Just barely has the Democrats’
oh-happy-day sobered up and already serious trouble is galloping their way.
Some of the nation’s largest Labor Unions have
actually come out against the health bill just approved by the all-powerful
U.S. Senate Finance Committee. And we can see why.
The proposal to tax high-priced health
insurance plans would affect half of the 1.6 million members of
the American Federation of State, County and Municipal Employees (AFSCME) union
alone.
Considering that most of them likely traded pay
raises for plusher insurance plans, it’s clear that a fee would kinda sting.
Unions are also pretty unhappy that the bill has no
government-sponsored option.
The Democrats do not want to mess with the unions.
They are a big reason why they got elected — and will be a big reason why they
get re-elected… or not. Something that the union coalition, which also includes
the AFL-CIO, the Air Line Pilots Association and the UAW, is happy to remind their
Senators.
Just one more way politics works into health
reform.
"We worked for all these people. We worked for
Obama," AFSCME head Gerald McEntee told USA
Today. "What do we get for it? We not only don't
get anything for it, we get a slap in the face."
Unless “slap in the face” is a hilariously cute new
term of endearment, it’s clear Labor Unions are none too pleased with the
Baucus Bill.
Unless the Democrats (and a certain Republican)
want to face television ads and "boots on the ground," they’re going
to have to find a way to placate the unions. Unfortunately, the unions’ demands
are strongly opposed by Moderate Democrats and Republicans — who
aren’t expendable either.
If you thought Senator Olympia Snowe’s vote for the health insurance
and health care reform bill from Senator Max Baucus was a big deal, you’d
be right.
Not only did her committee vote set the bill up for
final approval in the full Senate, but it now gives reformers (including the
White House) a major chance of passing the bill without resorting to
reconciliation.
Now, reconciliation is a procedural loophole that allows
the Senate to pass legislation with a simple majority of 51 votes. Only if a
bill is tied to the federal budget can reconciliation happen.
So obviously, health reform qualifies.
Democrats have long held reconciliation as their
ultimate trump card in case they couldn’t hold on to their
conservative party-mates and if Republicans threatened a filibuster. But now
with Senator Snowe’s likely vote, the chance of reconciliation is much,
much lower.
The White House wants nothing more than to call the
health bill bipartisan even if it’s only one Republican who signs on.
Really, it’s kind of like putting lipstick on a… well you get the
picture.
Finance
Committee Chairman Max Baucus kicked things off today declaring, "It's
time to get the job done…This is our opportunity to make history," before
he dipped into some vintage Ben Franklin to caution, “Well done is better than
well said.”
But clearly,
Senator Olympia Snowe didn’t see it as an either/or situation. Just before
indicating that she would vote yes on the pending health insurance
reform bill, she loftily declared, “When history calls, history calls,”
concluding with her own cautionary quote (by Longfellow): “Great is the art of
the beginning, but greater is the art of the ending.”
Walking
on air, Senator Baucus responded that her words would be “long remembered.” Following
the debate on the NY Times’
excellent live blog today, we saw a lot of
words that will be long remembered — for various reasons. Here are a
few gems:
Democratic
Senator Kent Conrad: “Doing nothing is not an option.”
Democratic Senator
Blanche Lincoln: “There is no doubt in my mind that the cost of doing nothing
is simply too high.”
Republican Senator
Mike Crapo: Well, yeah, I don’t know anyone “who believes we should not do
anything.”
Republican Senator
Orrin Hatch: “We’ve just been ramming this through.”
Republican
Senator Jim Bunning, smacking the bill: “This adds insult to injury.”
Republican
Senator John Ensign: “Medicare
will go bankrupt” in a decade.
And our
favorite, courtesy of Republican Senator Pat Roberts: “We are riding hell for
leather into a health care box canyon.”
But at the end
of the day, nothing speaks as loudly as the applause that arose in the room when
the bill finally passed 14 to 9.
A recent Associated Press-GfK poll hands President Obama a good
new/bad news moment which finds increased public support for his health care
overhaul, but still not a majority.
The poll found 40 percent of the country supports
health care and health
insurance reform, while 40 percent oppose reform. That’s a
nice six-point upswing for support and a nine-point downswing of opposition
since last month, according to Politico.
The change in public opinion in reform is extremely
significant, especially as the U.S. Senate Finance Committee is set to vote for
the bill this Tuesday. Polls like these (and the latest CBO
report) are exactly the ammunition the White House needs to put extra
pressure on on-the-fence lawmakers to pass reform.
