Washington -- In a highly unusual move, the House Energy and Commerce Committee on Sept. 23 adopted 23 new amendments to a House health system reform bill that the panel already had approved two months earlier.

Committee Chair Henry Waxman (D, Calif.) had reached an agreement with panel Republicans on July 31, on the eve of the congressional August recess, to revisit several additional pending amendments later, instead of working late into the night.

Rep. Joe Barton (R, Texas), the highest-ranking GOP member on the committee, said during the Sept. 23 markup he could not recall another time in his 25 years in Congress that lawmakers amended a bill after it was adopted.

The panel adopted two packages of 22 amendments and one stand-alone change to the Affordable Health Choices Act. Barton said the packaged changes are noncontroversial and bipartisan. For example, they would allow the Dept. of Health and Human Services to provide grants for employer wellness programs. The committee also unanimously adopted a stand-alone amendment that would require hospitals and health plans to publicize price data.

Waxman said the amendments will be considered as recommendations to the House bill when the House Rules Committee begins combining his panel's bill with similar bills adopted by two other House committees. But the amendments would not have the same weight as the official language in the committee-approved bill, he said.

GOP attempts revisions

The Energy and Commerce Committee also rejected two Republican amendments. One would have allowed participating physicians to balance bill public insurance plan patients. Rep. Michael Burgess, MD (R, Texas), who sponsored the amendment, argued that the change was needed to ensure that patients would be able to see the physicians of their choice. Some doctors opt out of government plans because of relatively low pay. Balance billing also would prevent physicians from charging higher rates to private payers to make up for relatively low government rates, Dr. Burgess said.

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