The Energy and Commerce Committee recessed early Friday afternoon following a chaotic start to a multi-day markup on a major health care overhaul.

The measure (HR 3200), the result of input from the Energy and Commerce, Ways and Means, and Education and Labor committees, would expand health insurance by requiring individuals to get coverage and mandating that employers provide coverage or pay a penalty. It includes subsidies for low-income workers and would create a government-run “public option” to compete with private insurance companies as part of a health insurance exchange.

The Energy and Commerce panel began the markup on Thursday with opening statements from all members and began consideration of amendments Friday.

Early on in Friday’s session, Chairman Henry A. Waxman, D-Calif., ruled out of order an amendment by Michael C. Burgess, R-Texas, that would have capped non-economic damages — such as pain and suffering awards — in medical malpractice cases at $250,000. Democrats have not addressed the issue of medical malpractice in any of their overhaul proposals, to the chagrin of doctors and the GOP, who contend that the costs doctors incur defending themselves from frivolous suits are a major driver of increased medical spending.

Waxman said that Burgess’ amendment fell under the jurisdiction of the Judiciary Committee because of the provisions regarding liability and jury instructions.

Amendments

• Paramedics. In other action Friday, the committee adopted by voice an amendment designed to help former military medics obtain jobs as civilian paramedics.

The amendment, by Jane Harman, D-Calif., would authorize grants to states to set up programs to help military medics become emergency medical technicians. Harman said that unemployment among discharged veterans of the Iraq and Afghanistan wars is about 30 percent.

• Package of Amendments. The chairman of the panel’s Health Subcommittee, Frank Pallone Jr., D-N.J., offered an omnibus amendment, composed of provisions from 13 separate bills authored by committee Democrats.

Several Republicans objected to individual proposals in the omnibus, including one that would require chain restaurants to print calorie counts on menus. Republican Joe Pitts of Pennsylvania also objected to a section on post-partum depression because it did not include language addressing depression following abortion. In previous years, the committee agreed to include a provision in legislation related to post-partum depression that would urge NIH to study the mental health consequences of a terminated pregnancy – either by miscarriage or abortion.

Because of the objections and Republicans bitter complaints that they’d had little time to read the 75-page omnibus amendment, Waxman agreed to postpone further consideration of that amendment until Monday.

• Duplicative Programs. The panel adopted an amendment, offered by John Sullivan, R-Okla., to require the Health and Human Services secretary to study whether any duplicative programs would be created by the health overhaul, and after reporting to Congress, unilaterally eliminate them. Most panel Democrats said they didn’t object to a study of duplicative programs, but they wanted to be able to control whether the programs are eliminated.

Nonetheless, Sullivan’s amendment was adopted 29-27, with support from seven Democrats, all but one of them Blue Dogs. Republicans applauded after the committee’s clerk announced the tally.

Waxman said he asked the Blue Dogs after the vote if they were trying to make a statement, and they told him no, they thought it was genuinely a meritorious amendment.

“There’s no doubt in my mind that if the Blue Dogs join with the Republicans they can bring this bill down,” Waxman said. But he doubts that will happen.

• Mental Health. The panel also adopted by voice vote an amendment from Gene Green, D-Texas, that would instruct the secretary to create a program for mental and behavioral health training.

• End-of-Life Issues. Wisconsin Democrat Tammy Baldwin offered an amendment that would create a program for the Department of Health and Human Services to award grants for educational campaigns on end-of-life issues.

To placate pro-life members on the panel, Baldwin asked for unanimous consent to add an additional clause that would prohibit the grants from going to any “government or non-government organization that promotes suicide, assisted suicide or the active hastening of death.”

Oregon Republican Greg Walden objected, saying that the wording would prevent funding for the program in his state. Since 1997, Oregon has permitted assisted suicide of the terminally ill. Waxman urged Walden to remove his objection as only a few minutes remained for members to get to a vote on the floor.

“We’ve got a thousand page bill here and all these amendments, we’ve got to rush to vote and I can’t even find out if you are cutting off funds to agencies in my state,” Walden erupted, heatedly. “You get cut off on the floor, you get cut off in the Rules Committee and you get cut off here.”

Baldwin assured Walden that the intent of the amendment was solely to promote greater awareness for advanced care planning. Walden reluctantly withdrew his objection, and the committee adopted the amendment by voice vote.

Markup Continues Monday

The panel will resume consideration of the measure Monday afternoon and is expected to spend most of the week on the legislation.


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