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The Cantwell Amendment

October 2, 2009 - by Donny Shaw

The Finance Committee’s health care mark-up is over. Now they wait a few days to get an official budget scoring on the bill from the Congressional Budget Office and then vote take a final vote some time next week. Before they finished, they approved an amendment that pushes the bill about as far to the left as the Finance Committee, which is more conservative than the Senate as a whole, was willing to go.

The amendment, proposed by Sen. Maria Cantwell [D, WA], would provide federal money for states to use to negotiate more affordable health care plans for individuals earning between 133 percent of the federal poverty level (where the Medicaid expansion would be cut off) and 200 percent of FPL ($21,660 for an individual). These plans would be run exclusively by private companies, though basic requirements for what must be covered under the plans would be defined by the government and they would be offered exclusively through the new exchanges. The government would also require these plans to dedicate at least 85 percent of premiums directly to providing medical care, and the plans would have to meet “specific performance measures and standards.”

An overview of the amendment provided by Sen. Cantwell explains it like this: “This amendment provides a federally funded, non-Medicaid, state plan which combines the innovation and quality of private sector competition with the purchasing power of the states.”

In other words, this is still completely unrelated to the public option plans that all the other health care bills moving through Congress contain. It would not increase increase competition or force down costs because it wouldn’t be available to the general public. But progressives still like it. “This is a much better way of running an exchange, in contrast to vague categories of what must be covered and policies sold at different actuarial levels,” Jon Walker says at FireDogLake.

The amendment was approved on a vote of 12-11. All Republicans on the Committee opposed the amendment and all Democrats besides Sen. Blanche Lincol n [D, AR] supported it.

Cantwell has said in the past that she couldn’t support a health care reform bill that didn’t have a public option, such as the Finance Committee version. But McClatchy notes that her amendment, along with a change made to Medicare reimbursement rates in the Finance Committee bill, will be enough for her to support it.

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