creates the PCORI to conduct comparative effectiveness research. Oversight and reforms of the American Red Cross and the Smithsonian Institution have proven that cabinet secretaries and other high-ranking government officials frequently are not able to properly fulfill their roles and responsibilities as board members.
Description: This amendment would strike the provisions requiring the Secretary of Health and Human Services, the Director of NIH and other high-ranking government officials, including elected officials and appointees, to be members of the board of the PCORI.

17 Stabenow D19 (84) Agreed to by Chairman To protect our nation‘s seniors from abuse and assist nursing homes The amendment is the same as S.631, the Patient Safety and Abuse Prevention Act, and was passed by the Finance Committee in the last Congress.

18 Ensign D4 (149) Thrown out Short Title: Increased FMAP for Medical Liability Reform; Description of Amendment: The amendment will insert language in Title III, Subtitle H of the Chairman‘s Mark to provide any state that enacts the medical liability limits reforms consistent with the provisions described below shall be eligible for a Federal Medical Assistance Percentage (FMAP) increase for two years for children. The FMAP increase would be paid for by reducing the federal poverty level threshold for tax credits in the bill by the amount necessary. With 2/3 of the Committee not voting in the affirmative, the Chairman's
ruling is sustained. The amendment is throw out. 10 - Nays, 6 - Ayes
(party-line otherwise)

19 Cornyn D13 (172) Thrown out Short Title: Limiting Non-Economic Damages in Medical Liability Lawsuits; Description of Amendment: Any state receiving funding under Medicaid shall enact a limit on total non economic damages against doctors and health care facilities of one million dollars or less.
With 2/3 of the Committee not voting in the affirmative, the Chairman's
ruling is sustained. The amendment is throw out. 11 - Nays, 6 - Ayes; (party-line otherwise)

20 Kyl C25 (392) Thrown out Short Title: Medical Liability Reform; Description of Amendment: This amendment would limit noneconomic damages in a civil medical liability lawsuit to $250,000 from any provider or health care institution, not to exceed $500,000 from all providers and health care institutions. It would also make each party liable only for the amount of damages directly proportional to such party's percentage of responsibility. With 2/3 of the Committee not voting in the affirmative, the Chairman's
ruling is sustained. The amendment is throw out; 10 - Nays, 7 - Ayes; party-line

21 Carper (Rockefeller) D3 (104) Agreed to by Voice Vote To extend the length of time states have to repay the federal share of a Medicaid overpayment. Description of Amendment: Under current law, states have to repay the federal share of any overpayments within 60 days of discovery; however, collections of overpayments especially in fraud cases seldom occur that fast.

22 Schumer D1 (61) Agreed to by Voice Vote
Schumer Amendment #D1 to Title III, Subtitle B ; Short Title: Affordable Biosimilars Reimbursement Equity Amendment; Description of Amendment:
The Medicare Modernization Act established that every biologic drug be assigned its own billing code. For Part B drugs this means each brand name biologic drug has its own Average Sales Price (ASP). To ensure that patients and the Medicare program utilize biosimilars appropriately, this amendment will create parity between brand name biologics and biosimilars and save patients and Medicare money. The amendment allows a Part B biosimilar product approved by the Food and Drug Administration and assigned a separate billing code to be reimbursed at the ASP of the biosimilar plus six percent of the ASP of the reference product.


23 Bingaman C7 (219) Agreed to by Voice Vote Protection for Individuals Seeking an Affordability Waiver from Employer Sponsored Insurance; Summary:Removes the requirement that individuals must ―present affordability waivers to employers.

24 Stabenow (Wyden, Kerry) C2 (274) Agreed to by Voice Vote Stabenow-Wyden-Kerry Amendment C-2 to the Chairman’s Mark; Short title/purpose: To ensure parity for mental health services within the exchange; Description of Amendment: The Chairman‘s mark authorizes a minimum benefit basic package – including mental and substance abuse services– that must be offered by health insurance plans participating in the State Exchanges. While the mark states that services offered through the four benefit categories must ―meet minimum standards set by Federal and state laws,‖ it is unclear whether The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (P.L. 110-343) applies to mental health and substance abuse services offered through State Exchange plans. The amendment would clarify the application of mental health and addiction parity to these new plans in all four benefit categories. This amendment would clarify the application of the federal Wellstone/Domenici mental health and addiction parity requirement to plans offered through State Exchanges by including a specific statutory cross reference to P.L. 110-343.

