Update: Amendments in Senate Finance Committee “Mark-Up”

REVISED:  09.310.09 — 12:30 p.m.

The second pro-life amendment offered by Senator Hatch today failed, 10-13.

The Amendment:  Hatch Amendment #C13 (Right of Conscience)

Short Title: Non-discrimination on abortion and respect for right of conscience

Description:

Non-Discrimination on abortion and respect for rights of conscience

(a) NON DISCRIMINATION.—A Federal agency or program, and any State or local government that receives Federal financial assistance under this Act (or and amendment made by this Act), may not-

1) subject any individual or institutional health care entity to discrimination, or

2) require any health plan created or regulated under this Act (or an amendment made by this Act), to subject any individual or institutional health care entity to discrimination, on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions.

(b) DEFINITION.—In this section, the term “health care entity” includes an individual physician or other health care professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization, or plan.

(c) ADMINISTRATION.—The Office for Civil Right of the Department of Heath and Human Services is designated to receive complaints of discrimination based on this section, and coordinate the investigation of such complaints.

The Vote:

Republicans

CHUCK GRASSLEY – yes

ORRIN G. HATCH – yes

OLYMPIA J. SNOWE – no

JON KYL – yes

JIM BUNNING – yes

MIKE CRAPO – yes

PAT ROBERTS – yes

JOHN ENSIGN – yes

MIKE ENZI – yes

JOHN CORNYN – yes

Democrats

MAX BAUCUS – no

JOHN D. ROCKEFELLER – no

KENT CONRAD – yes

JEFF BINGAMAN – no

JOHN F. KERRY – no

BLANCHE L. LINCOLN – no

RON WYDEN – no

CHARLES E. SCHUMER – no

DEBBIE STABENOW – no

MARIA CANTWELL – no

BILL NELSON – no

ROBERT MENENDEZ – no

THOMAS CARPER – no

Not Agreed to (10-13)

 

REVISED:  09.30.09 — 11:31 a.m.

The first pro-life amendment offered by Senator Hatch today failed, 10-13.

The Amendment:  Hatch Amendment #C14 (Abortion funding and coverage)

Short Title: Prohibits authorized or appropriated federal funds under this Mark from being used for elective abortions and plans that cover such abortions.

Description:

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, except in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself, or unless the pregnancy is the result of an act of rape or incest.

Nothing in this amendment would preclude an insurance issuer from offering a separate, supplemental policy to cover additional abortions. Such a supplemental policy would be funded solely by supplemental premiums paid for by individuals choosing to purchase the policy.

 The votes:

Republicans:

CHUCK GRASSLEY – yes

ORRIN G. HATCH – yes

OLYMPIA J. SNOWE – no

JON KYL – yes

JIM BUNNING – yes

MIKE CRAPO – yes

PAT ROBERTS – yes

JOHN ENSIGN – yes

MIKE ENZI – yes

JOHN CORNYN – yes

Democrats

MAX BAUCUS – no

JOHN D. ROCKEFELLER – no

KENT CONRAD – yes

JEFF BINGAMAN – no

JOHN F. KERRY – no

BLANCHE L. LINCOLN – no

RON WYDEN – no

CHARLES E. SCHUMER – no

DEBBIE STABENOW – no

MARIA CANTWELL – no

BILL NELSON – no

ROBERT MENENDEZ – no

THOMAS CARPER – no

Not Agreed to (10-13)

____________________________________________________________________________________________

No amendments directly pertaining to abortion received a vote on Tuesday. 

Three amendments relating to Comparative Effectiveness Research (”CER”) were defeated.  These amendments would have addressed concerns that CER could be used to mandate or encourage the withdrawal or curtailment of effective life-sustaining treatment to the elderly, terminally ill, chronically ill, or permanently disabled.

Roberts D5:  Would have prohibited cost from being a factor in any comparative clinical effectiveness research conducted using federal funds under this bill and existing law. Failed 8-14.

Roberts D4:  Would have removed the comparative effectiveness provisions in the bill (the Patient-Centered Outcomes Research Act of 2009).  Failed 9-14.

Kyl D8:  Would have added the “Preserving Access to Targeted, Individualized, and Effective New Treatments and Services (PATIENTS) Act of 2009” (S.1259).  The PATIENTS Act would have ensured that data obtained from CER would not be used to deny coverage of an item or service under a federal health care program.  It would have also ensured that CER would account for factors contributing to differences in the treatment response and treatment preferences of patients.  Failed 10-13.

