Senate health-care bill still has key provisions on Klobuchar-Franken wish list

Sledders play in the snow on the West Front of the U.S. Capitol in Washington on Saturday.
REUTERS/Jonathan Ernst
Sledders play in the snow in front of the U.S. Capitol in Washington Saturday while lawmakers worked inside on health-care legislation.

WASHINGTON, D.C. — Democrats needed all 60 members of their caucus to show up and vote this weekend on sweeping health-care legislation, and despite a record blizzard that dumped 16.4 inches of snow on the capital, that’s exactly what they got.

And while Sens. Amy Klobuchar and Al Franken didn’t get everything they wanted in the bill — you would be hard pressed to find a senator who did — they still got a lot.

“We’ve been trying to reform our health care system for close to a century. It’s been a long time coming, but this morning we’re one major step closer to getting it done,” said Franken, who proposed an amendment to control health-care administrative costs that’s still part of the package.

“Early Monday morning was an important step forward to a final vote on health care reform,” Klobuchar said. “After all the work and debate that’s gone into this over the past year, we owe the American people a vote on this issue.”

As Washington struggled with the nasty winter storm, Senate leaders avoided Democratic defections and absences and advanced the Senate’s health-care package past a crucial 1 a.m. test vote — 60-40, with no Republican support.

Probably the biggest victory for Minnesota’s senators is the rule pushed by Franken that requires 85 percent of health insurance premiums for large group plans and 80 percent for small-group and individual plans be spent on health care costs. Franken had filed an amendment asking for a 90 percent requirement across the board, though he said he’s happy with the requirement in the bill.

Sen. Amy Klobuchar
Sen. Amy Klobuchar

The key to that amendment is its permanence: Unlike some other provisions, this rule wouldn’t be invoked on a trial basis with an automatic sunset clause. Once it makes it into law, it’s law.

Other provisions in the bill proposed by Franken and Klobuchar: Removing annual and lifetime insurance-coverage limits, increasing health-care fraud sentencing guidelines and, perhaps biggest for Minnesota care providers, adding a so-called “value index” that aims to include quality of care as an insurance reimbursement criterion.

Tax on medical device industry
It was widely expected that the medical device industry would be taxed an additional $20 billion over 10 years — a provision also in the House bill. However, that’s down from the $38 billion in the original Senate legislation, and Klobuchar secured a one-year implementation delay.

The final version of the Senate bill also includes the so-called “EARLY Act”– a national breast-cancer awareness campaign targeting at-risk groups, a provision backed by Klobuchar. And the bill includes the expansion of a diabetes prevention program pushed by Franken.

“This final package includes many provisions that I’ve fought to include for months,” said Klobuchar in a statement when the final version was released Saturday. “The EARLY Act helps young women battling breast cancer, the Medicare fraud amendments will save billions of dollars for our taxpayers, the one-year delay in implementation of the medical device tax was important to our job-creating medical device industry, and, most importantly, the value index I authored for Medicare payments remains in the bill, as do other important cost reform measures.”

Several procedural votes remain, and they are expected to go down with the same 60-40 margin, setting up an evening showdown on Christmas Eve for the final vote on the Senate’s health-care bill.

Derek Wallbank is MinnPost’s Washington, D.C., correspondent and can be reached at wallbank[at]minnpost[dot]com.

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Comments (9)

  1. Submitted by Paul Udstrand on 12/21/2009 - 11:53 am.

    I’m trying to be optimistic here but I just have to ask, about this 85% thing: what exactly are the penalties or consequences for failing to meet this requirement? Who’s gonna audit this to make sure the requirement is being met? And where in the money is the bill to pay for audits and enforcement?

    As for the Breast Cancer and Diabetes stuff, they may or may not be effective depending on what they actually mandate. Can we get some details on this stuff?

  2. Submitted by david granneman on 12/21/2009 - 11:58 am.

    hello all
    i have a question for sen franken and sen klobuchar. why couldn’t you get the same deal for minnesota as nebraska got. why couldn’t you get 300 million dollars like louisiana got or 100 million sen dodd got. the democrates in the senate gave a new meaning for the word prostitiution. the american people will reward your efforts in the next election. YOU WILL BE FIRED.

