Friday, October 1, 2010 Close to a million insured workers will lose out on a significant bump in insurance coverage promised by health reform next year.
Courtesy of CNN
McDonald's (NYSE: MCD - News), Jack in the Box (Nasdaq: JACK - News) and other companies won a one-year exemption from a new rule requiring them to raise the maximum amount of coverage they offer employees.
All told 30 companies, also including insurers Cigna (NYSE: CI - News) and Aetna (NYSE: AET - News), received the waiver, affecting 968,765 enrollees.
Companies affected by the law were threatening to drop coverage completely or raise employees' premiums by as much as 200% in order to comply with next year's deadline, according to a government official familiar with the matter.
"We were in a situation where if we didn't take action, folks could lose their only source of coverage or pay an outrageously high premium. That wasn't acceptable," the official said.
White House spokesman Robert Gibbs explained the Obama administration's position Thursday.
"We want to ensure that in the time that it takes to implement the law, workers don't find themselves at the mercy of insurance companies jacking up rates," Gibbs said at a press briefing.
Beginning 2011, the new health law mandates that insurers and employers gradually remove annual dollar limits on an individual's insurance coverage and eventually eliminate these limits by 2014.
Cigna said the waiver applies to a plan that covers about 250,000 people. The company also said it plans to ask for an additional waiver each year until 2014.
In order to phase in this change, the law says that employers and insurers have to offer an annual coverage limit of least $750,000 by next year. The limit would increase to $1.25 million in 2012 and to $2 million in 2013.
Companies that hire a significant number of part-time workers — such as retailers — typically offer low-cost, low-coverage plans, called "mini-med" plans. Mini-med plans typically restrict individual insurance coverage to a few thousand dollars a year.
"We remain in conversations with our current provider and are confident that we'll continue to provide health care coverage for our 30,000 hourly restaurant employees," McDonald's said in a statement on Thursday. "We're pleased and encouraged by the progress that's been made by the Federal government on this issue."
The Department of Health and Human Services said waiver applications were taken on a "case by case basis." Among the factors officials consider are how much premiums would increase or how many employees would lose coverage without a waiver.
HHS spokeswoman Jessica Santillo said companies would again be able to apply for waivers next year.
Showing posts with label health care reform. Show all posts
Showing posts with label health care reform. Show all posts
Monday, October 11, 2010
Monday, April 5, 2010
Lockheed, Boeing and Others See Health Reform Charges
Reuters is reporting that Lockheed Martin Corp, Boeing Co, Goodrich Corp and Ingersoll-Rand Plc on Wednesday joined a growing list of companies that plan to book charges related to U.S. healthcare reform.
The federal government pays subsidies to large companies, including AT&T Inc, Caterpillar Inc and Deere & Co, to help pay for prescription drug benefits for retirees.
The U.S. healthcare overhaul signed into law last week by President Barack Obama would eliminate tax deductions that have been available to companies that provide such benefits.
Some corporate leaders have complained that the change amounts to a tax increase. White House officials have countered that it essentially closes a tax loophole.
Although the change does not take effect until 2013, accounting rules require that the charges be recorded in the period the legislation was enacted.
On Wednesday, the list of corporations expecting to take charges related to healthcare reform grew.
Lockheed Martin, the world's largest defense contractor, said it expected to record a $96 million, or about 25 cents a share, after-tax charge in the first quarter.
Boeing said it would take a charge of around $150 million, or 20 cents per share, against first-quarter results.
Aircraft parts supplier Goodrich expected the charge to be about $10 million, or 8 cents per share, in the first quarter, while air compressor and cooling systems maker Ingersoll-Rand forecast a charge of $41 million, or 12 cents per share.
Conversely, General Electric Co has said that it does not expect health care reform to have a "significant material impact" on its results.
The federal government pays subsidies to large companies, including AT&T Inc, Caterpillar Inc and Deere & Co, to help pay for prescription drug benefits for retirees.
The U.S. healthcare overhaul signed into law last week by President Barack Obama would eliminate tax deductions that have been available to companies that provide such benefits.
Some corporate leaders have complained that the change amounts to a tax increase. White House officials have countered that it essentially closes a tax loophole.
Although the change does not take effect until 2013, accounting rules require that the charges be recorded in the period the legislation was enacted.
On Wednesday, the list of corporations expecting to take charges related to healthcare reform grew.
Lockheed Martin, the world's largest defense contractor, said it expected to record a $96 million, or about 25 cents a share, after-tax charge in the first quarter.
Boeing said it would take a charge of around $150 million, or 20 cents per share, against first-quarter results.
Aircraft parts supplier Goodrich expected the charge to be about $10 million, or 8 cents per share, in the first quarter, while air compressor and cooling systems maker Ingersoll-Rand forecast a charge of $41 million, or 12 cents per share.
Conversely, General Electric Co has said that it does not expect health care reform to have a "significant material impact" on its results.
Monday, March 29, 2010
Coverage Now for Sick Children?
WASHINGTON — Just days after President Obama signed the new health care law, insurance companies are already arguing that, at least for now, they do not have to provide one of the benefits that the president calls a centerpiece of the law: coverage for certain children with pre-existing conditions.
Senator John D. Rockefeller IV criticized insurance companies that say they do not yet have to cover pre-existing conditions.
A blog from The New York Times that tracks the health care debate as it unfolds.
How the Health Care Overhaul Could Affect You
Mr. Obama, speaking at a health care rally in northern Virginia on March 19, said, “Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”
The authors of the law say they meant to ban all forms of discrimination against children with pre-existing conditions like asthma, diabetes, birth defects, orthopedic problems, leukemia, cystic fibrosis and sickle cell disease. The goal, they say, was to provide those youngsters with access to insurance and to a full range of benefits once they are in a health plan.
