Senate rejects health reform repeal

Washington -- The Senate, as expected, failed to adopt a House-passed repeal of the national health system reform law on Feb. 2 by a vote of 47-51.

Senate Minority Leader Mitch McConnell (R, Ky.) offered the repeal as an amendment to a bill reauthorizing the Federal Aviation Administration. However, the repeal amendment did not receive the 60 votes required under Senate rules to overcome Democratic parliamentary objections based on the repeal's estimated budgetary impact.

McConnell said the vote was a chance for Senate Democrats who supported the health reform law last year to reconsider their stance on it. "It's not every day that you can get a second chance on a big decision after you know all the facts." But no Democrats in the upper chamber voted in favor of repeal. Two Democrats were absent for the vote.

However, the Senate voted 81-17 on a separate amendment, written by Sen. Debbie Stabenow (D, Mich.), to undo a tax reporting mandate in the health reform statute that many small businesses opposed. If left in place, the targeted provision would require businesses, including physician practices, to file a 1099 form with the Internal Revenue Service for every vendor with whom it spends $600 or more in a year. The House has not acted on the Stabenow language as of this article's deadline.

"The AMA applauds the Senate's vote in support of the Stabenow amendment to repeal the unnecessary and burdensome IRS 1099 reporting requirement that was included as part of the health reform law," said American Medical Association President Cecil B. Wilson, MD. "It is estimated that paperwork already takes up as much as a third of a physician's workday -- time that could be better spent with patients -- and this provision would only increase that burden."

The Senate was expected to hold the final vote on the amended FAA reauthorization during the week of Feb. 7.

Senate Majority Leader Harry Reid (D, Nev.) had said this year that he would not permit a Senate vote on the House-adopted health reform repeal. But Reid relented after reaching an agreement with McConnell in late January to allow more amendments to future bills in exchange for fewer filibuster threats from the minority.

Still, the failed vote will not end Republican senators' campaign against the health reform law. Democratic senators said they will consider revisions to the law, such as the 1099 rollback, but Republican senators said the law is flawed beyond repair.

"Trying to fix it with a few good ideas is like pouring a few glasses of fresh water in a polluted river," said Sen. Jim DeMint (R, S.C.).

During the Senate debate, Republicans attacked the law's financial penalties against businesses that don't provide health insurance to their employees and against individuals who do not have a minimum level of health insurance, both of which take effect starting in 2014. They also repeatedly referred to a Jan. 31 ruling by a federal judge in Florida striking down the health reform law, a decision that will be appealed.

But Sen. Richard Durbin (D, Ill.) noted that of the 16 federal lawsuits against the health reform law, only judges in Virginia and Florida have ruled for the plaintiffs. Twelve of the cases were dismissed, and the other two ended with rulings supporting the law's individual insurance mandate. Durbin also noted that lower courts ruled against the Social Security Act and the Civil Rights Act of 1964 before the U.S. Supreme Court ultimately upheld those laws.

Sen. Tom Harkin (D, Iowa) said Republicans want to repeal the health reform law because it goes against their ideology. "They oppose the law's crackdown on abuses by health insurance companies. And they oppose any serious effort by the federal government to secure health insurance coverage for tens of millions of Americans who currently have none."