Senate Amendments Feature Insurer Exec Pay Limits, Malpractice Award Caps

Janice Simmons, for HealthLeaders Media , December 7, 2009

In a rare but not unprecedented move, the Senate met through Saturday and Sunday to top off the first week of reform debate. Aside from President Obama meeting with the Democratic Caucus on Sunday afternoon, several amendments did come up for a vote:

Insurer executive compensation. An amendment offered by Sen. Blanche Lincoln (D-AR) that would have limited the deductibility of health insurance company executive compensation to $400,000 per year attracted support from 56 senators—but fell short of the 60 votes needed to win approval.

Lincoln had argued that her amendment would have helped encourage insurance company executives to recognize patients' interests first. She added that since the early 1990s, the rate of insurers' revenue being spent on patient care has fallen to about 90% to 80%.

Malpractice award caps. An amendment offered by Sen. John Ensign (R-NV), which would have capped medical malpractice awards going to plaintiffs' attorneys to one-third of the first $150,000 in compensation awarded, received a 32 66 vote.

Sen. Richard Durbin (D IL), in floor debate before the amendment was voted on, said medical malpractice plaintiffs' attorneys already get paid 50% less than defense attorneys. Sen. Arlen Specter (D PA) said Congress should leave efforts to handle medical malpractice system problems to the states.

Home health benefits. An amendment offered by Sen. John Kerry, (D-MA) that would protect Medicare home healthcare benefits, received a 96 0 vote.

However, by a vote of 53-41, the Senate rejected a Republican effort to block cutbacks in payments to home health agencies that provide nursing care and therapy to homebound Medicare beneficiaries.

Divided along party line, Republicans charged that the cuts would hurt some of the nation's most vulnerable citizens; Democrats said, though, that the cuts would eliminate waste and inefficiency in home care.

Medicare. In a 97-1 vote, the Senate approved Sen. Debbie Stabenow's (D-MI) amendment that stated that nothing in the legislation would reduce benefits already guaranteed to seniors who get coverage through Medicare Advantage plans.

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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