The Senate Finance Committee Hearings on Chairman Max Baucus’ (D-MT) health care proposal continued Friday morning, September 25, 2009. The amendments offered by members of the Committee continued to address issues related to growth of the federal government and limitation to consumers’ choice and freedom, changes which are likely to emerge from the passage of a Senate Finance Committee bill.

Accountability and Transparency in Government Decision-Making over Health Care (Ensign Amendment C10)

Under both House and Senate bills, federal government officials or appointees would make crucial decisions over health care benefits, treatments and medical procedures that would be available to millions of Americans. Sen. Ohn Ensign(R-NV) offered an amendment to subject these officials to Senate confirmation for their appointment. Currently, the controversial House bill (H.R. 3200) allows for the creation of a Health Benefits Advisory Committee, which would consist of nine non-federally employed members appointed by the President, nine non-federally employed members appointed by the Comptroller General of the United States, and up to eight federally-employed members, also appointed by the President. These officials would make recommendations concerning benefits standards. Similarly, the Senate HELP Committee’s proposal creates a Medical Advisory Council, members of which would be appointed by the Secretary of Health and Human Services. Members of the Medical Advisory Council would determine what services are essential benefits, what coverage is affordable and acceptable for different income levels, and who would be penalized for not buying insurance. Decisions made by the Council would be automatically adopted unless Congress passed a joint resolution rejecting them. Nonetheless, the Senate Finance Committee voted against Sen. Ensign’s amendment on a party line vote, 10-13.

Promoting Accuracy in Health Care Financing (Cornyn Amendment C23)

One of the recurrent problems of government health care costs projections is that they are often too low, giving taxpayers a false sense of the true cost of the government enterprise. Senator John Cornyn (R-TX) introduced an amendment to ensure accuracy and reliability in amendments made to the Chairman’s mark. Sen. Cornyn’s proposal would have required all amendments that have already been accepted or ruled out-of-order by the Committee be re-assessed by the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT). Should the initial score of any amendment previously accepted be deemed inaccurate, Sen. Cornyn’s amendment would have required reconsideration by the Committee. This would ensure that the health care cost offsets cited in each amendment to the Chairman’s mark would be correct, and would allow the Committee to re-evaluate its decisions if this were not the case. With deficit neutrality of the Finance Committee’s bill a crucial litmus test established by President Obama, the amendment would serve to ensure accuracy in cost projections. The amendment failed on a vote of 11-12, with Senator Blanche Lincoln (D-AK) voting with Republicans for Sen. Cornyn’s amendment.

Limiting Patient Choice. (Kyl Amendment C10)

Senator Jon Kyl (R-AZ) introduced an amendment that would prohibit federal officials from defining the health care benefits, and the kinds of medical treatments and procedures Americans would get, that are offered by private health insurers. Giving the government the power to define and restrict benefits to fit into federal officials’ version of acceptable insurance plans would in effect nullify Americans’ current coverage and, given the dynamics of government benefit setting, further drive up costs. Kyl’s proposal would conserve Americans’ existing benefits by preventing federal officials from declaring them legally unacceptable. Sen. Kyl’s amendment failed with a vote of 9-14, with Senator Olympia Snowe (R-ME) voting with Democrats.

The Senate Finance Committee’s decisions on vital details of health policy reform, including transparency in new government bureaucracies and restrictions on patient choice, are revealing. Americans should continue to pay close attention to what members of Congress do, not just what they say. There is often a wide gap between congressional rhetoric and congressional action.

The Senate Finance Committee continues its mark-up of the Baucus bill on Tuesday, September 29th. Then it will consider amendments to add a government health plan to compete against private health insurance plans.

Kathryn Nix, Heritage Intern, provided the research for this blog.