Tuesday, Sept. 22, 2009 | 2 a.m.
- How the overhaul could alter the popular but costly Medicare Advantage (9-20-2009)
- Sticker shock: How the overhaul could exact a heavy toll on state finances (9-20-2009)
- Desperate for insurance, residents share health care woes (9-18-2009)
- Nationwide tour promoting health care reform ends in Las Vegas (9-18-2009)
- Harry Reid: Health care bill won't work for Nevada (9-16-2009)
- Grant to aid 400 waiting for Medicare (9-14-2009)
- Editorial: Lowering Medicare costs (9-2-2009)
- Medicare Advantage plans may lose federal cash (1-16-2009)
Republican Sen. John Ensign vowed to focus on health care reform, to show Nevadans he is working hard for them after the distractions that accompanied his disclosure of an affair this summer.
This week Ensign is poised to try to do that with more than 30 amendments to the health care bill.
Ensign is a member of the Senate Finance Committee, which today will begin the arduous task of sifting through proposed changes and preparing the bill for a vote by the panel, possibly by week’s end. It is tough work: The 23-member committee is staring down more than 500 amendments.
Ensign’s offerings span the hot-button issues of the health care debate and beyond: He wants to ban money for the controversial community activist group ACORN, block health coverage for illegal immigrants, halt the expansion of Medicaid and replace the word “fee” with the word “tax” throughout the bill.
Democrats see these as “nuisance amendments” aimed at grabbing publicity and derailing the bill.
But a senior Republican aide said Ensign is offering amendments important to the debate.
“These are huge issues,” said the GOP Senate leadership aide. “These are core issues that almost every Republican in Congress cares about.”
Ensign is not alone in attempting to alter the bill.
Republicans are offering amendments to gut the expansion of Medicaid, ensure abortions are not covered and require that federal employees buy their health care from the new exchange.
Democrats are proposing a range of amendments, including one to establish the public option — the government-run health program that would be offered alongside private plans as a competitive alternative on the health care exchange.
Working through all the amendments promises long days and nights ahead.
Ensign’s 30 amendments include proposals to:
• guarantee that no senior citizen would be dropped from the popular Medicare Advantage plans and forced onto a new health plan.
This amendment is an attempt to appeal to seniors who are nervous about changes to Medicare Advantage, which serves one in three Nevadans on Medicare. The program is costing the federal government 14 percent more than regular Medicare, and Democrats want to trim it back to parity. That could prompt some companies to eliminate Medicare Advantage plans, and the seniors covered by these plans would need to find a new insurer or sign up for regular Medicare.
Ensign’s amendment would prohibit proposed changes to Medicare Advantage if any senior’s coverage is changed.
• prohibit an expansion of Medicaid for poor residents if it requires states to pay more than an additional 1 percent of their current Medicaid costs.
This has been the subject of debate in Nevada, where the governor opposes expanding Medicaid unless it is fully paid for by the federal government. Senate Majority Leader Harry Reid is fighting to get a greater federal subsidy for Nevada.
Under the Senate bill, the costs to Nevada would increase by 5 percent a year, in large part because the state expects to have a large number of poor people sign up.
• prohibit federal money for ACORN, the low-income housing organization snared in an undercover journalism expose.
• require any new health czars to be confirmed by the Senate.
• replace the word “fee” with the word “tax” throughout the bill.
• require Social Security cards be shown to block illegal immigrants from receiving subsidies to help pay for health insurance. The bill already prohibits illegal immigrants from receiving subsidies to buy mandated health insurance.
Jim Kessler, vice president of policy at the centrist Third Way think tank, said with these amendments, Ensign is “trying to create a nuisance. He’s not trying to legislate. He’s trying to be difficult. The truth is, if these passed, he still wouldn’t support the bill,” he said.
“These aren’t really serious substantive amendments by someone thinking deeply about health care. These are political amendments designed to score points, designed to get press,” he added.
Ensign’s office did not respond to requests for comment about his legislation.
Senate Majority Leader Harry Reid does not sit on this committee or have proxy amendments.
Ensign has always been a go-to senator for Republicans, willing to jump into the fray with legislative initiatives. Republican leaders also likely support giving him an opening to turn the page after disclosure this summer of his affair with a staff member forced him to step down from his leadership position and saddled his colleagues with unwanted attention.
It is unclear just how many of Ensign’s 30 amendments will make it to debate as the senators go around the room and one-by-one offer their top priorities. But he will have his chance to make a mark.