The Senate Finance Committee completed its markup of a health care reform bill on Oct. 2, 2009. During the two-week long markup, committee members introduced more than 550 amendments, approximately 100 of which were incorporated into the underlying measure, while another 150 were debated and rejected. 

The most contentious amendments were those offered by Sen. Jay Rockefeller (D-W.Va.) and Sen. Charles Schumer (D-N.Y.) to create a Medicare-like government-sponsored “public option” to compete with private insurers on a new health insurance exchange. The Finance Committee bill authorizes federal start-up funds to create member-owned non-profit health insurance cooperatives in lieu of a government-sponsored health plan. 

The amendments differed slightly—the Rockefeller amendment would have created a public plan with reimbursement rates set by the Secretary of Health and Human Services based upon Medicare rates, while the Schumer amendment would have required the public plan to negotiate reimbursement rates and otherwise adhere to the same rules and regulations as private insurers.  

Both amendments failed. Rockefeller’s was voted down 15 to 8 while Schumer’s received a vote of 13 to 10.  Five Democrats—Finance Chair Max Baucus (D-Mont.), Kent Conrad (D-N.D.), Blanche Lincoln (D-Ark.), Tom Carper (D-Del.), and Bill Nelson (D-Fla.)—joined all five committee Republicans in opposing the Rockefeller amendment, while three Democrats—Baucus, Conrad, and Lincoln—joined the committee Republicans in opposing the Schumer amendment. 

The failure of the “public option” proponents in the Finance Committee is illustrative of the difficulty they will face on the Senate floor, where 60 votes are needed to secure passage. Some pundits are claiming that the failure of the Rockefeller and Schumer amendments may be a death knell for the public option.

While the Finance Committee has completed its markup, it is waiting for the Congressional Budget Office to score the final proposal before proceeding to a vote on final passage. Chairman Baucus has said that a vote is likely to occur late in the week of Oct. 5, with passage expected on a mostly party-line vote.  Democrats are holding out hope that moderate Republican Olympia Snowe (R-Maine) will support the measure, but Sen. Snowe has remained coy about her intentions.

Impact on General Dentistry: Because each of the health care reform bills being considered in Congress mandate that all insurance plans being offered on the new health care exchange include pediatric dental benefits, the existence of a public option and its method of reimbursing providers likely will have a great impact on general dentists. The AGD will continue to track this matter closely.