What’s even better, President Obama’s
approval numbers are back up to 56 percent AND he just won the Nobel Peace
Prize.
The Congressional
Budget Office stated yesterday that the Baucus bill would extend health insurance
to 94% of all eligible Americans. And reduce federal deficits by $81 billion over
ten years and probably lead to "continued reductions in federal budget
deficits" in the years after that.
You
mean it’s healthy and tastes great?
It’s sporty and gets good gas
mileage? It’s something that the Republicans can finally get behind? Yes, yes
and nope.
After
their own review of the 27-page report, Republicans found issue with the tax
increases, voicing further concern that insurers would pass new fees onto
consumers.
Others
wondered just how the bill got their miracle numbers? We loved this headline in
the New York Times health care blog,
Prescriptions: “Reduce the Deficit by Spending $829 Billion. Huh?” That’s was
sort of our initial reaction, too. That Medicaid savings figured heavily into
this was a given, but where was the rest from?
Here’s
what we found in the CBO’s cost-analysis: "The added revenues and cost
savings [from the bill] are projected to grow more rapidly than the cost of the
coverage expansion… consequently, CBO expects that the proposal, if enacted,
would reduce federal budget deficits (beyond 2019) relative to those projected
under current law" by up to one-half of 1% of the national Gross Domestic Product.
According
to the Washington Post,
those spending reductions could mean hundreds of billions of dollars in
savings. Now that’s impressive.
However,
on the bill’s provision of co-ops instead of the so-called public health insurance
option, the CBO were not so glowing. The report noted co-ops would not establish
"a significant market presence in many areas.”
Hmm,
a bit less impressive. But is it a necessary sacrifice?
Yesterday on
the Fox News show “On the Record with Greta Van Susteren” U.S.
Representative John Shadegg discussed health reform, but in a brand new light.
Congressman Shadegg sees a big problem with the current
health reform legislation, in particular the provision which mandates that
every American carry some form of health
insurance.
According to Shadegg, if you defy the law, then you
might face jail time.
While talking with Van Susteren, Shadegg explained
that those who can afford health insurance but choose not to buy a plan will be
fined. This fine, as the bill defines, is considered a federal tax.
In the case where Americans are “fined“
and don’t pay, they can be charged with a misdemeanor. Then the government,
claims Rep. Shadegg, can fine you an additional $25,000 and then put you in
jail for up to one year.
“People find it bizarre, but it shows
how far we’ve gotten away from what we ought to be focused on. Somebody
said it’ll solve the housing crisis, you know?“ said
the Arizona Congressman.
So this is a pretty strong claim that the health
insurance reform bill is out to fine Americans and put them behind bars.
“Can you imagine the sheriff going out
and running you in, throwing you in jail?“ questioned Van
Susteren.
No, we really can’t. If this is truly how
the bill is written, lawmakers definitely need to reconsider the language of
the bill.
“We ought to be focused on bringing down
the cost of health care for every American so they can afford it, deal with
preexisting conditions, deal with people who can’t buy coverage, help
them buy coverage,“ said Congressman Shadegg.
We couldn’t agree more. But why then make
jail time a focus of your conversation on television? Seems a bit odd.
Here’s the transcript of the “On the
Record…“ segment.
Arnold Schwarzenegger is the latest
Republican to support the developing health
insurance legislation.
In a statement,
he said that his goals as governor aligned with those of the Obama
administration — enhancing quality of care, keeping costs down,
improving people’s lives and securing economic recovery.
He underscored “the
vital importance of this issue, and that it should be addressed through
bipartisan cooperation.”
Already last
Monday, former Wisconsin governor and Bush administration health and human
services secretary Tommy Thompson came out in favor of the pending health care
legislation, calling it, “another important step toward achieving the goal of
health care reform this year,” adding that, “failure to reach an agreement on
health reform this year is not an acceptable option.”
And in his own statement yesterday, Mayor
Bloomberg also praised the bill: “The health reform proposal that Congress will
shortly consider is shaping up to merit broad, bipartisan support,
incorporating Republican ideas and earning deserved support from Republican
leaders such as former Senate Majority Leader Bill Frist.”
Oh yeah —
Bill Frist told Time magazine that if
he were still in Congress, the bill would get his vote.
Wow, that’s a
lot of Republican love from the sidelines. Perhaps some of the “let’s get it
done this year” sentiment is catching on…
In the past few months of the health insurance and health care
debate, most of the discussion revolved around whether or not we should have a
public government-run health plan inserted into the private market.
