The Senate Finance Committee continued its mark-up of the America’s Healthy Future Act of 2009 on Wednesday, September 30, 2009.

President Barack Obama made a couple of very high-profile promises concerning key issues that have emerged during the August recess and in contentious congressional town hall meetings. In his September 9, 2009 address to Congress and the nation in a special session of Congress, the President said that Americans could be assured that in his version of health care reform, there would be no federal funding of abortion nor the use of taxpayer funds to cover illegal immigrants.

In the key policy decisions of the Senate Finance Committee, those promises counted for little.

Protection of the Rights of Conscience (Hatch Amendment C13)

As noted, President Obama told Congress and the nation that, “no federal dollars will be used to fund abortions, and federal conscience laws will remain in place”. In that spirit, Senator Orrin Hatch (R-UT) presented two amendments to remove any uncertainty and reinforce the President’s very public commitment. Sen. Hatch’s first amendment would have protected federal conscience laws; it would have prohibited discrimination against medical professionals who did not want to practice or participate in abortion and protect the right of conscience of physicians and other health care professionals, as well as officials of health care facilities, organizations, and insurance plans. Countering Senate Democrats who declared the amendment unnecessary, Sen. Hatch said the bill’s language was ambiguous, and he sought to erase all doubt in the Committee’s intentions regarding the issue. The Committee voted against Sen. Hatch’s amendment 10-13. Senator Olympia Snowe (R-ME) voted with Senate Democrats against the amendment, while Senator Kent Conrad (D-ND) voted with Hatch and Senate Republicans for the amendment.

Federal Funding for Abortion (c-14)

Sen. Hatch’s second amendment would have prohibited federal funds from being used for elective abortions or to subsidize insurance plans that cover abortions. Hatch provided that nothing would stop insurers from offering supplemental policies for abortion—but plans funded or subsidized by the federal government could not provide abortion. Sen. Hatch’s amendment also provided exceptions to this law in the cases of rape, incest, or danger to the mother. Hatch’s rationale was to codify official promises made on both sides of the aisle that taxpayer dollars would not fund abortions. Though the Hyde Amendment already provides for such a restriction on the use of taxpayers’ money, it must be passed every year. Sen. Hatch’s amendment would have also written the President’s promise into law. The Hatch amendment failed in the Senate Finance Committee 10-13. Senators Snowe and Conrad also crossed party lines again in their votes.

Using Taxpayers Dollars to Cover Illegal Immigrants (Grassley Amendment C8 )

In his address on health care, President Obama also stated that, “…there are those who claim that our reform efforts would insure illegal immigrants. This, too, is false. The reforms…I’m proposing would not apply to those who are here illegally.” This statement ignited South Carolina Representative Joe Wilson’s controversial outburst.

To secure the President’s commitment, Senator Chuck Grassley (R-IA) introduced an amendment that would require proof of citizenship in order to access federal health programs. Sen. Grassley’s amendment would have required proper identification in applying for Medicaid benefits: Medicaid applicants, or the guardian of an applicant under the age of 18, would present government-issued identification at the time of application for Medicaid or CHIP benefits. Sen. Grassley’s amendment failed by a vote of 10-13. It was a party line vote, with Senate Democrats voting against the Grassley amendment.

Increased Consumer Costs. (Enzi Amendment C4, Grassley Amendment F1, and Hatch Amendment F17)

The President has said repeatedly that he would oppose middle class tax increases, and that, as a result of health reform, the typical American family would see a $2500 annual reduction in their health premium costs. Nonetheless, the Senate Finance Committee “mark” contains various taxes, which would be tantamount to middle class tax increases. These include taxes on insurance companies based on their market shares, taxes on drug manufacturers, taxes on medical device manufacturers, and taxes on clinical laboratories. Economists know, of course, that such additional taxes are passed on to consumers through higher insurance premiums and higher costs for drugs and medical devices. Senator Mike Enzi (R-WY), Senator Chuck Grassley (R-IA), and Senator Orrin Hatch (R-UT) proposed amendments to protect Americans against these proposed tax increases.

Sen. Enzi’s amendment would have required that- before implementing the bill’s new insurance rating rules, each state’s State Insurance Commissioner would have to certify that insurance premiums would not rise for a majority of residents. This amendment failed by a vote of 10-13 along a party line.

Sen. Grassley’s offered an amendment to strike the bill’s additional fees on health insurance plans. Title VI of the Chairman’s mark imposes a fee of $60 billion on insurance providers, which would be apportioned among all health insurance providers based on their market shares. The Grassley amendment was also defeated on a party line vote.

Finally, Sen. Hatch offered up an amendment that would have required the Government Accountability Office to certify that consumers would not pay the higher taxes imposed on health insurers, manufacturers of drugs and medical devices, and clinical laboratories. During the debate , Chairman Baucus expressed the novel belief that such annual fees would be borne by companies, and that they would not be passed onto the consumers. In that spirit, Sen. Hatch’s amendment would have codified the Chairman’s good intentions. The Committee nonetheless voted, along party lines, against the Hatch Amendment by a 10 to 13 vote.

The Senate Finance Committee, once again, has given ordinary Americans another insight into the gap between official Washington’s promises and the reality of the health care legislation being developed in Congress. Based on the President’s clearly stated intentions, on such matters as illegal immigration and taxpayer funding of abortion, it is obvious that the White House Office of Congressional Relations needs to do a better job communicating them to the Senate.

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