25 Cornyn D2 (161) Not Agreed to by Voice Vote Cornyn Amendment #D2 to Americas Healthy Future Act of 2009
Short Title: Ensuring Medicaid beneficiaries have access to a doctor; Description of Amendment: Prior to implementing the mandatory Medicaid program expansions in the Chairmans Mark, the Secretary of Health and Human Services must certify that at least 75 percent of physicians in the country accept Medicaid patients.

26 Cornyn D4 (163) Not Agreed to by Voice Vote Short Title: Ensuring seniors have access to physicians beyond 2010; Description of Amendment: Provide a positive update for physicians reimbursed under the Medicare fee schedule beyond 2011.

27 Cornyn D5 (164) Withdrawn, will discuss later after work with Baucus and Snowe
Short Title: The Patient‘s Right to Information on Quality; Description of Amendment: Require Medicare to release patient de-identified claims data to independent entities to generate ―Consumer Reports-like information for patients on the quality of their health care providers. (S. 1544)

28 Wyden D15 (58) Agree to by Voice Vote
Short Title: Requiring the Medicare Payment Advisory Commission to Consider Medicaid Payments When Making Recommendations to Congress on Medicare Reimbursement for Skilled Nursing Facilities; Description:This amendment adds the following to the Chairmans Mark; The Medicare Payment Advisory Commission shall review, and take into account, the interaction of Medicaid payment policies with Medicare payment policies for services provided in skilled nursing facilities when making Medicare payment recommendations for skilled nursing facilities. In doing such a review, the commission shall review Medicaid trends, spending and margins for skilled nursing facilities, and look at net margins for nursing homes from all payment sources.

29 Thursday (9/24/2009)

30 Crapo (Kyl-Roberts) D1 (136) Thrown out on a point of order Short Title: To preserve choice of plans for seniors under Medicare Advantage; Description of Amendment:
The amendment would amend the proposed Medicare Advantage cuts in the Title III, Subtitle D of the Chairman‘s Mark. The amendment would prohibit the implementation of the competitive bidding changes to the Medicare Advantage program in any bidding area where the proposed changes would result in decreased choice and competition for seniors in the Medicare program. Without 2/3 voting in the affirmative, the Chairman's ruling is sustained. The amendment is thrown out by point of order. Party-line w/snowe voting w/dems

31 Enzi C3 (417) Withdrawn for further consideration and discussion.
Short Title: Ensure American workers are protected from lower wages and job loss; Description of Amendment: Prior to implementing the employer assessments or fees described in Title 1, Subtitle D, the Secretary of Labor must certify that the implementation of such fees and assessments would not result in a reduction of workers‘ wages or an increase in the unemployment rate.

32 Nelson (Rockefeller) D1 (88) Not Agreed To (13-10) Short Title: Eliminate the Part D Coverage Gap and Require Drug Maker Rebates for Full-Benefit Dual Eligible Individuals;
Description of Amendment: Amends Section 1860D-2 of the Social Security Act by phasing-out the Medicare Part D coverage gap and requiring drug manufacturers to provide rebates for full benefit dual eligible beneficiaries that match Medicaid rebates. R's no with Baucus, Carper and Menendez

 

[Bradley in DC]

Second half

33 Stabenow C7 (232) Accepted by Chairman without objection
Short title/purpose: To allow stand-alone dental and vision plans to offer the required pediatric dental and vision services and to be offered in the individual and small group markets including within the insurance exchanges; Description of Amendment: The Chairmans mark states that no policies could be issued in the individual or small group market (other than grandfathered plans) that did not meet the actuarial standards described and that all plans in the individual and small group markets, at a minimum, would be required to offer coverage in the silver and gold categories. Furthermore, all plans must offer pediatric services, including dental and vision. The current language precludes stand-alone dental plans, which currently provide 97 percent of the dental benefits in the United States, from competing with medical plans for pediatric dental coverage in the Exchange.