To insurance companies, the language of the law is not so clear.
Insurers agree that if they provide insurance for a child, they must cover pre-existing conditions. But, they say, the law does not require them to write insurance for the child and it does not guarantee the “availability of coverage” for all until 2014.
William G. Schiffbauer, a lawyer whose clients include employers and insurance companies, said: “The fine print differs from the larger political message. If a company sells insurance, it will have to cover pre-existing conditions for children covered by the policy. But it does not have to sell to somebody with a pre-existing condition. And the insurer could increase premiums to cover the additional cost.”
Congressional Democrats were furious when they learned that some insurers disagreed with their interpretation of the law.
“The concept that insurance companies would even seek to deny children coverage exemplifies why we fought for this reform,” said Representative Henry A. Waxman, Democrat of California and chairman of the Energy and Commerce Committee.
Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate commerce committee, said: “The ink has not yet dried on the health care reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions. This is outrageous.”
The issue is one of many that federal officials are tackling as they prepare to carry out the law, with a huge stream of new rules, official guidance and brochures to educate the public. Their decisions will have major practical implications.
Insurers say they often limit coverage of pre-existing conditions under policies sold in the individual insurance market. Thus, for example, an insurer might cover a family of four, including a child with a heart defect, but exclude treatment of that condition from the policy.
The new law says that health plans and insurers offering individual or group coverage “may not impose any pre-existing condition exclusion with respect to such plan or coverage” for children under 19, starting in “plan years” that begin on or after Sept. 23, 2010.
But, insurers say, until 2014, the law does not require them to write insurance at all for the child or the family. In the language of insurance, the law does not include a “guaranteed issue” requirement before then.
Consumer advocates worry that instead of refusing to cover treatment for a specific pre-existing condition, an insurer might simply deny coverage for the child or the family.
“If you have a sick kid, the individual insurance market will continue to be a scary place,” said Karen L. Pollitz, a research professor at the Health Policy Institute at Georgetown University.
Experts at the National Association of Insurance Commissioners share that concern.
“I would like to see the kids covered,” said Sandy Praeger, the insurance commissioner of Kansas. “But without guaranteed issue of insurance, I am not sure companies will be required to take children under 19.”
A White House spokesman said the administration planned to issue regulations setting forth its view that “the term ‘pre-existing’ applies to both a child’s access to a plan and his or her benefits once he or she is in a plan.” But lawyers said the rules could be challenged in court if they went beyond the law or were inconsistent with it.
Starting in January 2014, health plans will be required to accept everyone who applies for coverage.
Until then, people with pre-existing conditions could seek coverage in high-risk insurance pools run by states or by the secretary of health and human services. The new law provides $5 billion to help pay claims filed by people in those pools.
Federal officials will need to write rules or guidance to address a number of concerns. The issues to be resolved include defining the “essential health benefits” that must be offered by all insurers; deciding which dependents are entitled to stay on their parents’ insurance; determining who qualifies for a “hardship exemption” from the requirement to have insurance; and deciding who is eligible for a new long-term care insurance program.
As originally conceived, most of the new federal requirements would have taken effect at the same time, in three or four years. The requirements for people to carry insurance, for employers to offer it and for insurers to accept all applicants were tied together.
But as criticism of their proposal grew, Democrats wanted to show that the legislation would produce immediate, tangible benefits. So they accelerated the ban on “pre-existing condition exclusions” for children.
Consumers will soon gain several other protections. By July 1, the health secretary must establish a Web site where people can identify “affordable health insurance coverage options.” The site is supposed to provide information about premiums, co-payments and the share of premium revenue that goes to administrative costs and profits, rather than medical care.
In addition, within six months, health plans must have “an effective appeals process,” so consumers can challenge decisions on coverage and claims.
Senator John D. Rockefeller IV criticized insurance companies that say they do not yet have to cover pre-existing conditions.
A blog from The New York Times that tracks the health care debate as it unfolds.
How the Health Care Overhaul Could Affect You
Mr. Obama, speaking at a health care rally in northern Virginia on March 19, said, “Starting this year, insurance companies will be banned forever from denying coverage to children with pre-existing conditions.”
The authors of the law say they meant to ban all forms of discrimination against children with pre-existing conditions like asthma, diabetes, birth defects, orthopedic problems, leukemia, cystic fibrosis and sickle cell disease. The goal, they say, was to provide those youngsters with access to insurance and to a full range of benefits once they are in a health plan.
To insurance companies, the language of the law is not so clear.
Insurers agree that if they provide insurance for a child, they must cover pre-existing conditions. But, they say, the law does not require them to write insurance for the child and it does not guarantee the “availability of coverage” for all until 2014.
William G. Schiffbauer, a lawyer whose clients include employers and insurance companies, said: “The fine print differs from the larger political message. If a company sells insurance, it will have to cover pre-existing conditions for children covered by the policy. But it does not have to sell to somebody with a pre-existing condition. And the insurer could increase premiums to cover the additional cost.”
Congressional Democrats were furious when they learned that some insurers disagreed with their interpretation of the law.
“The concept that insurance companies would even seek to deny children coverage exemplifies why we fought for this reform,” said Representative Henry A. Waxman, Democrat of California and chairman of the Energy and Commerce Committee.
Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate commerce committee, said: “The ink has not yet dried on the health care reform bill, and already some deplorable health insurance companies are trying to duck away from covering children with pre-existing conditions. This is outrageous.”
The issue is one of many that federal officials are tackling as they prepare to carry out the law, with a huge stream of new rules, official guidance and brochures to educate the public. Their decisions will have major practical implications.
