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Senate Votes on Two Women's Health Amendments

December 3, 2009 - by Donny Shaw

The Senate this morning took their first two votes on health care amendments. Both amendments – one from a Democrats and one from a Republican – were in direct response to the recent U.S. Preventive Services Task Force recommendations that women start screening for breast cancer at age 50, not 40, and that women above 50 get screening less frequently. Even though the Senate health care bill as written would not require the task force recommendations to be followed, both amendments seek to ensure that insurers do not use them as an excuse to reduce existing levels of preventive women’s care coverage.

Mikulski Amendment

Sen. Barbara Mikulski [D, MD] offered the Democratic amendment on women’s care. The amendment would set a baseline for women’s preventative care coverage that would have to be provided by all plans, and it specifies that the services could not require copayments. “Services that would be covered under the Mikulski Amendment are likely to include cervical cancer screenings for a broad group of women; annual mammograms for women under 50; pregnancy and postpartum depression screenings; screenings for domestic violence; and annual women’s health screenings, which would include testing for diseases that are leading causes of death for women such as heart disease and diabetes,” according to a press release from Mikulski. “Should a women under 50 decide to receive an annual mammogram, this amendment will cover it.”

It also includes a secondary amendment from Sen. David Vitter [R, LA] that basically nullifies the recent task force recommendations. It states, “the current recommendations of the United States Preventive Service Task Force regarding breast cancer screening, mammography, and prevention shall be considered the most current other than those issued in or around November 2009.”

The Mikulski amendment was approved by a vote of 61-39. Sen. Susan Collins [R, ME] and Sen. Olympia Snowe [R, ME] joined Democrats to vote in favor the amendment. Sen. Russell Feingold [D, WI] and Sen. Ben Nelson [D, NE] voted with Republicans against it.

Murkowski Amendment

Sen. Lisa Murkowski [R, AK] offered the Republican version. The Murkowski amendment would bar the government from using any recommendations from the US Preventative Services Task Force for setting binding health care guidelines. Instead, it would require insurers to consult with private medical groups in deciding what women’s preventative care services to cover. Insurers would be required to disclose the information used to make their coverage determinations to consumers. “That means doctors and specialists would be recommending what preventive services to cover, not bureaucrats in Washington,” Murkowski said in a press release.

Broadly, the amendment would also prevent the government from using “comparative effectiveness research” in deciding what services to cover and it would block the government from defining or classifying abortion or abortion services as “preventive care” or as a “preventive service.”

The Murkowski amendment was rejected by a vote of 41-59. Sen. Ben Nelson [D, NE] was the only Democrat to vote in favor of the Murkowski amendment along with all Republicans.

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