The status of that debate, of course, is still ongoing.
But there’s a budding debate that we
predict will take a front-and-center stage very soon. It’s the notion
of an individual mandate which requires all Americans to carry some form of health insurance.
Now, there are a lot of different arguments to this
gem of a topic, so today, we’ll just lay out the groundwork so we can
discuss all the puzzle pieces as the debate happens.
Here are some of the debate topics:
Is
an individual mandate constitutional?
Already, some have brought this into light. It could be a Supreme Court
type of case where they have to decide whether the federal government can
constitutionally enforce such a law. Then there’s the question of
whether allowing a mandate would set a precedent for future mandates by the
federal government.
How
should you enforce the mandate?
Senator Olympia Snowe was able to push through an amendment that delays and
reduces a fine for Americans who defy the individual mandate. Under Senator
Snowe’s amendment, the maximum fine for a family is $200 in 2014, rising
to $800 in 2017. Another point of debate will be how the government will be
able to identify those who could afford health insurance, but choose not to buy
coverage.
What
would an individual mandate mean for the private health insurance industry?
With a new customer pool of some 40 million Americans, an individual
mandate would mean the private industry would vastly increase. We’re
hoping all this does is lead to increased competition for these new customers,
improving quality and reducing price.
What
does the mandate mean politically?
For President Obama, an individual mandate for everyone is a bit hairy. The
president ran in the primary (against Secretary of State Hillary Clinton) upon
the idea that we shouldn’t have a mandate for
all. He’ll have to do a fancy political dance to avoid this
potentially damaging policy.
There’s probably going to be a lot more
on the individual mandate, and we’ll try to keep up on it.
A survey published Monday by the New
England Journal of Medicine reports that a large majority of
doctors believe there should be a public option. And large isn’t an
exaggeration: A whopping 73% support the creation of a government-sponsored
plan either alone or as choice alongside private health insurance.
“Whether
they lived in southern regions of the United States or traditionally liberal
parts of the country,” says Dr. Salomeh Keyhani, one of the studies
researchers, “we found that physicians, regardless — whether they
were salaried or they were practice owners, regardless of whether they were
specialists or primary care providers, regardless of where they lived — the
support for the public option was broad and widespread.”
The survey even
found far-reaching support within members of the American Medical Association,
a group that has yet to warm to the public option. The researchers said that a
desire to uncover “the real voice of physicians” was one
thing that motivated the study.
We suspect that
the public option’s popularity among doctors arises in part from
their prior experience with government-run health care through Medicare,
which the survey revealed they also thought of favorably.
Wow.
So does that make the public option doctor’s orders? We’ll
see. Amendments are still trickling through and congressional opinion seems,
well, judging by Nancy
Pelosi and John Boehner’s disagreement about public
support for the plan, as contentious as ever.
These days, health care and health
insurance are pretty gloomy subjects. Heated debates, waste, fraud
and even death panels!
While we hear everyday the horrors of the health
care system today, there are still plenty of positive aspects to our system and
the professionals we rely on to take care of us.
Take the Anne Arundel Medical Center in Parole,
Maryland, which is currently undergoing renovations. From an article in the Capitol, the third floor critical
care unit is getting the worst of the effects.
Because bright construction lights and glare are
seeping into patients’ rooms, hospital staff had to put dark film
coverings on the windows. Talk about making a hospital room as dreary as
possible.
But where we see dreariness, two AAMC nurses saw
opportunity. They decided to use the construction light pollution to illuminate
colorful paintings the windows and fill rooms with beautiful art.
We like it.
What a great job by the folks at AAMC of doing the
turning-lemons-into-lemonade thing.
“I don’t need
maternity care,” said Republican Jon Kyl last week during the Senate Finance
Committee’s health care discussion.
“Your mom probably did,” replied Democrat Debbie Stabenow. (See video below)
Zing! The two senators were debating an
amendment by Kyl that would have prohibited the federal government from
prescribing a minimum benefits package from all insurers, one that includes
maternity care. (The amendment was defeated by a vote of 14 to 9.)
We
couldn’t help but notice a few other instances where the overhaul of health care
has been taking shape as a women’s issue: most notably in Michelle Obama’s speech from the White House
a couple Fridays ago. Although absent from the debate until now, the first lady
stepped forward to address the impact health insurance reform represents for
women, calling it part of “the next step” in their advancement toward full
opportunity and equality.