Insurers say they often limit coverage of pre-existing conditions under policies sold in the individual insurance market. Thus, for example, an insurer might cover a family of four, including a child with a heart defect, but exclude treatment of that condition from the policy.
The new law says that health plans and insurers offering individual or group coverage “may not impose any pre-existing condition exclusion with respect to such plan or coverage” for children under 19, starting in “plan years” that begin on or after Sept. 23, 2010.
But, insurers say, until 2014, the law does not require them to write insurance at all for the child or the family. In the language of insurance, the law does not include a “guaranteed issue” requirement before then.
Consumer advocates worry that instead of refusing to cover treatment for a specific pre-existing condition, an insurer might simply deny coverage for the child or the family.
“If you have a sick kid, the individual insurance market will continue to be a scary place,” said Karen L. Pollitz, a research professor at the Health Policy Institute at Georgetown University.
Experts at the National Association of Insurance Commissioners share that concern.
“I would like to see the kids covered,” said Sandy Praeger, the insurance commissioner of Kansas. “But without guaranteed issue of insurance, I am not sure companies will be required to take children under 19.”
A White House spokesman said the administration planned to issue regulations setting forth its view that “the term ‘pre-existing’ applies to both a child’s access to a plan and his or her benefits once he or she is in a plan.” But lawyers said the rules could be challenged in court if they went beyond the law or were inconsistent with it.
Starting in January 2014, health plans will be required to accept everyone who applies for coverage.
Until then, people with pre-existing conditions could seek coverage in high-risk insurance pools run by states or by the secretary of health and human services. The new law provides $5 billion to help pay claims filed by people in those pools.
Federal officials will need to write rules or guidance to address a number of concerns. The issues to be resolved include defining the “essential health benefits” that must be offered by all insurers; deciding which dependents are entitled to stay on their parents’ insurance; determining who qualifies for a “hardship exemption” from the requirement to have insurance; and deciding who is eligible for a new long-term care insurance program.
As originally conceived, most of the new federal requirements would have taken effect at the same time, in three or four years. The requirements for people to carry insurance, for employers to offer it and for insurers to accept all applicants were tied together.
But as criticism of their proposal grew, Democrats wanted to show that the legislation would produce immediate, tangible benefits. So they accelerated the ban on “pre-existing condition exclusions” for children.
Consumers will soon gain several other protections. By July 1, the health secretary must establish a Web site where people can identify “affordable health insurance coverage options.” The site is supposed to provide information about premiums, co-payments and the share of premium revenue that goes to administrative costs and profits, rather than medical care.
In addition, within six months, health plans must have “an effective appeals process,” so consumers can challenge decisions on coverage and claims.
Sunday, March 21, 2010
Breaking News - House passes second historic health care vote
The aftermath of the great Washington health care debate has held true to form, breaking down strictly down partisan lines. House Democrats hailed their final vote on health care reform tonight as a historic breakthrough, ending more than 70 years of efforts to put all Americans under some form of health care coverage. Republicans just as forcefully denounced today's vote - which approved both the original Senate bill and some key "fixes" to it - as an irresponsible and needless expansion of big government amid ballooning federal deficits.
The bill passed 220 to 211.
Tonight's second vote was designed to rid the final legislation of some of the more-controversial provisions in the Senate version of the bill, such as the special multimillion-dollar increases in Medicaid for the states of Nebraska and Louisiana, which were instrumental to winning the support of wavering Sens. Mary Landrieu (D-LA) and Ben Nelson (D-NE). The vote also closes up the "doughnut hole" in the Medicare prescription drug benefit, which leaves seniors without drug subsidies for several months - which has likewise proved critical in winning the backing of the pharmaceutical industry and has been blanketing the airwaves with ads urging passage of the bill.
While the Senate still has to weigh in on the amended bill, most observers think that shouldn't be much more than a formality, especially at this late stage of the process. At the very least, the House vote ensures that there will be a health care bill on President Obama's desk, perhaps as early as the end of this week. And the president's signature will set into motion the most dramatic change to American health care since Lyndon Johnson signed Medicare into law in 1965.
The bill, which the Congressional Budget Office says will cost $940-billion over ten years, is expected to cover an estimated 32 million Americans who are presently uninsured. Among its major provisions:
-An "individual mandate" will require all Americans to purchase some form of health care coverage, with government subsidies provided to those needing financial assistance to do so. People who don't obtain coverage of some sort will be subject to federal fines, which would begin to take effect in 2015.
-All employers with 50 or more employees will be legally obliged to offer coverage - or else they will be assessed a stiff fine of $2,000 per uninsured employee.
-Insurance exchanges - that is, purchasing pools for individuals not covered by employer-provided or federal plans such as Medicare - will be able to obtain coverage.
-Private insurers will no longer be permitted to deny coverage or raise premiums on the basis of pre-existing medical conditions or illness.
-Cost controls will be phased in via expanded coverage plans, resulting in a $1.3 trillion reduction in the federal deficit during the next 20 years, against $940 billion in costs associated with the bill, according to estimates from the Congressional Budget Office.
The bill passed 220 to 211.
Tonight's second vote was designed to rid the final legislation of some of the more-controversial provisions in the Senate version of the bill, such as the special multimillion-dollar increases in Medicaid for the states of Nebraska and Louisiana, which were instrumental to winning the support of wavering Sens. Mary Landrieu (D-LA) and Ben Nelson (D-NE). The vote also closes up the "doughnut hole" in the Medicare prescription drug benefit, which leaves seniors without drug subsidies for several months - which has likewise proved critical in winning the backing of the pharmaceutical industry and has been blanketing the airwaves with ads urging passage of the bill.