34 Cornyn C7 (436) Ruled out of order Short Title: Ensuring the Accuracy of Punitive Taxes; Description of Amendment: The amendment would amend Title I, Subtitle D of the Chairmans Mark on Required Payments for Employees Receiving Premium Credits. The amendment would require the Secretary of Health and Human Services to annually submit to Congress for consideration the flat dollar amount required of employers under Subtitle D. In order to take effect, Congress must enact and the President must sign the penalty into law. If Congress fails to enact the penalty by September 30th of each calendar year, the penalty shall not take effect January 1st of the following year Without 2/3 voting in the affirmative, the ruling of the Chairman is sustained. The amendment is ruled out of order.
8 - Ayes, 8 - Nays;
35 Nelson D10 (97) Postponed Short Title: Medicare Advantage Enrollee Benefit Stability; Description of Amendment: Medicare Advantage (MA) plans in targeted areas are permitted to grandfather existing enrollees. Targeted areas are defined as metropolitan statistical areas (MSAs) where the weighted average of current MA bids is less than the average per capita fee-for-service expenditure in that MSA. Organizations are required to participate in competitive bidding within an MSA in order to offer a grandfathered plan in that same MSA.Grandfathered plans will receive a base payment to cover A and B benefits and a benefit stabilization payment. The base payment will be equal to the plan‘s competitive bid for non-grandfathered beneficiaries in the same MSA. The base payment for each plan would be modified by two factors: 1) it would be risk adjusted to reflect different population characteristics in the grandfathered plan; and 2) it would be adjusted by a utilization factor to account for differences in utilization between the grandfathered and competitively-bid plans. The benefit stabilization payment will be equal to the amount of the 2011 average rebate and will be updated by medical inflation annually.

36 Bunning C3 (396) Not Agreed to (9-14) Short Title: Excise Tax Exemption; Description of Amendment: This amendment amends the Chairman‘s mark to require that any taxpayer who requests an exemption on their tax return from the personal responsibility excise tax be granted an exemption.
Party line with Snowe voting with dems (no)
37 Grassley C9 (334) Withdrawn, then Not Agreed to (10-13) next day Purpose: To improve access to care for children in Medicaid; Description: This amendment requires states to raise reimbursement rates for Medicaid providers (such as pediatricians, childrens hospitals, and dentists) providing care for an eligible child to 100% of Medicare levels starting in 2014. States get 100% match for the additional cost of reimbursing providers for two years phasing back to regular matching rate by 2019. The additional cost of this provision is paid for by eliminating subsidies provided in the bill to people over 300% of poverty and lowering the overall subsidy amount to a sufficient amount to make up the difference. Party line with Snowe voting with dems (no) and Cantwell voting (yes) with Rs
38 Nelson D3 (90) Agreed to without objection



