Who Should Pony up for Health Insurance Reform?

Who Should Pony up for Health Insurance Reform? in Politics and Legislation

Here’s Senate Majority Leader Harry Reid suggestion: Plastic Surgeons and the People Who Love Them!

The connection? No idea!

The Senate health bill would impose a 5 percent tax on elective cosmetic procedures to help defray the cost of health care reform. Proponents claim it would raise an estimated $5 billion over 10 years toward the $849 billion pricetag of current legislation.

But how did the fans and practitioners of plastic surgery come to bear the burden of bankrolling health insurance reform? The only thing we could figure out is that it presumes that people getting plastic surgery are wealthy and can afford to shell out a little more. Whatever the case, we can’t help but see this is as rather creative taxing.

Granted, the market for cosmetic surgeries is sailing through the bad economy. The American Society of Plastic Surgeons reported that 12 million cosmetic procedures were performed in 2008, up 3 percent from 2007.

On the other hand, the measure could be less lucrative than proponents hope. In 2004, the state of New Jersey passed a 6 percent tax on plastic surgery that was expected to raise $24 million a year. But, in 2005, it only brought in about $7.5 million.

Of course, the so-called “Botox” provision isn’t the only inventive one in the Senate bill, but it’s certainly the most joke-ready. On second thought, maybe this is simply Washington’s way of finally getting back at the old “Hollywood for ugly people” barb.

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Abortion Amendment a Flashpoint in Health Insurance Debate. Again.

Abortion Amendment a Flashpoint in Health Insurance Debate. Again. in Politics and Legislation

Concessions on abortion coverage were vital in the House’s passage of their health insurance bill last Saturday. But those concessions are not sitting well with a lot of Democrats, including two of the main contenders for Ted Kennedy’s seat. Both frontrunners Attorney General Martha Coakley and Representative Michael E. Capuano have come out against the bill in response to the Stupak-Pitts Amendment, which prohibits federal plans from covering abortions.

“To pretend that now the House has passed this bill is real progress — it’s at the expense of women’s access to reproductive rights,” Coakley told Boston radio station WTKK-FM.

The president isn’t sold on the abortion provisions in the House bill, either. “There needs to be some more work before we get to the point where we’re not changing the status quo (on abortion),” President Obama told ABC News on Monday.

While the president is unequivocal about not allowing federal funds to subsidize abortion (this has been barred by the Hyde Amendment since 1976), he promises to balance this against “not restricting women’s insurance choices.”

This issue gets grey very quickly because reform can affect abortion in a myriad of ways — all that honors the Hyde Amendment — but pan out differently in practice. Unfortunately, this is generating a lot of bombast and misleading statements from both sides. It’s probably creating much more controversy than it should, but certainly understandable since abortion is such an emotionally wrought issue.

Even the White House acknowledges the sensitivity of the issue. They were quick to point out that this is a health care bill, not an abortion bill.

For a good, sober breakdown of the Stupak-Pitts Amendment’s nitty-gritty details, we recommend Politifact’s discussion of the matter.

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Health Insurance Reform in the Senate: The Real Battle

Health Insurance Reform in the Senate: The Real Battle in Politics and Legislation

As momentous as the passage of the House health insurance bill was this weekend, it was actually the easy part. The next step, passage in the Senate, will prove far more treacherous. How much more treacherous? Let’s review.

• In the House, Democrats enjoy a 258 to 177 majority. In the Senate, the Republicans are also a minority but possess considerably more power.
  
  
• That means that House Speaker Nancy Pelosi could afford losing 40 votes from her own party and still pass the bill. But Senate Majority Leader Harry Reid can’t afford to lose a single vote from his caucus members. And that’s just to bring the bill to the floor; he also needs it to thwart a Republican filibuster. 
  
  
• What’s more, Ms. Pelosi wields more control over proceedings in the House than Mr. Reid does in the Senate. She has a Rules Committee that determines debate parameters — including which amendments are offered. The best Mr. Reid can do is prepare himself for a near-certain ambush of amendments from Republicans. And possibly Democrats.
  
  
• This also means that where the floor debate in the House only took one day, it could (and probably will) take several weeks in the Senate.

And at this point, there isn’t even a bill to try to bring to the floor. Why? To There are two bills that have to be merged into one; a slew of factions to be appeased among the Democrats before even addressing Republican opposition; a plausible threat from Senator Tom Coburn to read all two-thousand pages of the bill aloud.

Phew, that’s a lot.

From where we’re standing, Mr. Reid’s task makes the bill’s passage in the House look as easy as falling off a log.

