By Catherine Knowles, C3’s Director of Policy
On Thursday afternoon, Senate Majority Leader Reid (NV) set the procedural wheels in motion for a vote on the Patient Protection and Affordable Care Act.
The first procedural vote is expected around 8pm on Saturday. It will be a cloture vote on the motion to proceed. Majority Leader Reid is working to line up the 60 votes needed to pass the cloture motion (a cloture motion must be approved by three-fifths of the Senate).
Continue reading for more information on the upcoming Senate vote as well as a summary of some of the provisions included in the Senate bill that C3 thinks are important for people living with colorectal cancer.
Typically, a cloture vote will be followed by a second procedural vote – a vote on the motion to proceed. This vote requires a simple majority vote to pass. However, Senate Republicans have agreed to waive this second procedural vote and forego reading the bill on the Senate floor in exchange for an all-day debate on the bill on Saturday (without this agreement, the Senate rules would have only required one hour of debate before the cloture vote).
The New York Times reports that Democratic Sens. Ben Nelson (NE), Mary Landrieu (LA), and Blanche Lincoln (AR) “are proving tough sells” on health care reform, “raising the prospect that one or perhaps all three of them could scuttle the bill before the fight over it even begins on the Senate floor.” Should the cloture vote fail, Democrats may be forced “to regroup and redraw the measure or even switch to a more contentious procedural shortcut around the need for a 60-vote majority.” Politico has a good article on the fast track options for moving the legislation forward.
Be sure to tune in and watch the debate and vote on Saturday. You can watch the vote on C-Span’s website.
The $849 billion Patient Protection and Affordable Care Act includes a public option that will extend health insurance coverage to 31 million Americans. The reimbursement rates for the public plan will not be tied to Medicare, and co-ops will still be offered. The bill will create an insurance exchange where people can compare and purchase health insurance, it expands Medicaid coverage to those earning 133 percent of the federal poverty level, and it offers subsidies to help those without employer sponsored insurance purchase health insurance.
Increasing the number of Americans with health insurance will help reduce mortality rates from colorectal cancer. Many studies show that people who are uninsured are substantially less likely to be screened for colorectal cancer. In addition, insurance status strongly influences survival among those diagnosed with colorectal cancer – individuals with private insurance who are diagnosed with Stage II colorectal cancer have better survival outcomes than individuals who are uninsured and are diagnosed with Stage I colorectal cancer.
Like the House health reform bill, the Senate bill eliminates pre-existing condition exclusions. Eliminating pre-existing conditions exclusions is very important for cancer patients. Pre-existing condition exclusions lock the millions of Americans with at least one chronic illness (nearly one third of the population) into existing plans and employment.
The bill will eliminate cost-sharing requirements for all preventive services (including colorectal cancer screening) that have a United States Preventive Services Task Force (USPSTF) A/B rating, and require coverage of these tests by private insurance.
It also has a section regarding community preventive screenings, and specifically lists cancer screenings as one of the community interventions needed to improve public health.
The bill establishes a prevention and public health fund to be administered through the Office of the Secretary at the Department of Health and Human Services to provide for an expanded and sustained national investment in prevention and public health programs. This new fund will support public health activities including prevention research and health screenings.
Many colorectal cancer patients face a lifetime of cancer treatment. Caps on insurance result in very difficult decisions about the care they will receive and how they are going to pay for it. The Patient Protection and Affordable Care Act eliminates “unreasonable annual benefits” and lifetime limits on the dollar value of benefits for any participant or beneficiary for all group health plans and health insurance coverage required to provide “essential health benefits” (i.e., any insurance company or plan that participates in the new health insurance exchange).
Senate Democrats have complied a section-by-section summary of the bill along with a timeline for implementation of the various provisions in the bill. In addition, the Congressional Budget Office (CBO) has reviewed the legislation. CBO’s analysis and cost estimate of the bill is available online.
The cloture vote on Saturday is an important step in getting a final health reform bill sent to the President, but there is still a long road ahead for health reform and many areas where the pending bills could be improved.
C3 has been closely following the various health reform proposals introduced in Congress, and will continue to work with legislators to advocate for the access to care that is critical to preventing, treating and beating colorectal cancer. Please feel free to share your thoughts with us by leaving comments below.


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