  3. Submitted by Eric Schubert on 12/21/2009 - 12:10 pm.

    Another key item included that Sen. Klobuchar and Sen. Franken have both supported is the Community Living Assistance Services and Support Act, or Class Act,which would help more people afford more long-term care services. We thank Sen. Klobuchar and Sen. Franken for their support of this legislation.

    Eric Schubert
    Ecumen (

  4. Submitted by Bernice Vetsch on 12/21/2009 - 12:26 pm.

    The Senate bill may contain much that is good, BUT without firm governmental control over health insurance premium prices –as the governments of Norway, Switzerland and others do– premium prices will continue to rise year after year after year. All insurers should also be non-profits, as they are in those countries. There, insurance companies make a profit. Here, we see corporatism at work.

    Corporatism ain’t a good thing. It is, rather, a corruption of capitalism in which corporate interests/profits are considered the highest possible value by lawmakers. Corporations should be the main source of wealth for a whole society — all of whose members have contributed in one way or another to any corporation’s success by providing infrastructure, transit/transportation, protection from crime and fires and invasions, amenities such as sports and the arts, libraries AND educated, healthy employees.

    The bills on offer fail the test of good government because, once again, corporate lobbyists were allowed to help write them to be sure their interests came before those of ordinary people.

  5. Submitted by Paul Udstrand on 12/21/2009 - 01:17 pm.


    The problem is this was supposed to be a health care reform bill. People keep pointing these bits and pieces that could just as or even more easily have been passed as stand alone bills as if they make this a health care reform. Any bill this size is bound to have some decent components, but that doesn’t justify the bait and switch. And I notice you say that this amendment “helps” more people afford long term care. We could’ve guaranteed long term care for everyone.

  6. Submitted by david granneman on 12/21/2009 - 02:06 pm.

    hello all
    we have been had – the american people will see no benifits until 2013. we get tax hikes and increased health care premiums immediately. would you buy a car from a dealer who said if you starting paying today i will gladly deliver the car to you in four years. i doubt anybody would take this deal – but YOU JUST DID FROM THE US GOVERNMENT. this money will be saved to help cover the costs when the actual plan begins. KNOWING THE HISTORY OF SOCIAL SECURITY – DO YOU REALLY THINK THIS MONEY WILL BE THERE IN FOUR YEARS WHEN WE NEED IT.

  7. Submitted by david granneman on 12/21/2009 - 02:16 pm.

    hello all
    last night before the vote sen reid said ONE AMERICAN DIES EVERY TEN SECONDS DUE TO NO HEALTH CARE.

  8. Submitted by Rebecca Hoover on 12/21/2009 - 06:15 pm.

    From what I saw, Franken actually tried to insurance ordinary Minnesotans were helped by this bill. His idea of limiting insurance corporation profits was a good one, his support of a pubic option was good, etc.

    Amy Klobuchar, however, is nothing but a prostitute for big insurance and drug companies She did little to ensure insurance rates would be affordable to the ordinary Minnesotan or even to ensure that more people would receive more coverage. Basically, Amy threw out crumbs to the masses. To women, Amy threw breast cancer prevention instead of more meaningful affordable insurance. This bill is devastating for women. Amy has sold her soul.

    I pray that she is a one-term senator. I cannot think of a senator I loathe more than Amy in her mean looking looking little black suits and pants. All she is missing is a pointed hat and a broom.

  9. Submitted by Richard Schulze on 12/21/2009 - 09:40 pm.

    If Republican were really so concerned about saving money, why didn’t they look to what works in the rest of the world (they’re all cheaper), pick the one that was most ideologically pure to them (many are private systems) and propose that?

    If Democrats were really so sure about universal coverage, ditto, there are dozens on the rack to choose from.

    Blaming both parties would include blaming the Republicans. As the party of accountability and personal responsibility I am sure that they will readily admit that, as their job is to legislate, if legislation comes out that is terrible, then they have failed at their job. The best “democracy” money can buy…

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