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Massachusetts: 12-4-09 This Week in Health Care Reform
December 7, 2009
ON CAPITOL HILL
Congress returned from its Thanksgiving break to begin a new and important phase in the historic attempt to pass health care reform legislation. As the Senate began its pivotal floor debate Monday, ACS CAN continued to work with lawmakers from both parties to attempt to amend the bill to remove cost barriers to care by ending arbitrary lifetime caps on benefits, reducing or eliminating co-pays for preventive services including mammograms and colonoscopies, and limiting the ability of insurance companies to charge more for coverage based on an applicant’s health status or age.
Access to, and coverage for, screenings and other essential preventative care measures, priority issues for ACS CAN, have been widely discussed in recent weeks. On Monday, Senator Barbara Mikulski (D-Md.) took up the issue when she introduced the first amendment to the health care bill, which would guarantee women access to lifesaving cancer screenings, such as mammography and Pap tests, and encourage insurers to consider a variety of different guidelines when making decisions about coverage. The amendment, which ACS CAN strongly supported, passed 61-39 on Thursday. An alternative amendment introduced by Senator Lisa Murkowski (R-Alaska) that would not have ensured no-cost preventive services for women failed shortly thereafter.
While the Senate’s strong support for eliminating co-pays and other financial barriers to screening represents a tremendous initial victory for the cancer community, we still have a long way to go. The Senate debate will almost surely continue up to Christmas and quite possibly afterward, with senators offering scores of amendments that could impact the debate's timeframe. Unlike the the House, where amendments had to receive Speaker Nancy Pelosi’s (D-Calif.) approval to move forward, Senate Majority Leader Harry Reid (D-Nev.) will not know in advance all of the amendments that senators may offer.
A brief overview of how events could play out from here follows:
• Over the next two to three weeks, senators on both sides of the aisle will continue to offer amendments on a variety of issues and with different intent. Some senators will want to improve the bill, while others will seek to score political points back home.
• In the meantime, Senator Reid will be working toward compromises on two large and outstanding issues – the public option and abortion – in order to garner the 60 votes he needs to bring debate to a close and pass the bill.
• Senators may offer amendments specific to those two issues in the coming days, and the Senate will likely vote them down. But at some point, we expect Senator Reid to “thread the needle” on those two issues with compromises that he thinks assure him the 60 votes he needs get the bill off the floor. Once he feels he has those vote commitments, he will incorporate the agreements into a manager’s amendment and ask for a vote. To get that vote, he will file a motion to invoke cloture (to close off debate), and it is on this critical motion that his quest for 60 votes will be put to the test.
• If that vote succeeds, debate would be limited to 30 additional hours, additional amendments that could be offered would be severely restricted and the Senate would proceed to final passage within a day or two at most.
• If and when the bill passes the Senate, it will be referred to a conference committee, where House and Senate leaders will reconcile the two bills into a final conference bill. Passage of the conference bill in the House and Senate is the penultimate step. From there, the bill will finally go to the White House for the president’s signature.
ACS CAN is closely monitoring the floor debate to ensure that any changes offered through amendments do not threaten the priority needs of people with cancer. Meanwhile, ACS CAN’s grassroots advocates across the country are contacting lawmakers to emphasize the importance of those priorities and to encourage the Senate to pass a comprehensive bill by the end of this year.
ACCESS TO MAMMOGRAPHY
As you are aware, the U.S. Preventive Services Task Force (USPSTF) published new guidelines in last month recommending against routine mammograms for women in their 40s and suggested that women aged 50 to 74 get a mammogram every other year instead of annually. On Tuesday, the Society’s chief medical officer, Otis Brawley, M.D., testified before the House Energy and Commerce Subcommittee on Health that reducing the number of breast cancer deaths in America requires improved access to mammography and clinical breast examination. Dr. Brawley also testified that health care reform legislation could reduce confusion and strengthen public confidence by ensuring that the USPSTF’s process for determining recommendations is transparent, inclusive and evidence-based. This week’s hearing received extensive media coverage, and Dr. Brawley was quoted in numerous outlets including The Boston Globe and the Wall Street Journal.
AROUND THE COUNTRY
As debate continues in the Senate, grassroots advocates are gearing up for another big month in the field. Volunteers and staff across the country are planning for "Twelve Days of Health Care Reform" activities, with particular emphasis on events targeting key senators. The South Atlantic Division is organizing a postcard drive with the message: "Don't let another season go by without passing health care reform." In Nebraska, we're working with partners on a "Health Reform Rocks" concert in an effort to engage more young people on the issue. Other states are planning media activities highlighting patient stories and holiday-themed drop-offs -– such as stockings, candy, or holiday cards – at district offices.
Thanks, as always, for all you do.
Dan