December 11th, 2009
03:19 PM ET
7 months ago

Senate health care bill to allow caps on annual benefits, Democratic aides say

Washington (CNN) – The health care bill currently being negotiated in the Senate would allow caps on annual insurance benefits, reversing a previous version of the plan that would have prevented insurance companies from establishing such limits, according to three separate Democratic aides.

"We were trying to minimize premium impacts," explained Jim Manley, a spokesman for Senate Majority Leader Harry Reid said, acknowledging the change.

The trade-off has drawn criticism from the American Cancer Society's
Cancer Action Network, a patient advocacy group.

"We were very surprised by this," said Stephen Finan, the group's senior policy director. Finan worries that cancer patients, who often require expensive procedures, could still face major financial losses if annual coverage benefits are capped too low.

Policymakers on the Hill are defending the legislation.


"The provisions in the bill are a big improvement over the current system in which cancer patients have to fight for coverage and often don't get the preventative services that catch cancers at an early stage. We hope to make the provisions even stronger in the bill Congress sends to the president," explained a Democratic Senate aide, who declined to be identified about the change.

Aides say senators will continue to review the policy closely as the
process moves forward.

"Ensuring affordable health care costs requires a balance between too
much insurance market regulation and not enough," said Erin Shields, an aide to Senate Finance Chairman Max Baucus, D-Montana. "That balance is what this bill aims to achieve, especially with regard to annual limits. Senators want to ensure this provision provides as much consumer protection as possible while
keeping premiums affordable."

–CNN's Ted Barrett, Ed Hornick John Bonifield and Elizabeth Cohen
contributed to this report.


Filed under: Harry Reid • Health care • Senate
soundoff (76 Responses)
  1. Dick

    " Senators want to ensure this provision provides as much consumer protection as possible while keeping premiums affordable."

    We started out with health care reform to MAKE premiums affordable. Now we want to KEEP premiums affordable? Just when did premiums become affordable?

    December 11, 2009 04:09 pm at 4:09 pm |
  2. Jayson

    It would be nice to live in some perfect world where everyone took care of each other and nobody was worried about making a profit. The facts of the matter are that we don't live in a perfect world. You can't say on the one hand that somehow the rich have a morale obligation to pony up the money for health care and every other entitlement that is short on funding while at the same time not having mandatory obligations on those taking advantage of what they are paying for in order to continue taking advantage of something like health care. You shouldn't be allowed to smoke, have unprotected sex, eat like a pig, or continue to do anything else that is voluntary and puts your health at risk in any way if your getting health care on the taxpayers dime...

    Of course none of this matters since the founders didn't go and put in a clause stating that tariffs were to be uniform throughout the counrty without good reason. They would have never gone along with this insane mentality that looks at those who are more successful should be used as piggy banks to fund programs in order to lock up portions of the population when election time comes around. They also wouldn't have made it so hard to amend the Constitution if they actually believed that it was a living document and subject to reinterpretation based on personal views of how the world should be.

    December 11, 2009 04:09 pm at 4:09 pm |
  3. Jimmy James

    More lies from the democrats. Now instead of the so republican plan of "get sick and die" it's the democrats plan of "get sick and die if you cost too much". I believe thats called rationing. Where are the cries of liars? Amazing.

    December 11, 2009 04:09 pm at 4:09 pm |
  4. Marc

    mjm: By your comment I believe you regret the fact that the government forced the industries to let the workers have some time for themselves instead of forcing them to work 12hs + hours per day (without weekends), don't you?

    December 11, 2009 04:09 pm at 4:09 pm |
  5. gl, From Pittsburgh

    Chairman Max Baucus, D-Montana. "That balance is what this bill aims to achieve, especially with regard to annual limits – He is the number one crook!

    December 11, 2009 04:11 pm at 4:11 pm |
  6. Jon

    If caps on the amount an insurance company will pay out our removed, this all goes to show that private insurance cannot be reformed. Open up Medicare for everybody now.

    December 11, 2009 04:14 pm at 4:14 pm |
  7. Brian from NJ

    So they'll cap how much care we get but won't cap how much $$$ a trial lawyer gets... hmmmm.

