The first change offered by Senate Democrats to their health overhaul bill appears crafted in part to blunt criticism of government rationing sparked by recent guidelines that recommend women get routine mammograms starting at 50 instead of 40.
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Maryland Democratic Sen. Barbara Mikulski
Senators are expected to vote on the amendment today, the Associated Press reports.
Maryland Senator Barbara Mikulski, who sponsored the amendment, said in a statement that it would require insurers to cover mammograms for women 40 and older, as well as some other preventive services, at little or no cost to patients.
She announced her plans for the amendment three days after the U.S. Preventive Services Task Force published the mammography guidance.
Soon after, critics of the guidance disparaged the Task Force, saying it was an apparatus of government interference. On the Senate floor, John McCain, Republican of Arizona, said, "Isn't that the kind of advisory board that this legislation could put into law, that those kinds of mandates could come down which could literally jeopardize the health and lives of Americans?"
Mikulski's amendment may help Democrats deflect that attack, especially since it has the support of Sen. Olympia Snowe, R-Maine. But, another thing the amendment does is underscore the economic significance of the new breast screening guidance. The preventive services panel looks at patient care and safety, not costs, so the Congressional Budget Office's estimates for the amendment provides a glimpse into the financial stakes.
The CBO estimates Mikulski's amendment would add $940 million to the cost of the overhaul over ten years, the senator's spokeswoman says. Not all of that money would go to mammograms, because the amendment could compel insurers to include other services.
Mikulski pushed a very similar provision that was included in the Senate Health, Education, Labor and Pension Committee's version of the overhaul. The New Republic reported last month that Majority Leader Harry Reid had scrapped that language when drafting the final Senate version because it was too ambiguous, and potentially too expensive.
Weaver is a reporter for Kaiser Health News, a nonprofit news service.