Democrats on the U.S. Senate Appropriations Committee rejected several attempts Thursday by Kansas Sen. Jerry Moran to block implementation of key parts of the federal health reform law.
Moran, a Republican, attempted to rescind funding needed by the Department of Health and Human Services to establish new online insurance marketplaces in every state and implement the controversial coverage mandates in the Affordable Care Act, or Obamacare.
Three of the four amendments that Moran offered during the committee’s consideration of the HHS appropriations bill were defeated 14-16 on party-line votes. The fourth was lost on a tie vote.
The first of Moran’s amendments would have prohibited HHS from spending any money to implement or enforce the requirement that large employers offer health insurance to their workers. He said the prohibition was needed even though the Obama administration announced last week that it intended to delay enforcement of the requirement – which only applies to employers with more than 50 workers – so that it could work with businesses to address their concerns.
Democratic Sen. Tom Harkin of Iowa said Moran’s amendment would prevent the administration from using the yearlong delay to work through those issues.
“The administration wants to work with businesses over the next year to figure out how to do this right,” Harkin said. “The senator’s amendment would prohibit the administration from even doing that.”
Other key provisions targeted
Moran also attempted to block implementation and enforcement of the individual mandate, which requires virtually all Americans to purchase health coverage or pay a penalty. He said the administration’s delay of the employer mandate could leave many individuals uncertain about their coverage options.
“In fact there may be an increased number of who will not have coverage as a result of that delay,” Moran said. “And so I would suggest that if we’re going to delay the implementation of the business mandate we should also delay the implementation of the individual mandate.”
To make his proposal to rescind $1.4 billion needed to establish the online insurance marketplaces more difficult for Democrats to vote against, Moran proposed to transfer the money to the National Institutes of Health to fund more medical research.
But Democrats on the committee said as much as they would like to give NIH a bigger funding increase, taking money needed to set up the marketplaces – or exchanges – was not the way to do it.
“That’s the choice you give us. It’s not a good choice,” said Illinois Sen. Dick Durbin.
Supporters of the reform law say the exchanges are essential to efforts to extend coverage to the uninsured and others who struggle to afford it. That’s because the only way to qualify for federal subsidies is to purchase coverage through an exchange.
Another amendment to block implementation of the exchanges was also defeated. Written by Kansas Sen. Pat Roberts and several other Republicans, it would have repealed the part of the law requiring exchanges in every state if even one of them wasn’t ready to start enrolling consumers by Oct. 1.
Medicare cost containment an issue
The controversial Individual Payment Advisory Board has long been a target of Republicans. It is responsible for keeping Medicare spending in check to offset other cost increases in the law.
Calling the board “one of the more onerous, damaging and dangerous” parts of the law because its recommendations could lead to the rationing of care, Moran tried to rescind all of its $15 million appropriation.
Harkin objected to Moran’s characterization of the board. He said in addition to a long list of patient protections, the law gives Congress the authority to block any cost-saving recommendations that it believes could negatively the affect care provided to seniors and disabled Americans served by Medicare.
“My friends on the other side say this is going to ration health care, but they (IPAB) are prohibited from doing that,” Harkin said.
If it had passed, Moran’s amendment would have used the $15 million to increase funding for a graduate program that helps to train doctors to work in children’s hospitals.
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