As a member of the House Ways and Means Committee, Rep. Shelley Berkley, D-Nev., voted last month to repeal a new excise tax on medical equipment, an issue that has been lobbied heavily by device makers.
But by the time it reached a House vote on Thursday, Berkley shifted and ended up voting against repeal, saying a late change by Republicans made it unpalatable.
The bill to scuttle the tax passed anyway, 270-146, but the Nevadan's change of heart -- as well as her vote in favor of a tax -- prompted flip-flop charges from Republicans and served as yet another example of how closely the parties are fighting for ground in the campaign for U.S. Senate pitting Berkley against Republican Sen. Dean Heller.
“Shelley Berkley thought about repealing the job-killing medical device tax, but once again Nancy Pelosi twisted her arm and convinced her to double-down on ObamaCare,” said Jahan Wilcox, a spokesman for the National Republican Senatorial Committee.
Reps. Joe Heck and Mark Amodei, both R-Nev., voted to repeal the tax, which would be levied on medical equipment used chiefly by hospitals and doctors, such as X-ray machines, CT scanners and pacemakers.
Talking to reporters earlier this week, Berkley said she also looked forward to voting for repeal. She maintained she was never a fan of the 2.3 percent tax that was put in the sweeping 2010 health care law to help pay for the overhaul of the health system.
While she voted for health care reform, "From the beginning I had reservations about using the medical device tax as a way to pay for the Affordable Care Act," she said, attributing her opposition to meetings she had with equipment makers during the drafting of the health bill.
Berkley was one of only two Democrats who voted for repeal when the House Ways and Means Committee on May 31 approved a rollback bill, 23-11. The other was Rep. Ron Kind of Wisconsin, where device makers have a heavy presence.
But at that point, the bill lacked a critical component -- provisions that would offset the roughly $29 billion that would be lost if the equipment tax was deep-sixed.
Before the bill reached the House floor on Thursday, Republicans unveiled their proposed offset. It aimed to raise $44 billion by eliminating a cap on how much the government could recover in overpayments to individuals who would be given subsidies to buy insurance under the health care law.
Democrats said the provision amounted to a tax increase on middle-class and low-income families most likely to depend on subsidies to afford government-required health insurance. According to a Joint Committee on Taxation report cited by Democrats, it "would increase the number of uninsured by 350,000."
The offset made the bill unacceptable to Berkley, according to chief of staff Richard Urey.
“Shelley Berkley is against a tax on medical devices," Urey said Thursday night. "However, she believes that we cannot offset the repeal of the tax by increasing health care costs on Nevada families, especially during these difficult economic times."
Berkley's votes on health and medical issues also are being scrutinized in light of the House ethics committee considering allegations that she may have used her position to benefit the practice of her husband, Las Vegas nephrologist Dr. Larry Lehrner, in part by promoting legislation favored by the kidney profession.
When asked this week, Berkley said she had not discussed the medical device tax with her husband, and he had not influenced her position.
Berkley said her contacts while working on the issue were not doctors "but companies that sell medical devices, and they convinced me this (tax) will be very detrimental to patients. In the end it all comes down to patient care."