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Health Care 'Fixes' Bill Headed Back to the House

Fixes include closing the Medicare “doughnut hole” in prescription drug coverage.

As Democrats were steering the final part of their historic health care reform package through a gauntlet of amendments in the Senate on Wednesday, the Senate parliamentarian ruled that two minor items in the bill were incorrectly included. The violations will force the Senate to change the “fixes” bill, which means it must now be sent back to the House for final passage.

President Obama signed the major portion of health care reform on Tuesday. But Senate Democrats promised to pass a second bill of fixes sought by House members under the fast track rules of reconciliation that protect it from a Republican filibuster.

Senate Democrats number 59 and need only 51 votes to pass the bill.

For much of Wednesday and into the early morning hours of Thursday, Senate Republicans offered dozens of amendments to the bill. Their goal was to force the legislation back to the House for another vote.

During the Senate’s 10 hour vote-a-rama Wednesday, all 29 GOP amendments were rejected. Then the parliamentarian sustained two GOP objections to the language of the bill.

The provisions that will be dropped are from the section of the bill dealing with Pell Grants for college students and do not significantly affect the student loan program or the health care fixes.

The bill, with the two minor changes demanded by the parliamentarian, is expected to pass the House easily and quickly.

Fixes include closing the doughnut hole

The fixes in that bill include more help for older people who fall into the so-called doughnut hole coverage gap for prescription drugs under Medicare. Those with high drug costs who face a coverage gap will receive $250 this year, and increasingly more help in future years until the gap is completely closed. Other changes include postponing a new tax on expensive insurance policies and offering more moderate-income families help to buy health coverage.

Senate Minority Leader Mitch McConnell of Kentucky, said the 150-page postscript bill made an already bad reform measure worse, adding more Medicare cuts, more tax hikes and more costs for the federal treasury. “The whole thing was one last slap in the face to American,” he said.

AARP CEO A. Barry Rand urged passage of the measure, which addresses top priorities of older Americans.

“With the cost of prescription drugs continuing to skyrocket, closing the doughnut hole will help millions of older Americans afford their needed medications and avoid more intensive and costly care later in life,” Rand said.

The bill of fixes and the underlying measure that already passed will extend health insurance to 32 million Americans, help workers buy long-term care insurance, stop insurers from denying coverage based on pre-existing conditions, and reduce Medicare spending by more than $500 million over 10 years.

“It may be an inconvenient truth,” said Sen. Minority Whip John Kyl of Arizona. “This legislation will ultimately lead to the rationing of health care.”

“I looked up this morning and the sky was not falling,” said Sen. Claire McCaskill, D-Mo., poking fun at Republican dire warnings about the impact of health care reform. “People in America are going to realize this bill is not full of booby traps. It’s full of good things.”

Although some of the GOP amendments were designed to make it embarrassingly difficult for Democrats to oppose, Democratic leaders pressed their caucus to oppose them all so that President Obama can sign the fixes measure soon.

Sen. Tom Harkin, D-Iowa, had urged Democrats to resist the “siren song of amendments that sound good but only have one purpose—to kill it.”

One of the amendments, by Sen. Tom Coburn, R-Okla., would have banned coverage of erectile dysfunction drugs for convicted rapists and child molesters under any federally administered health care plan.

The amendments were the last legislative salvo in the battle over health care reform, but Republicans plan to continue campaigning against a bill they believe is deeply unpopular with the public.

Indeed, some state attorneys general are suing to stop the effort, and Republicans plan to run in this fall’s elections on the promise to undo parts of a reform they say is too expensive and gives government too much control over medical care.

Democrats are hoping the public tide turns as people—such as older people with high drug costs—start receiving benefits from reform.

“This will positively affect every American family,” said Ralph Neas, head of the National Coalition on Health Care. “It will provide health care security and savings. [For] people suffering through anxious times in their health care and financial security, it will provide peace of mind.”

Tamara Lytle was Washington bureau chief and a correspondent for the Orlando Sentinel from 1997 to 2008.

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