WASHINGTON
Republicans are seizing on this week's recommendations for fewer Pap smears and mammograms to fuel concern about government-rationed medical care -- and to try to chip away support by women for President Obama's proposed health-care overhaul.
"This is how rationing starts," Jon Kyl of Arizona, the party's second-in-command in the Senate, declared during a news conference. "This is what we're going to expect in the future."
Sen. Lisa Murkowski of Alaska said, "Those recommendations will be used by the insurance companies as they make a determination as to what they're going to cover."
Democrats said that the recommendations had nothing to do with the big health-care bill. And besides, they said, the recommendations, especially one that women start mammograms at 50 rather than 40, were deeply flawed.
"It's entirely possible that this panel got it wrong, and I think they did," said Illinois Sen. Dick Durbin, the vote-counting Democratic whip.
The timing of the release of both sets of guidelines this week, though apparently coincidental, couldn't have been worse for majority Democrats. The bill faces its first survival test today, when it must win 60 votes to advance to the next step.
One Democrat wasn't taking chances on whether the recommendations had jeopardized access to affordable mammograms. Sen. Barbara Mikulski, D-Md., said she would introduce an amendment that would limit the costs of the breast-cancer tests for women 40 and older. "Otherwise, insurance companies may use this new recommendation as yet another reason to deny women coverage for mammograms," Mikulski said.
That was unlikely, the White House said.
"Under health-insurance reform, recommendations like these cannot be used to dictate coverage," said presidential spokesman Reid Cherlin.
The guidelines themselves stress that they're general recommendations for routine screening, not a replacement for the one-on-one health advice that women with various risk factors for breast or cervical cancer get from their doctors in choosing how often to get a Pap or mammogram.
"So, what does this mean if you are a woman in your 40s? You should talk to your doctor and make an informed decision about whether a mammography is right for you based on your family history, general health and personal values," said Dr. Diana Petitti, the vice chairwoman of the task force that made the mammogram recommendations.
Still, the new guidelines generated enough confusion and raised enough questions to force proponents of the health-care overhaul on the defensive.
Senate Finance Committee Chairman Max Baucus said the Senate health care bill he authored "doesn't do one single thing to change current law related to the way coverage decisions are made."
"Those decisions will be based only on science and thorough review, just as they are today," said Baucus, D-Mont. "Research comparing the effectiveness of different treatments for different patients cannot be used for rationing care."
"We're not rationing anything," said Rep. Lynn Woolsey, D-Calif. "It's a decision between a woman and her doctors."
All states except Utah make insurers cover mammograms, and 20 states require coverage that starts at age 40, according to 2007 data compiled by the National Women's Law Center, based in Washington.
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