While the Senate still has to weigh in on the amended bill, most observers think that shouldn't be much more than a formality, especially at this late stage of the process. At the very least, the House vote ensures that there will be a health care bill on President Obama's desk, perhaps as early as the end of this week. And the president's signature will set into motion the most dramatic change to American health care since Lyndon Johnson signed Medicare into law in 1965.
The bill, which the Congressional Budget Office says will cost $940-billion over ten years, is expected to cover an estimated 32 million Americans who are presently uninsured. Among its major provisions:
-An "individual mandate" will require all Americans to purchase some form of health care coverage, with government subsidies provided to those needing financial assistance to do so. People who don't obtain coverage of some sort will be subject to federal fines, which would begin to take effect in 2015.
-All employers with 50 or more employees will be legally obliged to offer coverage - or else they will be assessed a stiff fine of $2,000 per uninsured employee.
-Insurance exchanges - that is, purchasing pools for individuals not covered by employer-provided or federal plans such as Medicare - will be able to obtain coverage.
-Private insurers will no longer be permitted to deny coverage or raise premiums on the basis of pre-existing medical conditions or illness.
-Cost controls will be phased in via expanded coverage plans, resulting in a $1.3 trillion reduction in the federal deficit during the next 20 years, against $940 billion in costs associated with the bill, according to estimates from the Congressional Budget Office.
A Look At The Health Care Bill
By The Associated Press The Associated Press –
Congressional Democrats have released a final version of President Barack Obama's health care overhaul bill in advance of a House vote planned for Sunday. Some features of the legislation, which makes changes to the bill the Senate passed on Christmas Eve:
COST: $940 billion over 10 years, according to the Congressional Budget Office.
HOW MANY COVERED: 32 million uninsured. Major coverage expansion begins in 2014. When fully phased in, 95 percent of eligible Americans would have coverage, compared with 83 percent today.
INSURANCE MANDATE: Almost everyone is required to be insured or else pay a fine. There is an exemption for low-income people. Mandate takes effect in 2014.
INSURANCE MARKET REFORMS: Starting this year, insurers would be forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of pre-existing conditions, and from canceling policies because someone gets sick. Parents would be able to keep older kids on their coverage up to age 26. A new high-risk pool would offer coverage to uninsured people with medical problems until 2014, when the coverage expansion goes into high gear. Major consumer safeguards would also take effect in 2014. Insurers would be prohibited from denying coverage to people with medical problems or charging them more. Insurers could not charge women more.
MEDICAID: Expands the federal-state Medicaid insurance program for the poor to cover people with incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four. Childless adults would be covered for the first time, starting in 2014. The federal government would pay 100 percent of costs for covering newly eligible individuals through 2016. A special deal that would have given Nebraska 100 percent federal financing for newly eligible Medicaid recipients in perpetuity is eliminated. A different, one-time deal negotiated by Democratic Sen. Mary Landrieu for her state, Louisiana, worth as much as $300 million, remains.
TAXES: Dramatically scales back a Senate-passed tax on high-cost insurance plans that was opposed by House Democrats and labor unions. The tax would be delayed until 2018, and the thresholds at which it is imposed would be $10,200 for individuals and $27,500 for families. To make up for the lost revenue, the bill applies an increased Medicare payroll tax to investment income as well as wages for individuals making more than $200,000, or married couples above $250,000. The tax on investment income would be 3.8 percent.
PRESCRIPTION DRUGS: Gradually closes the "doughnut hole" coverage gap in the Medicare prescription drug benefit that seniors fall into once they have spent $2,830. Seniors who hit the gap this year will receive a $250 rebate. Beginning in 2011, seniors in the gap receive a discount on brand name drugs, initially 50 percent off. When the gap is completely eliminated in 2020, seniors will still be responsible for 25 percent of the cost of their medications until Medicare's catastrophic coverage kicks in.
EMPLOYER RESPONSIBILITY: As in the Senate bill, businesses are not required to offer coverage. Instead, employers are hit with a fee if the government subsidizes their workers' coverage. The $2,000-per-employee fee would be assessed on the company's entire work force, minus an allowance. Companies with 50 or fewer workers are exempt from the requirement. Part-time workers are included in the calculations, counting two part-timers as one full-time worker.
SUBSIDIES: The proposal provides more generous tax credits for purchasing insurance than the original Senate bill did. The aid is available on a sliding scale for households making up to four times the federal poverty level, $88,200 for a family of four. Premiums for a family of four making $44,000 would be capped at around 6 percent of income.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Small businesses, the self-employed and the uninsured could pick a plan offered through new state-based purchasing pools called exchanges, opening for business in 2014. The exchanges would offer the same kind of purchasing power that employees of big companies benefit from. People working for medium-to-large firms would not see major changes. But if they lose their jobs or strike out on their own, they may be eligible for subsidized coverage through the exchange.
GOVERNMENT-RUN PLAN: No government-run insurance plan. People purchasing coverage through the new insurance exchanges would have the option of signing up for national plans overseen by the federal office that manages the health plans available to members of Congress. Those plans would be private, but one would have to be nonprofit.
ABORTION: The proposal keeps the abortion provision in the Senate bill. Abortion opponents disagree on whether restrictions on taxpayer funding go far enough. The bill tries to maintain a strict separation between taxpayer dollars and private premiums that would pay for abortion coverage. No health plan would be required to offer coverage for abortion. In plans that do cover abortion, policyholders would have to pay for it separately, and that money would have to be kept in a separate account from taxpayer money. States could ban abortion coverage in plans offered through the exchange. Exceptions would be made for cases of rape, incest and danger to the life of the mother.