Short Title: Inspector General Report Comparing Prices Paid for Prescription Drugs under Medicare Part D and Medicaid; Description of Amendment: The Inspector General of the Department of Health and Human Services shall conduct a study comparing prescription drug prices paid by Medicare Part D insurers to those negotiated by state Medicaid plans for the top 200 drugs determined by both volume and expenditures. The prices should include all rebates and discounts the Medicaid and Part D plans receive. In conducting the study, the Inspector General is given the authority to collect all necessary information related to pricing necessary to produce comparisons of the Medicare and Medicaid drug benefits. The Inspector General shall assess--
(A) the financial impact of any price discrepancies on the federal government; and
(B) the financial impact of any price discrepancies on beneficiaries.
The report shall not disclose information that is deemed proprietary or likely to negatively impact a Medicaid program or Part D plans ability to negotiate drug prices. The report shall be submitted to Congress no later than October 1, 2011.
39 Nelson (Kerry) C1 (297) Agreed to without objection Short Title: Strike Interstate Sale of Insurance; Description of Amendment: Strike provisions in Chairman‘s mark (pages 12-13) to allow states to form ―health care choice compacts.
40 Enzi C3 (417) Agreed to (21 - Ayes, 0 - Nays, 2 - Passes) Short Title: Ensure American workers are protected from lower wages and job loss; Description of Amendment: Prior to implementing the employer assessments or fees described in Title 1, Subtitle D, the Secretary of Labor must certify that the implementation of such fees and assessments would not result in a reduction of workers wages or an increase in the unemployment rate.
Bingaman and Nelson passed
41 Enzi C9 (423) Not Agreed to (10-13) Short Title: To exempt any State that the States revenues have declined for 2 consecutive fiscal year quarters from any mandatory Medicaid expansions; Description of Amendment: Notwithstanding any other provision of this Act, with respect to a State, any provision of this Act or an amendment made by this Act that imposes on the State a federally-mandated expansion of Medicaid shall not apply to the State if the State's revenues have declined for the 2 most recent consecutive fiscal year quarters as of the date of enactment of this Act. Party-line
42 Crapo C2 (399) Not Agreed to (10-13) Short Title: To prohibit unfunded federal mandates on states; Description of Amendment: The amendment would amend the proposed Medicaid expansion in Title I, Subtitle G of the Chairmans Mark. The amendment would prohibit any expansion of the Medicaid program that would result in any additional costs for the States, now or in the future. Party-line
43 Cornyn C23 (452) Withdrawn Short Title: Promoting equality between low-income Americans and their elected officials; Description of Amendment: Requires any Member of Congress who votes for America‘s Healthy Future Act to enroll in the Medicaid program.
44 Menendez C9 (308) Agreed to by Voice Vote Short Title: Ensuring quality health care for those with autism and other behavioral health conditions; Description of Amendment:Specify that all plans must provide behavioral health treatment as part of mental health and substance abuse services.

