WASHINGTON – Republicans on the House Energy and Commerce Committee today submitted an amendment to the Rules Committee that include amendments accepted in the committee’s markup and later dropped in H.R. 3962, the latest Democratic health care bill.

During the full committee markup in July, Republican members offered, and Democrats accepted, amendments to improve the bill, including amendments to prohibit the rationing of medical care, prevent federal government bureaucrats from dictating to doctors on how to practice medicine, and help veterans retain their health care choices. Unfortunately, the Democrats omitted or gutted these amendments in H.R. 3962. This omnibus amendment includes eight of those amendments.

“When the appearance of bipartisanship without the inconvenience of its reality is thought desirable, one sure way to get it is by accepting Republican amendments in committee and then misplacing them in the speaker’s office,” said U.S. Rep. Joe Barton, R-Texas, ranking member of the committee. “So it was that multiple amendments on the health care bill, on issues ranging from preserving the doctor-patient relationship to recognizing the needs of rural America, had vanished when the speaker introduced her bill.  If you control the process, you control the outcome, and that’s why fair process so often seems to end at the speaker’s office door.”

For a copy of the amendment, click here.

Provisions included in the omnibus amendment:

U.S. Rep. Greg Walden amendment on rural members of MedPac

This amendment would help ensure that the Medicare Payment Advisory Commission more accurately represents the demographics of Medicare recipients. Only one of MEDPAC’s 17 commissioners has rural health care credentials, yet 26.8 percent of Medicare recipients live in rural. This amendment would require that five commissioners on MEDPAC be representatives of rural health care in order to more appropriately represent the Medicare population and its needs. This amendment was not included in H.R. 3962. 

“My amendments for fair representation for rural America were two of the very few that were agreed to with overwhelming bipartisan support in the Energy and Commerce Committee in July,” said Walden, R-Ore. “And yet, after the bill emerged from closed-door negotiations, the amendments had been stripped out. It’s just plain wrong, and it speaks to why Americans are so frustrated with the broken system of governing in Washington, D.C.”
 
Walden amendment on a Rural Health Advisory Committee

This amendment would help ensure that the new “Health Benefits Advisory Committee” established in the Democratic legislation accurately represents the interests of rural Americans. Currently 21 percent of the U.S. population lives in rural areas. Mr. Walden’s amendment would ensure that at least one quarter of the committee’s members be practitioners who have legitimate experience practicing in a rural area for at least a five-year period preceding their appointment. This amendment was not included in H.R. 3962. 

U.S. Rep. Mike Rogers amendment on using research for rationing care

H.R. 3962 guts the Rogers amendment accepted at committee. This amendment would prevent the federal government and private insurers from using federal comparative effectiveness research for care rationing or limiting reimbursement levels. The current legislation creates a Center for Comparative Effectiveness Research to conduct said research. While the bill prevents the CCER from using this research for rationing, the Center for Medicare and Medicaid Services or any other agency could still use comparative effectiveness research, including cost-effectiveness research, to make payment and coverage decisions to deny patients care. This amendment would prevent government and private agencies from rationing availability of life-saving drugs, therapies, and treatments based on government research, or limiting reimbursement for these services.

“Treatment decisions must be left up to a patient and their doctor, not bureaucrats,” said Rogers, R-Mich. “Comparative effectiveness research should be used as an information resource, not a coverage mandate. Denying treatment is a shameful way to treat Americans and it fails completely to improve the lives of those in need of medical care.”

U.S. Rep. Mike Burgess amendment on health plan review process

This amendment would ensure that all qualified health plans (including the public plan) under the bill will have a reasonable and accessible utilization review and appeals process so that insurance companies (or the public plan) are not allowed to deny needed care and step in-between a patient and their doctor. This amendment was not included in H.R. 3962. 

“My amendment would have given patients who have been denied a service by their health insurance – private insurance plans or the government-run public insurance plans – the ability to appeal that decision,” said Burgess, R-Texas. “This is a basic protection that all patients deserve, and it’s tragic that Speaker Pelosi disagrees.”

U.S. Rep. Ed Whitfield amendment on cuts to Ambulatory Surgical Centers

This amendment would place a moratorium on the reimbursement cuts to 10 of the top 11 procedures performed by interventional pain physicians in an Ambulatory Surgical Setting. It also includes accreditation language to ensure procedures performed in the ASC setting are required to be performed in an accredited setting, by a well-qualified physician as determined by HHS. This amendment would help ensure that valuable pain relieving procedures remain available to Americans in need. This amendment was not included in H.R. 3962. 

“For 2009, Ambulatory Surgical Centers are facing severe cuts in reimbursements. It is projected that 10 of the top 11 procedures performed by interventional pain physicians in an ASC will face a permanent reduction this year, which in turn could hurt patient access to these treatments,” said Whitfield, R-Ky. “I am disappointed that Speaker Pelosi chose to strike my amendment which would have remedied this problem and placed a moratorium on reductions in Medicare reimbursements to ASCs.”

U.S. Rep. John Shimkus amendment on protection for Christian Scientists

This amendment, accepted at committee, would add language to the Democratic health care bill ensuring that there is no religious discrimination for patients seeking spiritual care under plans in the new Health Insurance Exchange. This amendment was not included in H.R. 3962. 

“Those religious traditions that utilize non-traditional care, which are allowed as medical deductions by the IRS, should have them covered in any health care bill,” said Shimkus, R-Ill. “While I do not support the Speaker’s underlying bill, I do not believe federal legislation should discriminate against such practices.”

U.S. Rep. Steve Buyer amendment on veterans’ care

This amendment would allow veterans enrolled in the VA health care system and TRICARE to obtain coverage through the new Health Insurance Exchange in addition to their VA or TRICARE coverage. Under the current language, VA health care would be deemed "qualified" coverage. The problem with the language is that it is ambiguous and could be interpreted to disqualify individuals enrolled in VA health care or TRICARE from participating in the exchange. In 2007, almost 80 percent of veterans enrolled in VA care had additional health coverage. The Buyer amendment was not included in H.R. 3962. It explicitly provided that veterans and servicemembers may choose additional health insurance through the “exchange”, along with care provided by VA or DOD.

“I am hopeful that the Democrat leaders will keep their promise to America’s veterans and restore this critical section to the bill,” said Buyer, R-Ind. “Our veterans have earned VA health care as well as the liberty to choose whatever other coverage they prefer, and I will continue my efforts to ensure veterans’ choices are not limited by this bill when it comes to something as important to them as their health care.”

U.S. Rep. Phil Gingrey amendment on dictating treatment

This amendment would prevent government bureaucrats at the new Center for Comparative Effectiveness Research from dictating to physicians what treatments they can or can’t offer. In the legislation, the CCER is tasked with gauging what treatments and procedures are most cost effective. This manner of government-sponsored research, in conjunction with the new federal crowd-out health plan, would represent the first step toward implementing a policy of bureaucratic health-care rationing. This amendment will ensure that this new agency cannot take the next dangerous step and put a federal bureaucrat between the American people and their doctors. This amendment was not included in H.R. 3962.