Combative health debate continues: Senate considers insurance executives' pay, cost controls

News coverage is focusing on Senate consideration of amendments to the massive health reform bill.

The Associated Press: "Democratic senators are taking aim at insurance industry executive pay as they jockey for advantage in a rare weekend session to debate President Barack Obama's health care overhaul. Republicans are showcasing the bill's cuts to Medicare, seeking to undermine support for the legislation among seniors and others as partisan debate rages ... Both sides were bracing for more grueling and unpredictable debates and negotiations Saturday, with Senate Majority Leader Harry Reid, D-Nev., racing the clock to complete action on the 2,000-plus page bill by Christmas" (Werner, 12/5).

Fox News: "After five days of debate, only two issues have been tackled through amendments: expanding women's health screenings and Medicare. The really big issues remain stalled behind closed doors. ... Democrats are so far apart on their difference that they can't even bring up amendments to deal with them. It's so bad that, just to fill time, they spent most of Friday on nonbinding proposals that state they should be fiscally responsible, measures that would have no binding impact on health care legislation at all. (Carl Cameron, 12/4).

Bloomberg: "U.S. senators intend to vote today on a plan to limit the tax deductions insurance companies can take on executive salaries, taking aim at a favorite target in the debate over health-care legislation. The amendment from Arkansas Democrat Blanche Lincoln would cap tax-deductible salaries at $400,000 instead of the current national limit of $1 million. It would apply only to health insurers that get at least a quarter of their income from premiums generated by the bill's new mandate to buy coverage."

"Insurers such as Indianapolis-based WellPoint Inc. and Hartford, Connecticut-based Aetna Inc. are coming under fire as lawmakers consider how to overhaul the U.S. health-care system. Lincoln said the companies will benefit from millions of new customers generated by the legislation. ... WellPoint spokeswoman Kristin Binns said Lincoln's amendment was inconsistent with compensation practices and regulations in other industries" (Litvan and Jensen, 12/5).

The New York Times: At least two coalitions of senators are trying to tackle perhaps the biggest question looming over the Democrats' big health care legislation: whether the bill would be aggressive enough to slow seemingly out-of-control health care costs for both the federal government and average Americans."  

The Time notes that one of the coalitions is comprised of "freshmen Democratic senators, who have prepared their own package of amendments aimed at cost containment. Among their proposals is that a new independent commission responsible for identifying potential savings in Medicare, also be directed to look at the overall health care system and to make recommendations for voluntary steps that could be taken by doctors, hospitals and other health care providers to lower costs." (Herszenhorn, 12/4).

CongressDaily reports on the other coalition - which called itself "tri-partisan" "Sens. Joseph Lieberman, D-Conn., Susan Collins, R-Maine, and Sen. Arlen Specter, D-Pa.,  announced an amendment to accelerate pilot programs and increase transparency in healthcare delivery. The senators said the amendment would mandate online reports on physician quality that would allow physician comparisons and reward Medicare beneficiaries who pick high-rated physicians."

"In addition, it would require insurance companies to publicly report on information such as how frequently they deny claims. It would also beef up one program in the underlying bill to incentivize hospitals to limit patient infections and another that allows bundled payments for various treatments. The HHS secretary would get the power to implement successful pilot programs without congressional approval"  (Edney and Friedman, 12/4).

The Hill: "The Senate may be staying in session this weekend to keep the healthcare ball rolling, but don't expect any major developments. ... Talks continued among centrist Democrats, and Republican Sen. Olympia Snowe (Maine), on devising a form of the public option with which they can live, and among liberal Democrats demanding a strong public option remain in the bill. Despite these conversations, the two sides did not appear on the verge of a deal Friday. Sen. Sherrod Brown (D-Ohio), a strong supporter of the public option, expressed frustration that he and more than 50 Democrats who share his position are being asked to compromise to accommodate a handful of centrists" (Young, 12/5).

Roll Call reports that Brown  "warned Friday evening that he is 'done' compromising with moderates and will not accept any further changes to the provision. Brown's unhappiness with the progress of talks on the public option could signal a new complication for Majority Leader Harry Reid (D-Nev.) as he looks to corral 60 votes for a final health care reform bill. Brown said that he and other liberal Democrats such as Sen. Jay Rockefeller (D-W.Va.) who support the public option have already made numerous concessions to Senate moderates, who he accused of trying to hijack the legislative effort" (Stanton, 12/5).

Meanwhile, Politico reports: "Senate Democrats are growing increasingly worried that abortion will upend what had become a clear path to approving the overhaul bill. Sen. Ben Nelson (D-Neb.) sparked a fresh round of concern this week when he repeatedly and definitively vowed to filibuster the health care legislation unless it included abortion restrictions as tough as the so-called Stupak amendment in the House bill. 'I don't ordinarily draw a line in the sand, but I have drawn a line in the sand,' Nelson said Friday."

"Nelson certainly has a long history of agitating his party by withholding his vote until he wrings out every last concession from Senate leaders. But on the uncompromising issue of abortion, Democrats fear he may really be serious this time. 'There is a worry that Sen. Nelson means business,' said a senior Senate Democratic aide, who spoke on the condition of anonymity to discuss strategy" (Budoff Brown, 12/4).

CongressDaily: "Senate Democratic leaders are attempting to craft a compromise on abortion language in the healthcare bill that will not be as restrictive as House language but will win over anti-abortion rights Democrats, Majority Whip Durbin said today. 'At the end of the day, we need Sen. Nelson's vote,' Durbin said on a Families USA conference call. ... Majority Leader Reid announced Wednesday that Nelson's amendment was queued up next for consideration from the Democratic side, but Nelson begged off, asking for more time. 
... Sen. Orrin Hatch, R-Utah, is expected to co-sponsor the amendment and initiated the request for the delay" (Edney and Friedman, 12/4).

The Washington Post notes that on Friday, the Senate voted "voted to keep provisions to establish the Community Living Assistance Services and Support Act, or Class Act, despite concerns among centrist Democrats that the program would quickly run out of cash." The Act would "create a new government insurance program for long-term care that would raise more than $70 billion over the next decade."

"A majority of senators -- including 11 Democrats -- actually voted against Class Act, warning that congressional budget analysts say it would become a drain on the federal budget less than 20 years after enactment. But while the amendment, by Sen. John Thune (R-S.D.), garnered 51 votes, it fell short of the 60 needed for passage" (Montgomery and Murray, 12/5).

The Hill reports in a separate story that Lieberman, an observant Jew, planned to walk about five miles to Capitol Hill today to participate in the debate:  "Religious rules call for the Sabbath to be set aside for rest and worship, and prohibits work or the lighting of fires. Many Jews interpret these rules to bar the driving of cars since turning a key in the ignition is akin to kindling a fire. But he said the healthcare reform debate is too important to miss. He explained that religious law makes an exemption for actions that are for the welfare of the community" (Bolton, 12/5).