45 Stabenow C6 (278) Agreed to by voice vote. Short title/purpose: To ensure high quality, specialized care for children and youth with special medical, psychological, social and emotional needs who can accept and respond to the close relationships within a family setting, but whose special needs require more intensive or therapeutic services than are found in traditional foster care; Description of Amendment: This amendment would create a rule of construction that nothing in section 1905(a) of the Social Security Act shall be construed as limiting a State from covering therapeutic foster care for eligible children in out-of-home placements. *Cornyn talked about this in reference to Cornyn C23 and had some good points about Baucus' handling of the amendments throughout the markup.
46 Ensign C14 (413) Not Agreed to (10-13) Short Title: Protecting States from an Unfunded Mandate; Description of Amendment: If the change in a state‘s spending on Medicaid would increase by more than one percentage point from the previous year as a result of the Medicaid expansion provisions in Title I, Subtitle G of the Chairman‘s Mark, then the state shall be able to opt-out of the Medicaid expansion provisions in Title I, Subtitle G.
Party-line
47 Enzi C6 (420) Not Agreed to (10-13) Short Title: To provide additional choices to individuals who would otherwise be enrolled in Medicaid thru expansions in this bill; Description of Amendment: This amendment would allow individuals who would otherwise be enrolled in Medicaid thru the expansion in this bill the right to choose to be covered by Medicaid or a qualified private health plan offered through their State exchange. Party-line w/Wyden voting with Rs and Snowe voting with Ds
48 Menendez C4 (303) Agreed to by Voice Vote
Short Title: Ensure and clarify that children qualify as exchange eligible individuals and that there shall be the option of a child-only health insurance option and subsides in the exchanges. Description of Amendment: Ensure that minor children qualify as exchange eligible individuals, such as children in foster care, children in kinship care, children in families when parents are covered by employers who do not offer dependent coverage, children in families whose parents are uninsured, and other citizen and lawfully present U.S. resident children. This amendment would also provide for the availability of child-only health insurance coverage in the exchanges. Furthermore, the amendment would direct the Secretary to determine whether alternative means, such as direct subsidies to the exchanges, and refinements to tax credit eligibility determinations, are necessary to provide support for the purchase of such coverage for children.The Secretary would also be directed to determine and be given authority, if necessary, to exempt the child-only coverage option from age-rating requirements.
49 Cornyn C24 (453) Not Agreed to (6 - Ayes, 16 - Nays, 1 - pass)
Short Title: Promoting equality between low-income Americans and their elected officials; Description of Amendment: Requires Member of the Congress of the United States to enroll in the Medicaid program of their respective states. Party-line: nays: Snowe, Kyl, Bunning, Ensign (pass), and dems
50 Rockefeller D10 (10) Agreed to ( 15 - Ayes, 3 - Nays, 5 - Passes) Short Title: Amendment to the Medicare Commission provision
Description of Amendment:The amendment would strike the description of the Commission and add the language consistent with the concepts included in the following sections of the MedPAC Reform Act of 2009 (S. 1380), with a modification to replace all references to ―MedPAC with ―the Commission‖: Section 1(b), with a modification to require that Commissioners are ―free of any current conflicts and held to the highest standards of disclosure and accountability
Section 1(b), with a modification to include Administrator of the Health Resources and Services Administration (HRSA) as an ex-officio member of the Commission
Section 2(g) MACPAC Technical Amendments
Section 2(h) Lobbying Cooling-Off Period This also creates several commisions Party-line with: Snowe and Ensign voting w/dems and Passes: Grassley, Kyl, Crapo Roberts and Enzi
51 Friday (9/25/2009)
52 Ensign C 10 (409) Not Agreed to (10-13) Short Title: Transparency in Czars; Description of Amendment: Any czar handling health care issues shall be subject to the Senate confirmation process. Party-line
53 Kerry C 15 (240) Withdrawn with Unanimous Consent on the request of Senator Kerry.
Short Title: Narrow the Age Rating Band; Description of Amendment: The amendment will replace the 5:1 age rating band in the Chairman‘s Mark with a 2:1 age rating band. Taking together all permissible risk factors, premiums within a family category could not vary by more than a 3:1 composite ratio.
54 Cornyn C23 (452) Not Agreed to (11-12) Requires that all amendments accepted or ruled out-of-order during the Finance Committee’s consideration of the America’s Healthy Future Act of 2009 be re-scored by the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) for accuracy. Furthermore, if an initial score is found to be inaccurate or an amendment is found to have been incorrectly ruled out-of-order, the Committee shall debate and reconsider the amendment. party-line with Lincoln voting with Rs
55 Cantwell C2 (283) Agreed to by Voice Vote
Short Title: Pharmacy Benefit Manager (PBM) Transparency for Health Plans Operating in the Health Insurance Exchanges; Description of Amendment: The amendment requires pharmaceutical benefit managers (PBM) to share basic information with the commissioners of the exchanges and with any plans the PBMs contracts with in the exchanges. This information will be considered confidential and must be protected by the commissioners and the plans. The PBM will be required to confidentially disclose information on: (1) the percent of all prescriptions that are provided through retail pharmacies compared to mail order pharmacies, and the generic dispensing and substitution rates in each location; 2) the aggregate amount and types of rebates, discounts and price concessions that the PBM negotiates on behalf of the plan and the aggregate amount of these that are passed through to the plan sponsor; 3) the average aggregate difference between the amount the plan pays the PBM and the amount that the PBM pays the retail and mail order pharmacy. There are no mandates that these rebates are passed through, only that they be reported to plans. Further modified to apply same penalties to the Secretary of Health and Human Services for disclosing this information as applied in regards to Medicaid rebate data.
56 Kyl C10 (377) Not Agreed to (9-14)
Short Title: Ensuring Consumer Choice of Health Care Benefits; Description of Amendment: The amendment would prohibit the federal government from limiting consumer choice by defining the health care benefits offered through private insurance. Party-line with Snowe voting w/dems
57 Tuesday (9/29/2009)
58 Rockefeller C6 (186) Not Agreed to (15-8) Consumer's Health Care Act, S. 1278, as modified. Public Option Baucus, Conrad, Lincoln, Nelson, Carper voting w/ Rs
59 Schumer C1 (260) Not Agreed to (10-13) Level Playing Field Public Option Baucus, Conrad, Lincoln voting w/ Rs
60 Roberts D4 (140) Not Agreed to (9-14) To protect patients and doctors Snowe voting w/ dems
61 Kyl D8 (131) Not Agreed to (10-13) The Patients Act - The amendment would add the “Preserving Access to Targeted, Individualized, and Effective New Treatments and Services (PATIENTS) Act of 2009” (S.1259) Party line vote
62 Roberts D5 (141) Not Agreed to (8-14, 1 pass) Short Title: To protect patients and doctors