    This HC bill is becoming incoherent... go back to the drawing and try again. Everything they have done so far is leading to this nonsense and they need to scrap it and either do it right or not at all. No bill is better than a bad bill.

    I swear, if I didn't know any better, I would think the Democrats are trying to lose control of Congress next year...

    December 11, 2009 04:16 pm at 4:16 pm |
  8. bob in LA

    I have long known there would comprimises that would happen, but this sounds like a sellout to the insurnace industry. Caps on benefits are the source of many people's financial ruin. One of the reasons for this was to avoid that.
    Want the cap removed? Call your senator or the White House and let them know!
    But be nice! Voice your opinion and ask for reconsideration.

    December 11, 2009 04:17 pm at 4:17 pm |
  9. LYNETTE IN CA

    I'm not clear why the starting age for this is 55? How does this help families with children and preexisting medical needs of all ages?

    December 11, 2009 04:23 pm at 4:23 pm |
  10. D. Tree

    Take note people: its the CONSERVATIVES that want limits, not the liberals. The plain fact of the matter is that for all their griping about the budget, Conservative ideas simply cost more.

    December 11, 2009 04:23 pm at 4:23 pm |
  11. Anonymous

    Exactly what part of the constitution says that the boys on the hill have the ability to tell insurers what they can charge for premiums?
    We all can buy health plans that do NOT have caps. If you chose another plan that has caps that's your problem.

    Btw , the government has no place telling insurance providers what they will provide or what it costs. If you think differently then tell me what part of the constitution gives them that ability.
    liberals just never can get that the constitution was designed to limit the feds reach and protect the rights of the people, health care is not one of those rights.

    December 11, 2009 04:24 pm at 4:24 pm |
  12. Sniffit

    " Not having a cap would fall into the 'too good to be true, probably just a scam' category of products/services."

    So wrong it's frightening. Risk is not infinite. It is, in fact, very accurately measured by scientific study and actuarial math, then underwritten. That's precisely how insurance works. The medical community, including scientists and places like the CDC measure incidence rates for diseases all the time and quite accurately....they even tabulate the risk of occurence for things like epidemics. The costs can be easily extrapolated therefrom. The above statement is hard evidence of just how uninformed and misinformed the public is on these issues...just as the GOP wants them.

    December 11, 2009 04:25 pm at 4:25 pm |
  13. rob

    This whole process is so out of controll that even the Dems don't really know what they'll have when a bill makes its way to a vote. It seems that all they care about now is passing something, anything and calling it a victory.

    This is an absolute circus. I pray it blows up in there face and they have to start from scratch, maybe after the elections in Nov. 2010.

    December 11, 2009 04:34 pm at 4:34 pm |
  14. John, Brooklyn, NY

    Specific to Jimmy James...

    The reason that the Democrats are backing off is because dupes like you have been listening to the opponents of reform scream about rationing. In fact, the cruelist form of rationing is when the insurance company refuses to cover your illness and you are left with a CHOICE of dieing or keeping a roof over your head.

    December 11, 2009 04:34 pm at 4:34 pm |
  15. Larry

    So what are the caps? What about p[eople with chronic conditions (cancer)?

    Once again our spineless legislature has let us down.

    December 11, 2009 04:39 pm at 4:39 pm |
  16. dak

    SocialismBad says "Just when you'd thought the Democrats had run out of STUPID IDEAS they go and plop this one out there! Are these idiots completely brain dead??!! Talk about an automatic FINANCIAL DEATH PANEL built right into your health plan!!"

    Don't you understand that it's ALREADY IN YOUR HEALTH INSURANCE PLAN???!!!!! That's what you right-wingers can't seem to grasp! You people are just plain stupid. That's one of the things insurance companies do RIGHT NOW because they can get away with it because THEY HAVE NO COMPETION!!! That's why all of us "socialist" want a public option . . . . so the insurance companies can't keep doing things just like this to all of us!

    December 11, 2009 04:41 pm at 4:41 pm |
  17. Dave

    So, as far as I can tell, "health care reform" is not much more than making it a law saying I have to buy health insurance, and as a reward now the insurance companies can stop providing me benefits if it costs too much. I think I'd rahter not be able to afford health care and get nothing, than be forced to pay for health care and get not enough...