 

REVISED:  09.28.09

No amendments pertaining to life issues received a vote on Friday.  The Senate is not in Session on Monday.

On Tuesday, the Senate Finance Committee will likely consider three pro-life amendments filed by Senator Orrin Hatch (UT).  While the Committee accepted one pro-life modification to the bill last week as part of a package of amendments – the federal government cannot mandate abortion in the “essential benefits package” that private insurers must provide to participate in the system – there are still several problems with the Bill.  These include the following:

• At least one private plan in each premium rating area must provide coverage for abortion;
• The Government will spend $6 billion establishing co-ops  that could cover abortion;
• Refundable advanceable tax credits may be used to purchase health insurance that includes abortion (this provision includes the “Capps” funding mechanism that is supposed to prevent federal dollars from going directly to abortion, but does not alter the fact that the government is subsidizing insurance plans that cover abortion);
• Conscience protection also protects abortionists (and therefore could require pro-life insurance companies to contract with abortionists).

Senator Hatch will attempt to address these concerns with his amendments.  It is important to note, however, that even in the unlikely event that his amendments are accepted, the Finance Committee only “marks up” bills in concept.  In other words, the language in the final bill might not be sufficient after the Committee staff drafts it. 

Furthermore, when the text of the Senate Finance Bill is completed in Committee, there are still many additional steps before legislative language is finalized.   For instance, the Senate Finance Bill will need to be reconciled with the bill reported out of the Senate Health, Education, Labor, and Pensions (“HELP”) Committee.  For a detailed description of the process, please see http://blog.aul.org/2009/09/08/back-to-the-hill-guide-what-to-expect-next/.

Pro-life concerns will remain until the final version of health care reform is passed out of the Senate and the House, because there are many opportunities throughout the process for pro-abortion lawmakers to attempt to “mainstream” abortion as health care. 

I.                   Hatch Amendment #C12 (Assisted Suicide Amendment)

Short Title: Prohibits federal funds under this Mark from being used to pay for assisted suicide and offers conscience protections to providers or plans refusing to offer assisted suicide services.

Description:

Protecting Americans And Ensuring Taxpayers Funds in Government Health Care Plans Do Not Support Or Fund Physician-Assisted Suicide

The Federal Government, and any State or local government or health care provider that receives federal financial assistance under this Mark (or under an amendment made by this Mark) or any health plan created under this Mark (or under an amendment made by this Mark), shall not pay for or reimburse any health care entity to provide for any health care item or service furnished for the purpose of causing, the death of any individual, such as by assisted suicide, euthanasia, or mercy killing.

Prohibition Against Discrimination on Assisted Suicide

The Federal Government, and any State or local government or health care provider that receives federal financial assistance under this Mark (or under an amendment made by this Mark) or any health plan created under this Mark (or under an amendment made by this Mark), may not subject an individual or institutional health care entity to discrimination on the basis that the entity does not provide any health care item or service furnished for the purpose of causing, or for the purpose of assisting in causing, the death of any individual, such as by assisted suicide, euthanasia, or mercy killing.

II.                Hatch Amendment #C13 (Right of Conscience)

Short Title: Non-discrimination on abortion and respect for right of conscience

Description:

Non-Discrimination on abortion and respect for rights of conscience

(a) NON DISCRIMINATION.—A Federal agency or program, and any State or local government that receives Federal financial assistance under this Act (or and amendment made by this Act), may not-

1) subject any individual or institutional health care entity to discrimination, or

2) require any health plan created or regulated under this Act (or an amendment made by this Act), to subject any individual or institutional health care entity to discrimination, on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions.

(b) DEFINITON.—In this section, the term “health care entity” includes an individual physician or other health care professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization, or plan.

(c) ADMINISTRATION.—The Office for Civil Right of the Department of Heath and Human Services is designated to receive complaints of discrimination based on this section, and coordinate the investigation of such complaints.

III.             Hatch Amendment #C14 (Abortion funding and coverage)

Short Title: Prohibits authorized or appropriated federal funds under this Mark from being used for elective abortions and plans that cover such abortions.

Description:

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, except in the case where a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself, or unless the pregnancy is the result of an act of rape or incest.