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AARP Endorsement a Coup for House Health Insurance Bill

AARP Endorsement a Coup for House Health Insurance Bill in Politics and Legislation

With the AARP’s official endorsement yesterday, the House health bill is moving more confidently toward its floor vote, just one day away. Several aspects of this moment gave us pause. The AARP has never endorsed this kind of comprehensive health care overhaul, and the House bill is the most sweeping overhaul of health care policy in four decades.

"We started this debate more than two years ago with the twin goals of making coverage affordable to our younger members and protecting Medicare for seniors,” said AARP CEO Barry Rand to the Associated Press. "We've read the Affordable Health Care for America Act and we can say with confidence that it meets those goals with improved benefits for people in Medicare and needed health insurance market reforms to help ensure every American can purchase affordable health coverage.”

House Speaker Nancy Pelosi and Majority Leader Steny Hoyer are no doubt breathing a little easier. The AARP’s support (or lack thereof) has proved powerful in the past, helping to pass the 2003 Prescription Drug Benefit Act and stop the privatization of Social Security under former President George W. Bush.

But some major issues still remain. In particular, the coverage of illegal immigrants and restrictions on federal funds for abortion could both be explosive debates. The NY Times does a nice job of parsing out the different factions and deals being brokered around the latter, which are many and could still unravel the legislation. Here’s to hoping compromise prevails. 

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House Debuts Their Bill for Health Insurance Reform

House Debuts Their Bill for Health Insurance Reform in Politics and Legislation

Speaker of the House Nancy Pelosi presented the Affordable Health Care for America Act today, the House’s health reform bill.  At 1,990 pages and $894 billion, the measure would extend coverage to 36-million people and reduce future federal deficits by $30 billion over the next 10 years.

That last fact is a big win for President Obama and the Democrats who are face daily scrutiny from their Republican counterparts on adding to the deficit.

It would broadly expand Medicare and provide subsidies to moderate-income Americans to purchase insurance. And, as promised, it includes a public health insurance plan.

The bill has strong similarities with the one emerging from the Senate, but important distinctions as well. The Senate version would fund reform in part with a “Cadillac” tax on higher-priced policies (to the vocal dismay of labor unions). But the House bill would instead tax incomes of over $500, 000, something Speaker Pelosi calls the “millionaire’s tax.” Pelosi’s version also prompts almost twice the Medicare cuts on the prescription-drug industry as the Senate’s $80 billion cuts.

Other points of note are that, as expected, the House bill bars health insurance companies from denying coverage based on health history and requires employers to offer coverage to their workers.

On a sidenote, we enjoyed the NYTimes’ reporting on some of the symbolic theatre that accompanied the bill’s unveiling. Apparently, Representative John Dingell brought out the gavel he used in 1965, while presiding over the House the year it passed Medicare. “I had the privilege of sitting in the chair when we offered Medicare, originally offered by my old dad,” Mr. Dingell said, brandishing the old mallet at the rally.

“I used this here gavel to preside over the House, and I’m going to lend it to whoever gets to preside over this legislation, because a good piece of wood doesn’t wear out with one great event,” he declared.

Mr. Dingell’s father, John Dingell Sr. began pushing for national health insurance in 1943.

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The Public Health Insurance Option and the Public Misconception of Reform

The Public Health Insurance Option and the Public Misconception of Reform in Politics and Legislation

The big news, to a health insurance blog anyway, was the health reform bill in the U.S. Senate will include a public health insurance option, reported CNN.

A senior aide to Senate Majority Leader Harry Reid told CNN that the public option would be included in the bill and have a clause allowing individual states to opt-out of the plan if they chose.

The opt-out clause, something we blogged about last week, is a political answer to for the progressive Democratic base that’s becoming increasingly agitated at the bill’s current form.

Risky move, Senator. Holding on to votes like conservative Democrats like Senator Ben Nelson and Senator Blanche Lincoln could make or break health reform. And we surely can’t forget about Senator Olympia Snowe, who is the only Republican to show interest in what the Democrats are pushing.

So say we do get reform. Say it passes in December and the Democrats, especially President Obama, get a $800 billion Christmas present. Does that mean we the people get ours too? Actually, no, we don’t.

Most of the bill’s provisions, as it currently stands, don’t go into effect until 2013. That’s four years of wondering if the bill to change the health care and health insurance system will work.

Now, on one hand it makes sense. The health system in the United States is such a complicated mess there’s no way we can implement major changes within a few months or even a year. Giving us four years of prepping will likely do a lot of good to help ensure what does work, will work very well.

But for Americans who need relief now, this bill is going to be a big disappointment. And there’s a very good chance public opinion of the bill will take a dive soon after its potential passage.

According to a recent poll from Kaiser Family Foundation, half of America believes that health care and health insurance changes will start to happen in the next year.