GOP HEALTH CARE SUMMIT IDEAS: Following a bipartisan health care summit last month, Obama announced he was open to incorporating several Republican ideas into his legislation. But two of the principle ones — hiring investigators to pose as patients and search for fraud at hospitals and increasing spending for medical malpractice reform initiatives — did not make it into the legislation released Thursday. The legislation incorporates only one, an increase in payments to primary care physicians under Medicaid, an idea mentioned by Sen. Charles Grassley, R-Iowa.
Congressional Democrats have released a final version of President Barack Obama's health care overhaul bill in advance of a House vote planned for Sunday. Some features of the legislation, which makes changes to the bill the Senate passed on Christmas Eve:
COST: $940 billion over 10 years, according to the Congressional Budget Office.
HOW MANY COVERED: 32 million uninsured. Major coverage expansion begins in 2014. When fully phased in, 95 percent of eligible Americans would have coverage, compared with 83 percent today.
INSURANCE MANDATE: Almost everyone is required to be insured or else pay a fine. There is an exemption for low-income people. Mandate takes effect in 2014.
INSURANCE MARKET REFORMS: Starting this year, insurers would be forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of pre-existing conditions, and from canceling policies because someone gets sick. Parents would be able to keep older kids on their coverage up to age 26. A new high-risk pool would offer coverage to uninsured people with medical problems until 2014, when the coverage expansion goes into high gear. Major consumer safeguards would also take effect in 2014. Insurers would be prohibited from denying coverage to people with medical problems or charging them more. Insurers could not charge women more.
MEDICAID: Expands the federal-state Medicaid insurance program for the poor to cover people with incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four. Childless adults would be covered for the first time, starting in 2014. The federal government would pay 100 percent of costs for covering newly eligible individuals through 2016. A special deal that would have given Nebraska 100 percent federal financing for newly eligible Medicaid recipients in perpetuity is eliminated. A different, one-time deal negotiated by Democratic Sen. Mary Landrieu for her state, Louisiana, worth as much as $300 million, remains.
TAXES: Dramatically scales back a Senate-passed tax on high-cost insurance plans that was opposed by House Democrats and labor unions. The tax would be delayed until 2018, and the thresholds at which it is imposed would be $10,200 for individuals and $27,500 for families. To make up for the lost revenue, the bill applies an increased Medicare payroll tax to investment income as well as wages for individuals making more than $200,000, or married couples above $250,000. The tax on investment income would be 3.8 percent.
PRESCRIPTION DRUGS: Gradually closes the "doughnut hole" coverage gap in the Medicare prescription drug benefit that seniors fall into once they have spent $2,830. Seniors who hit the gap this year will receive a $250 rebate. Beginning in 2011, seniors in the gap receive a discount on brand name drugs, initially 50 percent off. When the gap is completely eliminated in 2020, seniors will still be responsible for 25 percent of the cost of their medications until Medicare's catastrophic coverage kicks in.
EMPLOYER RESPONSIBILITY: As in the Senate bill, businesses are not required to offer coverage. Instead, employers are hit with a fee if the government subsidizes their workers' coverage. The $2,000-per-employee fee would be assessed on the company's entire work force, minus an allowance. Companies with 50 or fewer workers are exempt from the requirement. Part-time workers are included in the calculations, counting two part-timers as one full-time worker.
SUBSIDIES: The proposal provides more generous tax credits for purchasing insurance than the original Senate bill did. The aid is available on a sliding scale for households making up to four times the federal poverty level, $88,200 for a family of four. Premiums for a family of four making $44,000 would be capped at around 6 percent of income.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Small businesses, the self-employed and the uninsured could pick a plan offered through new state-based purchasing pools called exchanges, opening for business in 2014. The exchanges would offer the same kind of purchasing power that employees of big companies benefit from. People working for medium-to-large firms would not see major changes. But if they lose their jobs or strike out on their own, they may be eligible for subsidized coverage through the exchange.
GOVERNMENT-RUN PLAN: No government-run insurance plan. People purchasing coverage through the new insurance exchanges would have the option of signing up for national plans overseen by the federal office that manages the health plans available to members of Congress. Those plans would be private, but one would have to be nonprofit.
ABORTION: The proposal keeps the abortion provision in the Senate bill. Abortion opponents disagree on whether restrictions on taxpayer funding go far enough. The bill tries to maintain a strict separation between taxpayer dollars and private premiums that would pay for abortion coverage. No health plan would be required to offer coverage for abortion. In plans that do cover abortion, policyholders would have to pay for it separately, and that money would have to be kept in a separate account from taxpayer money. States could ban abortion coverage in plans offered through the exchange. Exceptions would be made for cases of rape, incest and danger to the life of the mother.
GOP HEALTH CARE SUMMIT IDEAS: Following a bipartisan health care summit last month, Obama announced he was open to incorporating several Republican ideas into his legislation. But two of the principle ones — hiring investigators to pose as patients and search for fraud at hospitals and increasing spending for medical malpractice reform initiatives — did not make it into the legislation released Thursday. The legislation incorporates only one, an increase in payments to primary care physicians under Medicaid, an idea mentioned by Sen. Charles Grassley, R-Iowa.
Friday, March 12, 2010
Pelosi Predicts a Health Bill Within 10 Days
WASHINGTON — Speaker Nancy Pelosi mobilized House Democrats on Friday for a final effort to pass an overhaul of health care, predicting approval in the next 10 days with help from President Obama, who delayed a trip abroad to try to win over wavering Democrats.
Speaker Nancy Pelosi said a proposed overhaul of the student loan program would be included in the final health care bill.
The White House said Mr. Obama would begin his trip to Indonesia and Australia a week from Sunday, three days later than scheduled, allowing him to be on hand for what is shaping up as the pivotal period for his top domestic initiative. Mr. Obama will travel to Ohio on Monday to push for passage.
