Health care reform gets its first real test in the Senate today. After a rare Saturday session, the Senate will vote tonight on whether to push the reform bill to the next level and bring it to the Senate floor for official debate.
The bill would insure an additional 31 million Americans at a cost of nearly $850 billion. It would be paid for in part by increasing taxes on those making more than $200,000 a year.
Republicans are uniformly against the bill, so Democratic leaders need all 60 members of their caucus to vote in favor of the bill tonight in order to stop a Republican filibuster and move the bill forward.
But two new sets of recommendations for cancer screenings released this week have complicated the health care debate even further.
The first study released by a quasi-government panel called The United States Preventive Services Task Force said that women no longer need to get annual mammograms to detect breast cancer until they are over the age of 50. The second report came out Friday, issued by a different group, the American College of Obstetricians and Gynecologists. Their report says women do not need to get their first pap exam to screen for cervical cancer until they are 21 years old and, after that, only need to be screened once every three years as opposed to an annual exam.
Both studies fly in the face of everything patients have been told by doctors for years in order to prevent their chances of getting cancer: Get screened, early and often. So patients and doctors have been left confused and frustrated.
Linda Benitez is a breast cancer survivor. She told ABC News, "Whoever is coming up with this ridiculous recommendation, I think they need to think twice."
Dr. Peter Jokich, a physician at Rush University Medical Center in Chicago, said, "I think it's totally ridiculous. I may not be politically correct, but I think this is really about money and politics. It's about the beginning of rationing care."
Republicans seized on those concerns and are pointing to the cancer screening guidelines as a big "I told you so."
John Kyl, a Republican senator from Arizona, said the guidelines point to the future of health care in the U.S.
He said, "This is how rationing starts."
These are the same arguments made this summer/a> when conservative critics of health care reform evoked images of so-called "death panels" made up of federal bureaucrats who would supposedly make decisions about a patient's care. It may have been a mischaracterization of the health care reform plan at the time, but it did strike a chord with Americans concerned about how reform will affect their choice of providers and access to quality care.
"What's really problematic for Democrats," says Rick Klein, political analyst for ABC News, "is they've been on the defensive through so much of this debate and here comes another argument, something else to scare people about what's in this bill."
Democrats have spoken out this week, trying to assuage any concerns over the screening guidelines.
Sen. Arlen Specter of Pennsylvania, himself a cancer survivor, said the recommendations are just that -- recommendations.
"We are not going to have health care reform which limits screening on items like pap smears and mammograms," he said. "The panels are free to make whatever recommendations they like. But it is up to the congress to set public policy."
Even though these panels and their studies have no direct link to the pending health care legislation the timing couldn't be worse for Democrats. "It's a difficult time. They're trying to get 60 votes in the Senate ... so anything that scares people about what this bill would do, gives another talking point to opponents, is something they can't afford," says political analyst Rick Klein.
The White House has been aggressively trying to discount criticisms, suggesting the studies will mean some kind of rationing of care in the health care reform bill.
In a blog post yesterday, White House communications director Dan Pfeiffer called any such argument "bogus." He went on: "Let's just say this as plainly as possible: Under health insurance reform, this research cannot be used to dictate coverage."
But for Democrats trying to push health care reform through, the damage may already be done. It's unclear whether Senate Majority Leader Harry Reid has the 60 votes he needs to secure a floor debate. At least two Democrats, Mary Landrieu of Louisiana and Blanche Lincoln of Arkansas, are still on the fence. And Democrats also need support from Independent Joe Leiberman, who has said he is against the public option included in the Senate bill.
So either the bill lives to see another day and a full debate, or it dies and it's back to the drawing board.