Senate Renews Health Care Debate, but Efforts are Voted Down
Although several states indicated they will not implement the health care law now that one federal district judge has ruled it void, a Republican effort Wednesday to add an amendment to an airports construction bill to repeal the law failed by a Senate vote of 51-47.
Senate Minority Leader Mitch McConnell's decision to use the House-passed repeal as an amendment to the Federal Aviation Administration legislation did not win a single Democrat vote.
But it has gotten the clock ticking on discussion about repeal. Lawmakers took to the Senate floor Wednesday to argue their points on the health care law once more.
Senators also voted another amendment alongside the House repeal bill. A Democratic amendment offered by Michigan Sen. Debbie Stabenow, which called for the full repeal of the 1099 reporting requirement for medical businesses purchasing equipment worth $600 or more, passed by a vote of 83-17.
But that is just one of a host of features that critics say demonstrate major flaws in the legislation.
Can America Mandate Medical Care?
Future of health care in America
"They know it's a rotten bill," said Sen. Orrin Hatch, R-Utah, speaking of his Democratic counterparts. "They've already agreed and taken the amendment of Sen. (Mike) Johanns of Nebraska to do away with the 1099 expensive overregulatory problem ... but that's a very modest small thing compared to the extraordinary cost" of the program.
"This is going to be a big, big issue in 2012," Hatch told Fox News.
All 47 Senate Republicans who oppose the legislation argue that not only is it paid for with accounting gimmicks like double-counting Medicare savings and using 10 years of taxes for six years of spending, it calls for "high taxes, less choices and bureaucrats making health care choices for Americans."
"The basic premise is flawed," said Sen. Jim DeMint, R-S.C., adding that efforts to repair the existing law is "like pouring a few glasses of fresh water into a polluted river."
But Sen. Max Baucus, D-Mont, the chairman of the Senate Finance Committee and an instrumental character in passage of the law, lamented those who say the $1 trillion, 10-year bill costs too much.
"It does cost a trillion dollars. But it raises a trillion dollars so it costs nothing," he said, adding that many of the people who will pay fees for the service support the legislation.
Baucus added that the law also extends the life of the Medicare trust fund by 12 years, which would be lost under repeal, as would be an additional prescription drug benefit offered to Medicare recipients.
McConnell, R-Ky., called it a side effect of Washington politics that someone could conclude that adding trillions of dollars to the federal budget would save money.
As lawmakers on the Senate floor debated their position, in a Senate Judiciary Committee hearing, other senators reviewed the constitutionality of the law, a move that comes too late, said Sen. Charles Grassley, R-Iowa.
"Under our system of limited and enumerated powers, the sensible process would have been to have held a hearing on the law's constitutionality before the bill passed, not after," Grassley said.
The hearing came just two days after District Judge Roger Vinson ruled in a lawsuit filed by 26 states that the law had to be thrown out because the individual mandate violates the Commerce Clause of the Constitution because it orders Americans to participate in commerce even if they don't want to do so.
Sen. Dick Durbin, the No. 2 Democrat in the Senate who led the hearing, predicted that Vinson will be overturned.
"When the Affordable Act -- Affordable Care Act comes before the Supreme Court, I'm confident that they will recognize that Congress can regulate the market for health care that we all participate in, and that it can regulate insurance, which is the primary means of payment for health care services," he said, adding that Vinson's ruling is akin to the "activist" judicial decisions that conservatives claim to hate.
As senators continue the debate, some states have said they will not do anything to institute the law since Vinson voided it. Florida Republican Gov. Rick Scott said Tuesday he plans to put the brakes on the state's role in putting the law into place while Wisconsin Attorney General J.B. Van Hollen called it "dead."
However, most insurers, hospital executives and state officials say they expect they'll keep carrying out the overhaul.
"It's still the law of the land," said William Hoagland, vice president for public policy at health insurer Cigna. "We'll continue to proceed with its requirements, and (the ruling) will not slow that down. We have no other choice until this thing is resolved one way or the other." Insurers spent millions to block passage of the law.
"I don't think people are going to hit the stop button," said Paul Keckley, executive director of the Deloitte Center for Health Solutions, a research arm of the consulting firm. "You probably don't make the big bets right now, but you make the incremental investments in case you have to make the big bets six or 12 or 18 months down the road. Everyone proceeds with an informed approach."
While the law works its way through the judicial system up to the Supreme Court -- a process that could take a year or two but is expected to be completed by time the law goes into full force in 2014 -- government regulators are sure to write thousands of pages of federal rules covering hospitals, doctors, states, insurers and others. And states are still working on their own legislation.
According to the National Conference of State Legislatures, lawmakers have introduced more than 250 bills relating to states' role in the overhaul so far. About 50 propose challenges to the law or say states should refrain from carrying out particular provisions. More than 70 deal with insurance changes, and more than 40 address how to establish the state markets where people can buy coverage.
But even as states and insurers move forward with their plans to cover everyone by 2014 -- at a price that's likely to rise as higher risk and subsidized patients join the networks -- many do ponder what happens if the Florida judge's ruling is upheld.
Without the mandate, "it's a house of cards," Hoagland said.