When health care reform finally hits the floor of the U.S. Senate, most likely after the Thanksgiving holiday, Alaska Sen. Mark Begich plans to be in the middle of the fray with a batch of floor amendments to propose.
Because he is not on one of the two senate committees that have dealt with health care bills, the Senate Health and Finance committees, Begich's first chance at influencing the bill will be on the senate floor.
The senator is working on a package of floor amendments with a group of moderate senators, all fellow Democrats, he said Nov. 11.
Given the likelihood that the margin of passage for health care reform will be razor-thin in the Senate, as it was in the U.S. House, Begich will have unusual amount of stroke for a first-year senator.
Begich didn't reveal details of his strategy or the substance of all of his major amendment proposals in a Nov. 11 briefing in Anchorage, but said one of his top priorities is to give Medicare the ability to negotiate prices for drugs with pharmaceutcal companies.
Medicaid and the Veterans Adminstration now negotiate prices for drugs, but the pharmaceutical industry lobbied through a provision that prevents similar negotiating authority for Medicare, a huge federal program that provides health services to senior citizens.
Forcing Medicare to pay the list price for drugs has become a big source of profits for drug companies, and a target for intense advertising in home states for congressmen and senators seeking to change the arrangement, Begich said.
"If this is adopted, it will save our government $106 billion in the first 10 years," the senator said.
Among other amendments, Begich will seek is a new provision for tax benefits to encourage recreation and sports for young people as an aid to healthier living.
"People would be able to include certain expenses for childrens' athletic activities on their itemized deduction," Begich said.
In other comments on health care, Begich said he's not sure the government-run health insurance option that is in the House-passed bill will survive in the senate. He said a private nonprofit insurance entity could be an option that survives the Senate, however.
A lot of what a public option could accomplish can also be done through the new insurance-pooling exchanges that would be created under the legislation, Begich said.
He said he expects a number of amendments to be made that would propose variations on a government-sponsored system that may be acceptable to most senators.
A priority for him is that changes to the health care system be "deficit neutral," meaning they won't cost the government more money.
Begich also said he is critically examining the continued exemption of insurance companies from anti-trust laws, but wants insurance companies to able to compete for health insurance business across state lines so there would be more competition in the Alaska health insurance market.
Like many others in Congress, Begich wants insurance reform to end practices like denials based on preexisting conditions and limits to lifetime benefits. He also wants portability of health insurance, so workers can take their coverage with them if they change jobs.
Currently, many Americans are trapped in jobs because they are afraid they will lose coverage if they switch employers and health plans, Begich said.
The senator also wants the size threshold for small businesses, where they would be required to offer health coverage, increased to 50 or 100 from the thresholds of 25 to 50 employees now in bills pending in Congress.
He will also seek increased Medicare reimbursement for physicians, even if it's temporary.
"If I can get only a year or two, I'll take it," Begich said.
Tim Bradner can be reached at
tim.bradner@alaskajournal.com.
