Senate Democrats push ahead on health bill

Reporting from Washington — 

After days of delay, Senate Democrats pushed ahead Thursday with their drive to pass a healthcare bill by Christmas, approving the first amendment to their giant bill: a measure to expand women’s access to preventive services such as mammograms.

The proposal by Sen. Barbara A. Mikulski (D-Md.), which passed on a largely party-line 61-39 vote, would authorize the federal government to require insurers to cover women’s preventive care and screenings without co-payments.

The amendment is expected to cost about $940 million over 10 years. It had the backing of numerous groups representing patients, doctors and women.

Daniel E. Smith, president of the American Cancer Society Cancer Action Network, said the proposal would “guarantee women access to lifesaving cancer screenings such as mammography and Pap tests.”

Democrats easily defeated, by a 58-42 vote, a proposal by Sen. John McCain (R-Ariz.) to send the bill back to committee to restore more than $400 billion in proposed cuts in what the federal Medicare program will pay insurance companies and healthcare providers over the next decade.

The Senate bill would use those savings to offset the cost of expanding coverage to an estimated 31 million by 2019.

Republicans allege the cuts would hurt seniors, a case they made again Thursday by focusing on Medicare Advantage, a program in which the government contracts with insurers to provide Medicare benefits to more than 10 million people.

The program has been popular, in part because insurers often provide benefits not available to seniors on traditional Medicare. But studies have shown Medicare Advantage also costs the government more than traditional Medicare, prompting calls for the government to pressure insurers to cut their costs.

GOP lawmakers and insurance companies have assailed that effort. “I dare say that if you had asked seniors earlier this year what they expected healthcare reform would look like, it certainly wouldn’t have involved massive cuts to a program that they’ve shown they like and they want,” Senate Minority Leader Mitch McConnell (R-Ky.) said.

Some insurers may trim the benefits if the federal government pays them less.

But several advocates for the elderly, including AARP, have rejected many of the GOP charges that the Senate bill would hurt seniors.

“AARP believes that savings can be found in Medicare through smart, targeted changes aimed at improving healthcare delivery, eliminating waste and inefficiency, and aggressively weeding out fraud and abuse,” Chief Executive A. Barry Rand said in a letter to Senate Majority Leader Harry Reid (D-Nev.). “We believe that Medicare changes in this bill begin to move us down this path, without reducing guaranteed Medicare benefits.”

The votes Thursday broke a logjam that has slowed Senate debate to a crawl this week.

But with Democratic leaders threatening to bring the Senate in over the weekend and potentially through the holiday, senior lawmakers were still trying Thursday evening to work out how to handle many more amendments.

noam.levey@latimes.com

Janet Hook and Kim Geiger in the Washington bureau contributed to this report.