But even as the yearlong battle hurtled toward a conclusion, approval of the bill was hardly certain, so lawmakers were preparing for a week of arm-twisting and high drama. Although they have been debating the issue for a year, some House Democrats said Friday that they could not say how they would vote because they had not seen the final text of the legislation or an official estimate of its cost.
Some issues that could swing blocs of votes, like insurance coverage for abortions, remain unresolved. House Democratic leaders said they had suspended their efforts to reach a compromise with party members who oppose abortion and the use of federal money to subsidize insurance that includes coverage of the procedure. That could cost them the votes of some House Democrats who supported the health care bill in the fall after it was amended to impose tight restrictions on abortion coverage.
The Capitol, normally quiet on a Friday, was abuzz as Democrats and Republicans readied for what is likely to be a frenetic push, leading to a series of climactic votes.
At the same time, members of both parties struggled to decipher a ruling by the Senate parliamentarian about how they would have to navigate through the complex rules governing the legislative technique being used by Democrats to win final approval of the bill. While their interpretations differed, Democrats said they believed they could meet its requirements with this sequence of events:
As soon as Thursday or Friday, the House would pass the health care bill approved by the Senate in December. The House would immediately approve a package of changes in a separate bill, using a procedure known as budget reconciliation, to avoid the threat of a Republican filibuster in the Senate.
Mr. Obama would sign the Senate health care bill, making it the law of the land. The budget reconciliation bill would go to the Senate, where Republicans intend to offer dozens of amendments and points of order in an effort to alter or stop it. Assuming they are able to fend off the Republican blocking efforts, Democrats could pass the reconciliation package with a simple majority vote, amending the health bill in a way that makes it acceptable to Democrats in the House and the Senate and to Mr. Obama. The president would then sign the reconciliation bill, completing the process.
The Senate Republican leader, Mitch McConnell of Kentucky, said Democrats were “twisting themselves into pretzels trying to figure some way to get this health care bill passed.”
“The reason all of this arm-twisting and deal-making and parliamentary maneuvering is going on is that people hate this bill,” Mr. McConnell said. “They are trying to convince their members, within eight months of an election, to ignore their constituents and do something that the public is opposed to.”
Ms. Pelosi said a proposed overhaul of the student loan program would be included in the reconciliation bill, a decision that cheered many Democrats. The education bill is popular in the House, and some Democrats said it could help win support for the overall package, in part because it cuts off subsidies to big banks at a time of populist anger against Wall Street.
“This is a controversial, difficult vote for a lot of people, me included,” said Representative Robert E. Andrews, Democrat of New Jersey. “The more things that you can go home and say are in the bill that are sort of universally popular, yeah, it helps.”
He noted, for example, that the bill would provide additional money for community colleges and Pell grant scholarships.
But another New Jersey Democrat, Representative Bill Pascrell Jr., criticized packaging the health care and education bills together. “We will be confusing the American people more than we already have,” said Mr. Pascrell, who supports both bills.
Ms. Pelosi welcomed Mr. Obama’s decision to delay his trip.
“I’m delighted that the president will be here for passage of the bill,” she said. “It’s going to be historic. And it would not be possible without his tremendous, tremendous leadership, his persistence, his concern for the American people, always guided by his statement that we will measure our success by the progress being made by America’s working families.”
The bill would provide coverage to more than 30 million people who are uninsured, would require most Americans to carry insurance and would prohibit insurers from denying coverage to people who are sick. In both houses, Republicans strenuously oppose the legislation, saying it would raise taxes, cut Medicare and lead to higher premiums for many people who are relatively young and healthy.
Though Democrats said the bill could come to a vote by the end of the week, they have missed many self-imposed deadlines on health care, and when pressed on the schedule, Ms. Pelosi said she could not guarantee final House action by March 21, when Mr. Obama is to leave on his trip.
“I’m hoping that it will be in that time frame,” she said, adding, “We stand ready to stay as long as it takes to pass the bill.”
Representative Anthony D. Weiner, Democrat of New York, expressed the optimism of many in his party after the House Democratic Caucus met Friday.
“There’s been a tidal change, I think, in the last 72 hours or so,” Mr. Weiner said. “People have become more confident that we’re going to get this done.”
Abortion is perhaps the most contentious outstanding issue. Representative Steny H. Hoyer of Maryland, the Democratic leader, said he had discussed the issue with Representative Bart Stupak of Michigan, a leader of the anti-abortion Democrats. But Mr. Hoyer said, “I made it clear I was not negotiating.”
House Democrats dislike the Senate health bill and do not want to vote for it without an assurance that the Senate will pass the budget reconciliation bill to eliminate politically unpopular provisions, like one giving Nebraska extra Medicaid money.
Speaker Nancy Pelosi said a proposed overhaul of the student loan program would be included in the final health care bill.
The White House said Mr. Obama would begin his trip to Indonesia and Australia a week from Sunday, three days later than scheduled, allowing him to be on hand for what is shaping up as the pivotal period for his top domestic initiative. Mr. Obama will travel to Ohio on Monday to push for passage.
But even as the yearlong battle hurtled toward a conclusion, approval of the bill was hardly certain, so lawmakers were preparing for a week of arm-twisting and high drama. Although they have been debating the issue for a year, some House Democrats said Friday that they could not say how they would vote because they had not seen the final text of the legislation or an official estimate of its cost.
Some issues that could swing blocs of votes, like insurance coverage for abortions, remain unresolved. House Democratic leaders said they had suspended their efforts to reach a compromise with party members who oppose abortion and the use of federal money to subsidize insurance that includes coverage of the procedure. That could cost them the votes of some House Democrats who supported the health care bill in the fall after it was amended to impose tight restrictions on abortion coverage.
