Senate casts 1st health care vote, adopts measure to safeguard mammograms, preventive tests

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Senate casts 1st votes to overhaul health care

WASHINGTON — In its first vote on health care overhaul, the Senate Thursday narrowly approved an amendment to safeguard coverage of mammograms and preventive screening tests for women under a revamped system.

The 61-39 vote on an amendment by Sen. Barbara Mikulski, D-Md., and Sen. Olympia Snowe, R-Maine, would allow the Health and Human Services secretary to require insurers to cover preventive health screenings free of charge.

Under special provisions agreed to prior to the tally, 60 votes were needed to pass the amendment. The margin underscored the fragility of the coalition Democrats are counting on to move forward on President Barack Obama’s signature issue.

Though Democrats have 60 votes in the Senate, two Democratic senators voted against the amendment — Sen. Russell Feingold of Wisconsin and Ben Nelson of Nebraska. It was saved by three Republicans voting in favor — Snowe, Susan Collins of Maine and David Vitter of Louisiana.

Waiting in the wings is an amendment to restrict abortion funding, except in cases of rape, incest, or to save the life of the mother. Drafted by Nelson, an abortion opponent, it looms as perhaps the biggest challenge for the Democrats.

Thursday’s vote comes in the wake of heated controversy over a government advisory panel’s recent recommendation that routine mammograms aren’t needed for women in their 40s. Although the advisers’ recommendation was nonbinding, it prompted fears that the health care legislation would usher in an era of rationing.

The Mikulski-Snowe amendment would give the health and human services secretary authority to require health plans to cover additional preventive services for women. The Congressional Budget Office said the amendment would cost $940 million over a decade.

Mikulski said her amendment would guarantee that decisions are left to women and their doctors, not placed in the hands of government bureaucrats or medical statisticians. She accepted a modification to her amendment by Vitter that would specifically prevent the controversial recommendations on mammograms from restricting coverage of the test.

However, Republicans said that Mikulski’s amendment still left too much discretion to the HHS secretary. A competing amendment by Sen. Lisa Murkowski, R-Alaska, would prevent the government from using the recommendations of outside advisers to deny coverage of preventive services, including mammograms and Pap tests.