Nothing in this amendment would preclude an insurance issuer from offering a separate, supplemental policy to cover additional abortions. Such a supplemental policy would be funded solely by supplemental premiums paid for by individuals choosing to purchase the policy.

Rationale:

All other major federal health programs preclude federal funds from being used to support abortion or any benefits package that includes abortion, beyond the limited circumstances of life endangerment and rape/incest. In some programs such as SCHIP (State Children’s Health Insurance Program) this is written into permanent law; in others, such as Medicaid, Medicare and FEHBP (Federal Employees Health Benefits Program) longstanding appropriations riders, the Hyde Amendment and parallel provisions, have long prevented federal funds from paying for abortions or from supporting any of the costs of a health plan that includes them. In FEHBP, because federal funds are used to supplement private premium dollars, all the health plans offered to federal employees must completely exclude abortion except for these very limited circumstances. This amendment would respect the same policy in the health care reform legislation, while allowing truly private insurance coverage for elective abortions to continue as long as this is done through a supplemental policy, chosen and funded by the purchaser and kept completely separate from the federally subsidized package of benefits. In this way longstanding federal policy on abortion funding will be preserved, anyone who wants abortion coverage may purchase it, and people will not be forced to pay for other people’s abortions.

REVISED:  09.24.09

No amendments pertaining to life issues received a vote on Thursday.

REVISED: 09.23.09

No amendments pertaining to life issues received a vote on Wednesday.

Pro-Life Amendments Filed in the Senate Finance Committee

Abortion Mandate 

Hatch Amdt. #C14 (355)

Prohibits authorized or appropriated federal funds under this Mark from being used for elective abortions and plans that cover such abortions.  

Enzi Amdt. #12 (426)

To ensure that mandates on abortions are prohibited.  

Enzi Amdt. #C13 (427)

To ensure that abortions are not paid for with federal funds and for the purchase of supplemental abortion coverage without federal funds.

Enzi Amdt. #C14 (428)

To ensure state abortion laws and regulations are not preempted by provisions in the underlying bill.  

Conscience Protections

Enzi Amdt. #C15 (429)

To ensure that conscience protections are applied. 

Hatch Amdt. #13 (354)

Non-discrimination on abortion and respect for right of conscience.

Physician Assisted Suicide

Hatch Amdt. #C12 (353) [Accepted in Concept]

Prohibits federal funds under this Bill from being used to pay for assisted suicide and offers conscience protections to providers or plans refusing to offer assisted suicide services.

REVISED: 09.22.09

The Senate Finance Committee incorporated a modification that includes numerous amendments.  Consideration of other individual amendments is expected to begin on Wednesday; however, no life-related amendments are expected to be considered on that day. 

The modification to the original bill encompasses several life-related issues. 

1. Mandatory abortion coverage in “Minimum Benefits package” removed.

Background:  The Senate Finance Bill originally allowed the federal government to mandate abortion coverage as part of the “minimum benefits package,” to the extent allowed by the Hyde Amendment. Today, that would only include abortions in the case of rape, incest and the life of the mother; however, if the Hyde Amendment were ever eliminated from the HHS Appropriations Bill, coverage for all abortions would be mandated. 

Correction:  Page 4 of the modification removed the language that created this requirement; therefore, the federal government cannot mandate abortion coverage in the “minimum benefits package.” 

Important Note:  This does not alter the following:   the government will spend $6 billion establishing co-ops that could cover abortion; refundable, advanceable tax credits may be used by individuals to purchase health insurance that covers abortion, and; at least one plan in each premium rating area must cover abortion.

2. Family Planning and School-based Health Centers:  Two amendments by Senator Stabenow were included in the modification.   The first (#C3, Page 13) expands eligibility for family planning coverage under Medicaid. The second, (#D11, Page 13) establishes school-based health centers.

3. Prohibition on Funding for Assisted Suicide and Conscience Protection:  Senator Hatch’s amendment (#C12, Page 17) was included.  This amendment would prohibit federal funding for assisted suicide and provide conscience protection for those who refuse to participate in assisted suicide. 

Important Note:  The Senate Finance Committee marks up bills “in concept” rather than with explicit language.

Tagged as: Abortion, americans united for life, AUL, Baucus, Congress, health care, Healthcare, mark-up, Obama