Description of Amendment: Amend Title III, Subtitle F, Patient-Centered Outcomes Research Act of 2009 to prohibit cost from being a factor in any comparative clinical effectiveness research conducted using federal funds, including funds under this Subtitle and those appropriated through the American Recovery and Reinvestment Act of 2009.
Snowe voting w/ dems, Ensign passed
63 Grassley (Hatch) D2 (108) Agreed to (23-0) Medicare Physician Payment Equity All aboard!
64 Stabenow C8 (280) Agreed to w/o objection To ensure all insurance plans conform to the same consumer protections and market rules
65 Bunning C1 (394) Not Agreed to (9-14) Equal access to affordable healthcare Snowe voting w/ dems
66 Grassley (Bunning) C3 (328) Agreed w/o objection To require Members of Congresss and all Congressional staff to purchase coverage through Exchanges
67 Crapo (Roberts) C1 (398) Not Agreed to (10-13) To amend the employer shared responsibility requirement and protect small business Party line vote
68 Ensign C5 (404) Ruled out of order Health Account Balance Protection Act Ensign moved to appeal the ruling but failed
69 Menendez C6 (305) Accepted without objection
Protecting consumers when they are in an emergency room: Each health care plan and health care insurance issuer offering coverage in the exchange shall provide enrolled individuals coverage for emergency services without regard to prior authorization or the emergency care provider‘s contractual relationship with the health plan.
70 Lincoln D9 (41) Accepted without objection
Expand CMS Innovation Center to consider testing direct access models of care under Medicare
71 Kyl C11 (378) Not Agreed to (9-14) Ensuring consumers' choice of insurance options that best meet their health needs Snowe voted w/ dems
72 Grassley C4 (329) Not Agreed to (11-12) Providing consumers with the same health insurance options as Members of Congress Carper voted w/ Rs
73 Hatch C10 (351) Agreed to (12-11) Restoration of Funding for abstinence education. The amendment would direct $50mil a year through FY2014 appropriated under Title I, Subtitle I of the Chairman's Mark for Section 510 of Title V of the Social Security Act Conrad and Lincoln voted w/ Rs
74 Baucus modification/side by side to Hatch Agreed to (14-9) PRE-adulthood training: amend Title V of Social Security Act to directly appropriate to HHS $75 million for a Personal Responsibility Education for Adulthood Training for each of the fiscal years FY2010 through FY2014 Snowe voted w/ dems
75 Grassley C15 (340) Not Agreed to (10-13) Promoting state flexibility and individual freedom Party line vote
76 Wednesday (9/30/2009)
77 Hatch C14 (355) Not Agreed to (10-13) Prohibits authorized or appropriated federal funds under
this Mark from being used for elective abortions and plans that cover such abortions. Conrad voted w/ Rs while Snowe voted w/ dems
78 Enzi C1 (415) Not Agreed to (11-12) The amendment lowers the actuarial value of
the bronze plan to 60 percent and maintains the out-of-pocket limit
specified in the Chairman‘s mark. Conrad voted w/ Rs
79 Grassley C8 (333) Not Agreed to (10-13) Purpose:
An amendment to require presentation of identification in applying for Medicaid benefits