A staggering 49 percent think within the next year, people will get financial help in buying health insurance plans. What’s more, 51 percent believe health insurance companies will accept all applications with pre-existing conditions.

So no relief for four years and the push for a public option that could doom health reform entirely?

Talk about a political time bomb.

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The HHS on How Health Insurance Reform can Help Women with Breast Cancer

The HHS on How Health Insurance Reform can Help Women with Breast Cancer in Politics and Legislation

We don’t really have to tell you that cancer and health insurance don’t really get along all too well.

These days, Americans with serious pre-existing health conditions, such as breast cancer, definitely have trouble finding coverage.

In light of Breast Cancer Awareness Month this October, Secretary Kathleen Sebelius and the Department of Health and Human Services released a report highlighting the benefits that health reform will have for women with breast cancer.

The report touts different aspects of the current health reform bill, including out-of-pocket cost limits, access to health insurance exchanges for comparison shopping and the eventual elimination of pre-existing condition exclusions.

In addition to the health insurance side of things, the HHS says health reform will also help improve care quality for breast cancer patients.

We thought it was a pretty good (and timely) way to promote the health reform bill’s passage through Congress.

Even though it’s not really a scientific report, you can see the full text of it here: http://www.healthreform.gov/reports/breastcancer/index.html.

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Senate Shoots Down Bill to Intercept Medicare Pay Cuts

Senate Shoots Down Bill to Intercept Medicare Pay Cuts in Politics and Legislation

Unsurprisingly, the bill to block pay cuts to Medicare doctors was defeated in the Senate yesterday. This is the bill that would have intercepted the sustainable growth rate (SGR) formula that is more or less intended to curb doctors’ rates from climbing too fast.

Both the American Medical Association and the AARP said they were “deeply disappointed,” reports the Wall Street Journal’s health blog.

But, if history is any indication, the proposed 21% cuts won’t go through anyway. Congress usually passes a short-term fix to stop that year’s scheduled cuts. Then does it again the next year and the one after that, but always stops short of scrapping the system altogether.

The way Senate Majority Leader Harry Reid put it: “Right now, we’re going to a one-year fix.”

Here’s the thing: Blocking the cut would add $247 billion in federal spending over the next decade. And while there is talk that the Republicans will offer amendments to offset the cost, nothing has yet materialized.

However, the issue is far from over. More wrangling is going to ensue around this, especially with the recently introduced House bill that would completely axe the SGR formula. 

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The Opt-Out Clause: CPR for the Public Health Insurance Option?

The Opt-Out Clause: CPR for the Public Health Insurance Option? in Politics and Legislation

The public health insurance plan is back.

Back on the court.

Back on tour.

Back on the make with new hair, new shoes and — sing it, Patti — a new attitude.

What makes it so politically viable this time? A little opt-out clause that may very well be the magic bullet the Obama administration has been seeking.

The newest vision for the public option proposes establishing a national health care plan that states can opt out of. That means that Republicans and conservative Democrats could more easily sign off on the overall legislation knowing that they can defer the actual decision to local governments.

And, clearly, it would get on board progressive Democrats who insist on a government-sponsored plan. That it has a good chance of garnering bipartisanship that runs more than one-deep? Even better.  

Now, it’s true something similar has already been proposed (the Carter plan), wherein states could choose to opt in for a national plan.

But it’s been estimated that an opt-in would only produce a government plan in 10-20 states whereas the hurdle of having to affirmatively vote a public plan out on a referendum could conceivably bring that number up to 47, reports the Huffington Post.

This idea is still young, yet to be officially introduced, but out of everything that’s bubbling up in the current phase of amendments and bill-melding, this is one we’re keeping an eye on. 

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Labor Unions Bitter Over Health Insurance Provisions in Baucus Bill

Labor Unions Bitter Over Health Insurance Provisions in Baucus Bill in Politics and Legislation

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.

This is going to be a tough one.

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Chances of Reconciliation to Pass Health Reform Looks Slim

Chances of Reconciliation to Pass Health Reform Looks Slim in Politics and Legislation

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.

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Snowe’s a Go and so Is the Baucus Health Reform Bill

Snowe’s a Go and so Is the Baucus Health Reform Bill in Politics and Legislation

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:

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.

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Uptrend of Public Support for Health Insurance Reform?

Uptrend of Public Support for Health Insurance Reform? in Politics and Legislation

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.

Happy Friday, Mr. President.

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CBO: Baucus Bill Covers 94% of Americans – and Reduces Deficit

CBO: Baucus Bill Covers 94% of Americans – and Reduces Deficit in Politics and Legislation

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?

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How Health Insurance Reform Will Lead To Jail by Congressman John Shadegg

How Health Insurance Reform Will Lead To Jail by Congressman John Shadegg in Politics and Legislation

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.

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