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healthcartoon.pngOne Senate committee, and its watered-down proposal for
health care reform, is the focus of all eyes in Washington this week.
Specifically, the Finance Committee is going through more than 500 amendments to a plan
offered by Sen. Max Baucus
of Montana.  The
measure would require Americans to buy private health insurance but eliminates
any “public option” designed to compete with the private industry.

Hundreds of the amendments (large pdf) are just noise, including
one-liners aimed at killing any reform at all. Some push a tiny special
interest (i.e. Sen. John Ensign of Nevada seeks Medicare subsidies for a single
type of medical device) or create an election talking point, for instance about
how tough the candidate is on illegal immigration.

Here’s a short rundown of key amendments:

Affordability. In
response to a broad outcry from committee members, Baucus has already offered
his own amendment to slightly trim the amount that middle-class families would
have fork over to Blue Cross and friends—about 20% of their income, counting
copays and deductibles. A slew of other amendments, including one from key
Republican Olympia Snowe of Maine, would also aid middle-class affordability,
though modestly.

Public Option. The
current bill outline rejects a public option—a sort of voluntary Medicare
subscription—in favor of weak and unproven “co-ops” that citizens would have to
form themselves. Amendments by Sens. Jay Rockefeller (D-VA) and Charles Schumer
(D-NY) among others would restore a mild public option for individuals and
small businesses. Some Republicans, including Kyl and Orrin Hatch of Utah, want
to kill even the co-op idea. Snowe calls for instituting a public option only
if private insurers fail to make their product “affordable,” however that might
be defined—a so-called trigger option that will seem to some a desirable
compromise, but one that would certainly be killed by industry lobbying before
any trigger was pulled.

State patient protections.  A long-time pet demand
of conservatives is that insurers be allowed to sell a plan in many states, but
subject to the regulations of only one state of the insurers’ choosing. This
would do away with the Patients’ Bill of Rights laws passed by a majority of states,
including independent medical review of treatment denials or minimum standards
of care. Conservatives including Kyl and Sen. Mike Enzi of Wyoming are carrying
these amendments. On the other side, Sens. John Kerry of Massachusetts, Schumer
and Maria Cantwell of Washington propose amendments to preserve state
protections (in Cantwell’s case, allowing national plans to form but subject to
“all state insurance regulations”). On a related issue, an amendment by Sen.
Bob Menendez (D-NJ) would strengthen the minimum standard for states to aid
individuals to whom insurers deny treatment. The bill as stated by Baucus might or might not allow such interstate policies--it's purposely vague

Insurer rate regulation. This is missing from the Senate debate, but the most effective way to keep
insurance premium increases to a minimum while still allowing insurers a fair profit.
Consumer Watchdog’s model for such regulation is the California law governing
auto and other property and casualty insurers. Insurers have to prove to
regulators that a proposed rate increase is necessary before
imposing the increase. The law, passed by voters in 1998 as Proposition 103,
has saved consumers an estimated $62 billion since it went into effect, while
preserving a competitive market. Consumer Watchdog urges the Senate Finance
Committee to include such regulation in its health reform bill. Vice President
Joe Biden recently discussed rate controls in a speech outlining unaffordable
premium increases that vary wildly from state to state.