The Capitol, normally quiet on a Friday, was abuzz as Democrats and Republicans readied for what is likely to be a frenetic push, leading to a series of climactic votes.
At the same time, members of both parties struggled to decipher a ruling by the Senate parliamentarian about how they would have to navigate through the complex rules governing the legislative technique being used by Democrats to win final approval of the bill. While their interpretations differed, Democrats said they believed they could meet its requirements with this sequence of events:
As soon as Thursday or Friday, the House would pass the health care bill approved by the Senate in December. The House would immediately approve a package of changes in a separate bill, using a procedure known as budget reconciliation, to avoid the threat of a Republican filibuster in the Senate.
Mr. Obama would sign the Senate health care bill, making it the law of the land. The budget reconciliation bill would go to the Senate, where Republicans intend to offer dozens of amendments and points of order in an effort to alter or stop it. Assuming they are able to fend off the Republican blocking efforts, Democrats could pass the reconciliation package with a simple majority vote, amending the health bill in a way that makes it acceptable to Democrats in the House and the Senate and to Mr. Obama. The president would then sign the reconciliation bill, completing the process.
The Senate Republican leader, Mitch McConnell of Kentucky, said Democrats were “twisting themselves into pretzels trying to figure some way to get this health care bill passed.”
“The reason all of this arm-twisting and deal-making and parliamentary maneuvering is going on is that people hate this bill,” Mr. McConnell said. “They are trying to convince their members, within eight months of an election, to ignore their constituents and do something that the public is opposed to.”
Ms. Pelosi said a proposed overhaul of the student loan program would be included in the reconciliation bill, a decision that cheered many Democrats. The education bill is popular in the House, and some Democrats said it could help win support for the overall package, in part because it cuts off subsidies to big banks at a time of populist anger against Wall Street.
“This is a controversial, difficult vote for a lot of people, me included,” said Representative Robert E. Andrews, Democrat of New Jersey. “The more things that you can go home and say are in the bill that are sort of universally popular, yeah, it helps.”
He noted, for example, that the bill would provide additional money for community colleges and Pell grant scholarships.
But another New Jersey Democrat, Representative Bill Pascrell Jr., criticized packaging the health care and education bills together. “We will be confusing the American people more than we already have,” said Mr. Pascrell, who supports both bills.
Ms. Pelosi welcomed Mr. Obama’s decision to delay his trip.
“I’m delighted that the president will be here for passage of the bill,” she said. “It’s going to be historic. And it would not be possible without his tremendous, tremendous leadership, his persistence, his concern for the American people, always guided by his statement that we will measure our success by the progress being made by America’s working families.”
The bill would provide coverage to more than 30 million people who are uninsured, would require most Americans to carry insurance and would prohibit insurers from denying coverage to people who are sick. In both houses, Republicans strenuously oppose the legislation, saying it would raise taxes, cut Medicare and lead to higher premiums for many people who are relatively young and healthy.
Though Democrats said the bill could come to a vote by the end of the week, they have missed many self-imposed deadlines on health care, and when pressed on the schedule, Ms. Pelosi said she could not guarantee final House action by March 21, when Mr. Obama is to leave on his trip.
“I’m hoping that it will be in that time frame,” she said, adding, “We stand ready to stay as long as it takes to pass the bill.”
Representative Anthony D. Weiner, Democrat of New York, expressed the optimism of many in his party after the House Democratic Caucus met Friday.
“There’s been a tidal change, I think, in the last 72 hours or so,” Mr. Weiner said. “People have become more confident that we’re going to get this done.”
Abortion is perhaps the most contentious outstanding issue. Representative Steny H. Hoyer of Maryland, the Democratic leader, said he had discussed the issue with Representative Bart Stupak of Michigan, a leader of the anti-abortion Democrats. But Mr. Hoyer said, “I made it clear I was not negotiating.”
House Democrats dislike the Senate health bill and do not want to vote for it without an assurance that the Senate will pass the budget reconciliation bill to eliminate politically unpopular provisions, like one giving Nebraska extra Medicaid money.
President Obama Delays Pacific Trip For Healthcare
WASHINGTON (Reuters) - President Barack Obama is delaying his trip to Indonesia and Australia next week to stay home and focus on his final push for a healthcare overhaul, White House officials said on Friday. Obama, who had been scheduled to leave on March 18 on his first overseas travel of the year, plans to depart instead on March 21, the officials said.
The decision to delay the trip comes as Obama presses his fellow Democrats for a quick final vote on healthcare reform, which has ignited a long-running political brawl with Republican opponents and consumed Congress for the past nine months.
Congressional leaders, who have repeatedly missed deadlines for finishing the overhaul, had resisted the White House target of completing work before Obama's originally planned departure overseas next Thursday.
"The president will delay leaving for Indonesia and Australia - will now leave Sunday," White House spokesman Robert Gibbs said in a message on twitter.com.
He said first lady Michelle Obama and their two daughters, who had been due to accompany the president, "will not be on the trip."
Obama now intends to return to Washington on March 26 instead of his original plan for March 24, officials said.
The decision to delay the trip comes as Obama presses his fellow Democrats for a quick final vote on healthcare reform, which has ignited a long-running political brawl with Republican opponents and consumed Congress for the past nine months.
Congressional leaders, who have repeatedly missed deadlines for finishing the overhaul, had resisted the White House target of completing work before Obama's originally planned departure overseas next Thursday.
"The president will delay leaving for Indonesia and Australia - will now leave Sunday," White House spokesman Robert Gibbs said in a message on twitter.com.
He said first lady Michelle Obama and their two daughters, who had been due to accompany the president, "will not be on the trip."