“Women aren’t just disproportionately affected by this issue because of the
roles that we play in families,” Mrs. Obama said. “Women are affected because
of the jobs that we do in this economy.”
Some
of her key points included that:
Women are more likely to work
part-time or in small businesses or organizations that don’t provide insurance.
Women can be denied coverage
because of pre-existing conditions such as having had a C-section, an
experience of domestic violence, or being a mother (having had a baby).
For more on this subject, see our previous post
on how 7 in
10 women are underinsured or have no health insurance or
yesterday’s NY
Times article by Nancy Folberg, Economics
Professor at the University
of Massachusetts, Amherst, which deftly breaks down how women are
economically disadvantaged by our current system.
The latest Wall Street Journal/NBC poll conducted
this month offered a few interesting insights to what the people, you, think
about health reform and those making the big decisions.
We looked at the results of a few questions from
the 50-plus question poll so we could offer a what-does-it-all-mean type of
analysis.
Here were a few of the poll questions, plus some of
our own analysis:
Question:
Do you generally approve or disapprove of the job Barack Obama is doing in
handling the issue of health care reform?
These numbers are pretty open-ended as the
respondents on both sides could be potentially for or against a sweeping health
reform. So we should take this as a natural division of how a politician can
never make everyone happy.
Question:
Do you generally approve or disapprove of the way that Republicans in Congress
are handling the issue of health care reform?
These numbers are unfortunately also lackluster.
Both parties in Congress almost always have bad approval numbers, and the
reasons for the 65 percent disapproval could be almost anything.
Question:
How well do you think you understand the health care legislation that is
currently being debated in Congress — do you understand it very well,
pretty well, only some, or not very well?
Responses:
57 percent responded very or pretty well. 43 percent responded some or not very
well.
A 14-point swing was a bit more than we might have
thought, but it’s still a telling sign that a large percentage of
Americans still don’t know very much about this health reform bill.
That only leads to misinformation and, many times, unproductive debates.
Question:
From what you have heard about Barack Obama’s health care plan, do
you think his plan is a good idea or a bad idea?
Responses:
39 percent said it was a good idea, 41 percent said it was a bad idea.
This really highlights the deep divisions this
country actually has about health reform. Let’s face it, making
significant changes to a system that’s so big and complex can be a
scary thing. These numbers also reiterate the fact that it’s almost
impossible to make everyone happy when it comes to reform.
Question:
And from what you have heard about Barack Obama’s health care plan,
do you believe it will result in the quality of your health care getting
better, worse, or staying about the same as now?
If you were to point to one thing that could truly
kill health reform, this is probably it. If more Americans believe health care
is about to get worse for them after reform, there’s no way Congress
and the president can politically pull it off. There has to be solid assurances
and proof that health reform won’t worsen the quality of health care
for it to pass.
Question:
Do you feel [the following] absolutely must be included as part of health care
legislation, you would prefer it be included, you would prefer it NOT be
included, or you feel it absolutely must NOT be included?
Responses:
89 percent say reform absolutely must or would prefer that insurance companies are
required cover those with pre-existing conditions.
This is a huge number. Everyone agrees that we need
to be able to provide health insurance
and health care for those who have health conditions. On a side note, if there’s
going to be a “villain” in this tale, the storytellers are
doing a good job making health
insurance companies the scapegoats.
Responses:
57 percent say at absolutely must not be or would prefer not to have a
requirement that all individuals to carry health insurance in the health reform
plan.
Even though Americans want insurance companies to
cover all pre-existing conditions, they’re not willing to match it
with an individual mandate. But because insurance companies will only go for
eliminating pre-existing conditions if there is a mandate, this one might
happen despite of Americans’ worry. We think this number more
reflects our general distaste for rights restrictions and the thought of the
government making us spend money on something.
It’s
official: Governor Deval Patrick has appointed Paul G. Kirk to take over
Kennedy’s seat.
So,
does this mean the intense courting of Senator Snowe will abate? And if so, does
this renew hope for a public option? But wait, will the Republicans really let
Gov. Patrick invoke “emergency law” to make the appointment? And what’s the
latest on Senator Byrd’s convalescence?
The
phrase ‘moving target’ comes to mind. As does ‘suspense thriller’ and ‘herding
cats.’
