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Senate Committee Engaged in Multi-Week Mark-Up of Health Reform Bill; Provisions, Amendments on Women’s, Children’s Health

The Senate Health, Education, Labor, and Pensions Committee began marking up a draft health reform bill, The Affordable Health Choices Act, on June 17. Like the draft legislation examined in a House Education and Labor Committee hearing this week (see The Source, 6/26/09), the draft bill aims to overhaul the existing health care system and provide coverage to some 47 million uninsured Americans.

Among other provisions, the bill would: prohibit the denial of insurance coverage based on pre-existing conditions; require insurance plans to cover preventive care that received an “A” or “B” rating in the current recommendations of the United States Preventive Services Task Force; allow coverage to be extended to dependents through age 26; establish several councils or task forces to evaluate health programs; authorize “such sums as may be necessary” for FY2010-2014 for school-based health clinics, with special emphasis on establishing such facilities in medically underserved areas; and establish loan programs for students in primary health care professional training programs.

Also included in the draft are provisions to permanently establish an Office of Women’s Health within department of Health and Human Services (HHS) (p. 327). Headed by an assistant secretary, the office would be charged with establishing “short-range and long-range goals…for issues of particular concern to women throughout their lifespan.” A coordinating committee on women’s health also would be established to identify and address women’s health needs across HHS departments and agencies. The bill would authorize “such sums as may be necessary” for FY2010-2014 for the office. The Office of Women’s Health and the coordinating committee currently operate within the HHS but do not have permanent statutory authority.

On June 23, the committee adopted the following amendments to the bill:

  • an amendment by Sen. Bernie Sanders (I-VT) to add oral health care services to those provided by school-based health clinics that receive federal funding, 22-1; and
  • an amendment by Sen. Jeff Merkley (D-OR) to provide employees who are nursing mothers with reasonable break times to express breast milk, by voice vote.

The same day, the committee also adopted a package of amendments en bloc, by unanimous consent, including:

  • an amendment by Sen. Mike Enzi (R-WY) to strike the definition of “community” under the school-based health clinic program (see p. 367);
  • a second amendment by Sen. Enzi to strike the authority for optional services under the school-based health clinic program;
  • an amendment by Sen. Richard Burr (R-NC) to require all services provided by school-based health clinics be “age appropriate”; and
  • an amendment by Sen. Lisa Murkowski (R-AK) to require the secretary of HHS to consider communities with high per capita numbers of children and adolescents who are uninsured, underinsured, or enrolled in public health insurance programs when disbursing grants to school-based health clinics.

On June 24, the committee adopted, by unanimous consent, a second package of amendments en bloc, including an amendment by Sen. Orrin Hatch (R-UT) to create a mentoring program for minority, low-income children to encourage them to pursue careers in health care. The same day, the committee defeated, 9-14, an amendment by Sen. Judd Gregg (R-NH) that would have placed limits on the amount of damages a plaintiff could receive in an obstetrical or gynecological medical malpractice case.

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