— The health care bill 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 Democratic aides.
"We were trying to minimize premium impacts," said Jim Manley, a spokesman for Senate Majority Leader Harry Reid, 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.
When asked if the language goes against one of the fundamental promises Democrats made in health care reform, Sen. Tom Harkin, chairman of the Senate Health, Education, Labor and Pensions Committee, said it was "one of the compromises we had to make."
"We do have no lifetime caps, and we put in there no unreasonable annual caps," he told CNN.
Democrats say they had to make that compromise because telling insurance companies to get rid of annual caps on the amount of coverage would significantly raise the price of premiums for all Americans.
No one is saying who put the loophole in the bill. The provision was added behind closed doors in Reid’s office when he and a small group of Democrats — along with White House officials — merged two Senate committee bills into the one that’s now on the floor.
Policymakers on Capitol 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," a Democratic Senate aide, who declined to be identified, said 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, Brianna Keilar and Elizabeth Cohen contributed to this report.