So
much is hanging in the balance for health insurance reform right now and
any single element could tip it. Paul G. Kirk’s appointment gives Democrats the
coveted 60th vote to filibuster-proof legislation if Senator Byrd is
healthy enough to vote. But not if the Republicans successfully argue that the
legislative maneuvering that got him appointed was a disguised power grab.
It
was just five years ago that lawmakers nullified then-governor Mitt Romney’s power
to fill Senate vacancies, fearing he might appoint a fellow Republican if John Kerry
had won his bid for presidency.
So,
that isn’t anything new. What has Republicans in arms is that Gov. Patrick
signed Kirk’s appointment into immediate effect by categorizing it an
“emergency.” Which, considering the bills on health care, climate change and
economic recovery legislation coming up, some would say it is.
The
appointment could change the strategy for the Democrats, as well. Can they push
through their more controversial health insurance reforms (read: public option) now that they have 60 Senate votes?
We’ve
blogged about this before, but it’s presently coming into sharp relief: A
“trigger” may be just the right compromise to pass health insurance
reform this year.
The idea is
that a public plan would exist purely as a back-up measure, to be triggered
only if the legislation fails to provide affordable health coverage for enough
Americans.
It also has the
potential to keep pressure on the health
insurance industry and still hit policy objectives like
insurance-market reform, competition and cost management.
At the very least,
this idea might have the power to win over the only Republican in reach, Senator
Olympia Snowe. It would not only score the 60th vote necessary to send the bill
to the president, it would also technically make the bill bipartisan.
And from what
we can tell, it’s as close as you can get to (somewhat) appeasing both sides of
the public option debate.
The
problem is, well, there’s no public option guarantee, which is a major issue
for many on the left. To prove their seriousness, over 150
rallies are scheduled to protest the health insurance industry and
voice support for a public option nationwide today.
But
the trigger idea does actually have a shot at passing a Congressional vote. The
way we see it, it’s the left’s time for compromise.
So, what
happens next? Senator Snowe is expected to propose the trigger in an amendment,
though it remains to be seen if it’s in the Finance Committee or when a bill
reaches the Senate floor.
What do you
think about the public plan as a trigger back-up? Tweet it or comment below.
Last week, lawmakers in the U.S. Senate Finance Committee
submitted their amendments to the health care and health
insurance reform bill proposed by Chairman Max Baucus.
For the most part, many of the amendments stand to enhance
the bill, but it doesn’t look like any new Republicans are going to
jump ship to approve this measure.
It’s still only Senator Olympia Snowe
from Maine is the Democrats best chance to give them the elusive 60th vote they
need to send the bill to the president.
Politically, Democrats no longer have to appease
to all Republicans, just one. Looking at some of the amendments submitted, it’s
still all a political game. As an example brought to you courtesy of The New York Times,
Senator John Ensign proposed deleting all instances of the word “fee” in the bill
with “tax” to paint the health reform bill as a tax increase for Americans.
What’s clear is that there will be no
other Republicans in the Senate to vote for this bill. There’s almost
no chance at all.
It truly all comes down to Senator Snowe. Well, if
Massachusetts allows Governor Deval Patrick to appoint an interim Senator to replace
the late Edward Kennedy that would probably work for the Democrats too.
Just barely has the Democrats’
oh-happy-day sobered up and already serious trouble is galloping their way.
If you thought Senator Olympia Snowe’s vote for the 
Finance
Committee Chairman Max Baucus kicked things off today declaring, "It's
time to get the job done…This is our opportunity to make history," before
he dipped into some vintage Ben Franklin to caution, “Well done is better than
well said.”
A recent Associated Press-GfK poll hands President Obama a good
new/bad news moment which finds increased public support for his health care
overhaul, but still not a majority.
The Congressional
Budget Office stated yesterday that the Baucus bill would extend 
Yesterday on
the Fox News show “On the Record with Greta Van Susteren” U.S.
Representative John Shadegg discussed health reform, but in a brand new light.
Arnold Schwarzenegger is the latest
Republican to support the developing 
In the past few months of the health insurance and health care
debate, most of the discussion revolved around whether or not we should have a
public government-run health plan inserted into the private market. 
A survey published Monday by the 
“I don’t need
maternity care,” said Republican Jon Kyl last week during the Senate Finance
Committee’s health care discussion. 
We love polls. (Even those a few days old.)
It’s
official: Governor Deval Patrick has appointed Paul G. Kirk to take over
Kennedy’s seat.
We’ve
blogged about this before, but it’s presently coming into sharp relief: A
“trigger” may be just the right compromise to pass health insurance
reform this year.