    We are not a democracy. We aren't even a capitalistic soceity anymore. We are the surfdom of bankers and insurance companies.

    And the really sad part? I can't get any of my fellow countrymen to care more about these issues than whether or not gay people can get a piece of paper saying they are married, or whether we should force women to have babies or not. I wonder if the Chinese will indulge us in such useless debates when they take over...

    December 11, 2009 04:50 pm at 4:50 pm |
  18. Jimmy James

    To John in Brooklyn. My point is this isn't reform. They will raise our taxes, our premiums and our debt all in the name of passing something they call healthcare reform. Whats the rush if it doesn't take effect for 4 years? They will allow limits on coverage ( caps) yet won't go near tort reform. Those trial lawyers are a bigger lobby than the insurance industry. None of this is reform. It's something they can claim is reform so they can claim they passed it. I want reform but real reform. No caps, tort reform, no pre existing conditions bull, no dropping because you get too sick. It looks like this bill does absolutely none of this.

    December 11, 2009 04:57 pm at 4:57 pm |
  19. PREDICTA

    Caps on Insurance policies occur. But, if you pay for a better plan, there are no caps. I hear alot of people saying their employers only offer 1 plan with caps. But that's not the insurance company's fault. It's the employer's fault; If your company is only offering 1 plan, it's probably because it's the cheapest plan for them, as they do pay part of your premium, in most cases. Big companies do offer multiple plans, and the less expensive ones do have caps.

    December 11, 2009 04:58 pm at 4:58 pm |
  20. Dar

    What a bunch of BS and lies this has turned out to be, the goverment wont need death panels because when you hit your cap when you are older......guess what, you get to pay out of your own pocket you dumb asses.

    If you think for a second that the goverment really loves you and wants to do what is best for you, well you had better think again fools.

    The Odumbo way is a sad way to go people and alot of you are falling for it.

    Why do you think that the unions want this so badly???? Because their retirement funds are running out and Odumbo is trying to help the people that helped him get elected. WAKE UP!

    It's so sad that we have so many sheep following the wolf in this once great country. The days are getting darker and the blind sheep can't see that. Sad, very very sad.

    December 11, 2009 05:02 pm at 5:02 pm |
  21. www.circleparkforum.com

    Reid has completely failed us all as Majority Leader.

    Between the trashing of the public health insurance option and now this news about allowing caps on annual insurance benefits, Democrats have proven that they can't lead.

    They've thrown away a golden opportunity to advance real change and, next November, they will pay for their betrayal of the trust that Americans placed in them, as they so richly deserve.

    December 11, 2009 05:12 pm at 5:12 pm |
  22. S Callahan ..make your life better read Psalm 51

    This concerns me a great deal.....it affects more than just treatments....
    The leg the family stands on will be pulled out from under then...you
    think there are bankrupcies because of health care now..imagine if this goes through! Come on you guys..there is a better way...think outside the box!

    December 11, 2009 05:16 pm at 5:16 pm |
  23. David

    What a load of cr*p. There is certainly no limit on medical bills when we get sick. There isn't much point in having health insurance unless we're covered when we get sick. I hate the fact that I've paid insurance premiums for decades and still face the very real possibility of bankruptcy due to an illness. It's clear the senate is rolling over and playing dead for the insurance lobby.

    December 11, 2009 05:16 pm at 5:16 pm |
  24. Peter

    All the promises were made when you started this Congress, but nothing will be delivered when the bill is finished.

    Congress is a joke, lower than used car salesmen.

    We will pay out the @&& and get nothing but the shaft. While politician get to strut around claiming they have saved us from ourselves.

    December 11, 2009 05:18 pm at 5:18 pm |
  25. Rick in AZ

    Everything Democrats want in the Health Care bill is being torpedoed by the Republicans. Single payer, Public option, benifit caps, womens right to choose, pre-existing conditions. This is not Reform: it's caving in. How ineffectual can Harry Reid be if he can't get his party in line. No matter what the Bill will look like not one Rebublican will vote for it. Harry it's time to tell the Rebublicans to get out of the way and just do it.

    December 11, 2009 05:30 pm at 5:30 pm |
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