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Health bill opponents make most of mammogram advisory

Democratic leaders, including Senate Majority Whip Richard J. Durbin (Ill.), right, are still not sure they have enough votes to move the bill.
Democratic leaders, including Senate Majority Whip Richard J. Durbin (Ill.), right, are still not sure they have enough votes to move the bill. (Manuel Balce Ceneta/associated Press)

"This is how rationing begins. This is the little toe in the edge of the water," Rep. Marsha Blackburn (Tenn.) said Wednesday on Capitol Hill. "This is when you start getting a bureaucrat between you and your physician."

The issue has also grabbed the attention of conservatives such as radio show host Rush Limbaugh and Fox News host Glenn Beck, both of whom fanned discredited allegations earlier this year that the administration wanted to create "death panels" to hasten the demise of terminally ill patients. Beck jokingly referred to the mammogram recommendations as "good news for the government" because it would reduce "the expense of those pesky people."

Obama administration officials strongly reject that contention, saying the U.S. Preventive Services Task Force, which issued the guidelines, has no power to affect coverage decisions by insurance companies. Nor does the task force "determine what services are covered by the federal government," Health and Human Services Secretary Kathleen Sebelius said Wednesday.

The officials also pointed out hypocrisy in the GOP objections: The Republicans' health-care alternative would not provide coverage for mammograms or other preventive services. And they noted that conservatives have long complained that the threat of frivolous malpractice lawsuits leads doctors to overuse costly and unnecessary tests, including mammograms.

Administration officials said they first became aware of the task force's recommendation in early October, after a medical journal accepted its report and prepared to publish it Nov. 17.

The task force provided a routine notification to HHS officials, though the department had no say over the findings nor control over when they would be published, according to senior department officials.

White House aides said the political team leading the fight to pass health-care reform first heard about the mammogram report in the past two weeks and viewed it as potential fuel for opponents, one official said.

But there were no more than a few brief conversations about it, the official said, in part because the administration had no control over the findings, their distribution or the timing.

"It occurred to us that it could be twisted and distorted," said one official who was not authorized to speak publicly on the issue.

The task force is made up mostly of primary-care doctors and nurses who serve four-year terms and are appointed by the director of the Agency for Healthcare Research and Quality. The current members were appointed during President George W. Bush's administration; no new members have been nominated since Obama took office.

On Capitol Hill, Nelson's announcement that he would vote to begin debate was followed quickly by a statement that made clear he still has problems with the bill, including language aimed at restricting federal funds from covering abortions.

"It is not for or against the new Senate health-care bill released Wednesday," Nelson said of his intended vote. "It is only to begin debate and an opportunity to make improvements. If you don't like a bill, why block your own opportunity to amend it?"

If the Saturday vote fails, Reid will head back to the drawing board to rework the bill. The most vulnerable provision is one that creates a government-supported insurance option -- a proposal that is opposed by Nelson and Lincoln, along with Sen. Joseph I. Lieberman (I-Conn.) and several other members of the Democratic caucus. But Reid has reassured senators that the bill can be changed on the floor through amendments.

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