Description of Amendment:
The amendment amends Title 19 of the Social Security Act to require an applicant (or the parent or guardian in the case of a child under the age of 18) to present at the time of application for Medicaid or CHIP benefits government-issued photo identification and that identification must be authenticated with the issuing agency. Party line vote
80 Kyl C15 (382) Not Agreed to (10 - Ayes, 12 - Nays, 1 - Pass) Clarification that real-time information sharing, with
appropriate privacy protections, is required among the Social Security Administration, the Department of Homeland Security, and the Internal Revenue Service. Party line vote but Cantwell was passed.
81 Nelson F1 (478) Agreed to (14-9) The modified Chairman's Mark increases the threshold for claiming the Section 213 itemized deduction for medical expenses from 7.5 percent to 10 percent of AGI. This admendment would exempt individuals age 65 and older (and their spouses) from the increased AGI threshold. Individual age 65 and older (and their spouses) would be eligible to claim the Section 213 deduction if their medical expenses exceed 7.5 percent of AGI. This amendment would apply to taxable years beginning after December 31, 2012 and ending before January 1, 2017. Snowe voted w/ dems
82 Kyl F8 (529) Not Agreed to (9-14) Under current law individuals may itemize catastrophic medical expenses if they exceed 7.5% of AGI. This amendment
would reduce that threshold to 5.0% Snowe voted w/ dems
83 Grassley F1 (483) Not Agreed to (10-13) Protecting health care consumers from increased health insurance premiums. Party line vote
84 Enzi C4 (418) Not Agreed to (10-13) Ensuring Americans are protected from dramatic cost increases. Party line vote
85 Cornyn D7 (166) Not Agreed to (9-14) Short Title: Protecting Seniors‘ Access to Care.
Description of Amendment: The Chairman’s Mark provides a one-year “fix” to the Medicare fee schedule through 2010, but in 2011 physicians will face approximately a 25 percent pay cut. The amendment would prevent cuts to physicians serving Medicare patients in 2011 and 2012 by providing a 0.5% update to the Medicare fee schedule for each of those two years. If the amendment were adopted, there would be a total of three years of 0.5% updates for physicians reimbursed under the Medicare physician fee schedule. Snowe voted w/ dems
86 Hatch C17 Not Agreed to (10-13) Provide that the annual fees on the four health industry segments not take effect until the General Accountability Office has certified that no portion of the annual fee is likely to be passed on to consumers of the products manufactured or imported by the companies on which the tax is levied. Party line vote
87 Roberts (Hatch) F2 (536) Ruled out of order Ensuring Individuals and Families Can Keep Their Health Care
Benefits non germane
88 Roberts F4 (538) Ruled out of order Strike the provision in the Chairman’s Mark that prohibits the cost of over-the-counter medicine from being reimbursed through a health FSA, HRA, HSA or Archer MSA. non germane
89 Bunning F4 (533) Agreed to without objection Amendment to prevent tax increases from increasing the cost
of medical care provided to veterans.
90 Ensign (Carper) C8 (407) Agreed to (19-4) To codify and enhance existing regulations designed to encourage
individuals to adopt healthy behaviors through voluntary participation in programs of health promotion and disease prevention Baucus, Conrad, Bingaman, Kerry, Lincoln, Stabenow, Cantwell and Wyden all voted w/ Rs
91 Stabenow D6 (71) Agreed to without objection To establish guidelines to ensure patient access for our nation‘s emergency rooms
92 Cornyn C22 (451) Not Agreed to (9-14) The Chairman‘s Mark exempts Medicaid beneficiaries
from the personal responsibility requirement. This amendment would require certain non-elderly, non-pregnant Medicaid beneficiaries to sign a state-designed personal responsibility or member agreement. The personal responsibility agreement would include broad responsibilities and rights Carper voted w/ Rs, Bunning and Crapo voted w/ dems
93 Cornyn C30 (459) Not Agreed to (10-13) Reducing waste, fraud, and abuse in the Medicaid program. Party line vote
94 Kyl D2 (125) Not Agreed to (10-13) Ensuring Seniors’ Care Will Not Be Rationed through the
Physician Feedback Program Party line vote
95 Thursday (10/01/2009)
96 Crapo F1 (534) Not Agreed to (11-12) This amendment provides that no tax, fee or penalty imposed by this legislation shall be applied to any individual earning less than $200,000 per year or any couple earning less than $250,000 per year. Lincoln voted w/ Rs
97 Ensign F2 (541) Not Agreed to (11-12) The amendment would limit that new tax liability by exempting individuals making less than $200,000 per year and families making less than $250,000 per year. Lincoln voted w/ Rs
98 Snowe (Lincoln, Bingaman) F9 (521) Agreed to by Voice Vote Exclude HIPPA-excepted benefits form the excise tax on high cost plans; w/ Lincoln C3 {247}
99 Hatch F6 (496) Ruled out of order Make the transition relief for the excise tax on high cost health insurance plans contingent upon a GAO study concluding that the relief is fairly apportioned among the states under the 16th Amendment. 7 - Ayes, 9 - Nays, non germane
100 Bunning F2 (531) Not Agreed to (9-14) Sunset tax increases in the mark that increase the out-of-pocket health care costs for Americans or cause employers to invade the privacy of their workers Snowe voted w/ dems
101 Bunning F3 (532) Not Agreed to (9-14) Amendment to conform the definition of medical expenses for all taxpayers in a manner that allows people who like the health coverage they have to keep it. Snowe voted w/ dems
102 Cornyn F5 (555) Not Agreed to (10-13) Protecting small businesses from higher costs - certify no provison will impose additional costs on small business Party line vote
103 Ensign F6 (545) Not Agreed to (11-12) Change the index of the high cost insurance in the Chairman's' bill to CPI-medical Stabenow voted w/ Rs
104 Cantwell C15 (296) Agreed to (12-11) Provides a federally funded, non-Medicaid, state plan which combines the innovation and quality of private sector competition with the purchasing power of the states Lincoln voted w/ Rs
105 Kyl F4 (525) Not Agreed to (9-14) Eliminate health insurance providers' fee Snowe voted w/ dems
106 Grassley C11 (336) Agreed to by Voice Vote Protect state budgets from the maintenance of effort mandate
107 Kyl F6 (527) Not Agreed to (10-13) Short Title: Eliminate Flexible Spending Account Cap
Description of Amendment: The amendment would eliminate the $2,000 cap on flexible spending accounts. Party line vote
108 Bunning F1 (530) Not Agreed to (9 -Ayes, 13 - Nays, 1 -Pass) Sunset tax increases in the mark on 12/31/19 Snowe voted w/ dems, Cantwell passed
109 Kyl C17 (384) Not Agreed to (10 -Ayes, 12 - Nays, 1 -Pass) Increase Current Limits on HSA Contributions Cantwell pass
110 Kyl C14 (381) Not Agreed to (10-13) 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 Party Line Vote
111 Lincoln F1 (472) Agreed to (14- Ayes, 8 - Nays, 1 -Pass) Executive compensation limits on health insurance providers Snowe voted w/ dems, Ensign passed
112 Grassley F5 (487) Agreed to without objection Fail-safe mechanisms to ensure health care reform does not increase the budget deficit
113 Wyden D17 (60) Agreed to by Voice Vote Ensuring Continuation of Benefits for seniors Covered Under Medicare Advantage
114 Kerry C10 (235) Withdrawn Ensuring that premium tax credits continue to make health insurance affordable
115 Kerry C8 (233) Withdrawn Empowering state exchanges to be prudent purchasers
116 Schumer (Snowe) C3 (262) Agreed to (22-1) Hardship waiver at 8% Kyl voted no and requested for the Roll Call
117 Wyden (Carper) D10 (53) Agreed to by Voice Vote Personalized Medicine and Access to Critical Lab Tests
118 Kyl F3 (524) Not Agreed to (10-13) Eliminate device fee Party line vote
119 Rockefeller C22 (202) Agreed to (13- Ayes, 9 - Nays, 1 - Pass) Universal coverage for children Snowed voted w/ dems, Wyden pass
120 Rockefeller F1 (465) Agreed to (13-10) This amendment makes various changes to the Modified Chairman's mark Party line vote
121 Ensign F1 (540) Not Agreed to (11-12) Strike the provision in the Chairman's bill that caps Flexible Spending Accounts Lincoln voted w/ Rs
122

 

[Bradley in DC]

See also Keithhennessey.com