Obama now intends to return to Washington on March 26 instead of his original plan for March 24, officials said.
Tuesday, March 9, 2010
Obama Using 'Bounty Hunters' for Health Care Fraud
The White House announcement came as Obama prepared to travel to Missouri on Wednesday, taking his closing argument to the nation's heartland. The trip will be his second public appearance this week to rally support and fire up nervous Democrats.
The White House released details of the anti-fraud plan hours after a fresh challenge to the administration from major business groups that unveiled a multimillion-dollar ad campaign arguing that under Obama's plan "health care costs will go even higher, making a bad economy worse."
Monday, March 8, 2010
Obama's Health Care Pitch to Democrats: Trust Me
WASHINGTON (AP) --
In private pitches to Democrats, President Barack Obama says he will persuade Congress to pass his health care overhaul even if it kills him and even if he has to ask deeply distrustful lawmakers to trust him on a promise the White House doesn't have the power to keep.
That, in a sometimes darkly joking way, is what the president is telling Democratic House members as he begins an all-out push to coax Congress into passing his proposals despite voters' misgivings and Republicans' dire warnings.
''He made the case, 'Listen, we put in a very hard year working on health care reform and the time for action is now,''' said Rep. Ron Kind, D-Wis., one of several Democrats who met with Obama at the White House on Thursday.
Obama joked that the political battle has contributed to the recent rise in his cholesterol, Kind said, and the president noted how ironic it would be if health care drove him to his grave.
In private pitches to Democrats, President Barack Obama says he will persuade Congress to pass his health care overhaul even if it kills him and even if he has to ask deeply distrustful lawmakers to trust him on a promise the White House doesn't have the power to keep.
That, in a sometimes darkly joking way, is what the president is telling Democratic House members as he begins an all-out push to coax Congress into passing his proposals despite voters' misgivings and Republicans' dire warnings.
''He made the case, 'Listen, we put in a very hard year working on health care reform and the time for action is now,''' said Rep. Ron Kind, D-Wis., one of several Democrats who met with Obama at the White House on Thursday.
Obama joked that the political battle has contributed to the recent rise in his cholesterol, Kind said, and the president noted how ironic it would be if health care drove him to his grave.
Tuesday, March 2, 2010
President Obama open to adding GOP ideas to health plan
Associated Press Writer Erica Werner,
reported this about 8 mins ago
WASHINGTON – President Barack Obama said Tuesday he was open to four new Republican proposals on health care legislation, a gesture of bipartisanship meant to jump-start his stalled drive to overhaul the system.
Obama detailed the ideas, all of which were raised at a bipartisan health care summit last week, in a letter to congressional leaders. In a nod to his 2008 presidential rival, Obama also said he had eliminated a special deal for Medicare Advantage beneficiaries in Florida and other states that drew criticism at the summit from Sen. John McCain, R-Ariz.
The proposals Obama listed are: sending investigators disguised as patients to uncover fraud and waste, expanding medical malpractice reform pilot programs, increasing payments to Medicaid providers and expanding the use of health savings accounts.
"I said throughout this process that I'd continue to draw on the best ideas from both parties, and I'm open to these proposals in that spirit," wrote Obama, who will make remarks Wednesday at the White House on a path forward for his legislation.
He rejected the GOP's preferred approach of scrapping the existing sweeping overhaul bills and starting afresh with step-by-step changes.
House Speaker Nancy Pelosi, D-Calif., said Obama's letter "brings us just another step closer to passing the bill."
"We hope to incorporate some of the suggestions," she said.
Obama's announcement did not appear to win over any Republicans, who complained the underlying legislation remained fatally flawed, and the Senate GOP leader warned of reprisals in this fall's midterms elections if the Democrats go forward. But it could give wavering Democrats political cover by showing the White House has been willing to compromise in the wake of last week's summit.
"We're anxious to get health care done, which we will get done," Senate Majority Leader Harry Reid, D-Nev., said after Obama released the letter. Democrats proceed at their own political peril, said Senate Minority Leader Mitch McConnell, R-Ky.
"I want to assure our Democratic friends that if they are somehow able to pass this bill in the House, it will be the issue in every race in America," McConnell said.
At its core the Democrats' legislation would extend coverage to 30 million uninsured Americans over 10 years with a first-time mandate for nearly everyone to buy insurance and a host of new requirements on insurers and employers. However, the package soon to reach the House will be less expensive than the one the House passed in November and will contain no government-run insurance program to compete with private insurers, making it more appealing to some moderates.
Democrats are eyeing a controversial procedure known as "budget reconciliation" to get the legislation to Obama. Under this process, the House would pass the Senate-passed overhaul bill, and both chambers would pass a package of changes to the legislation designed to appeal to House Democrats. The changes — they could include Obama's suggested Republican ideas — could pass under budget rules allowing a simple majority vote in the Senate. It's Democrats' only way forward because Republicans control 41 Senate votes, just enough block the 60-vote supermajority usually required for action.
But the approach infuriates Republicans, even though they've used it in the past, and makes some Democratic moderates uneasy. White House chief of staff Rahm Emanuel defended the tactic after emerging from a meeting at the Capitol with Reid and House Speaker Nancy Pelosi, D-Calif.
"Reconciliation is a vehicle that's been used many times," Emanuel said. "This is a normal procedure, nothing different out of it."
Obama said he was open to these four GOP ideas:
Conducting undercover investigations of Medicare and Medicaid providers to search for waste, fraud and abuse, an idea put forth by Sen. Tom Coburn, R-Okla., at least week's summit.
Experimenting with specialized health courts as an alternative to jury trials in medical malpractice cases to cut down on defensive medicine. That idea has been promoted both by Democrats and Republicans, including Coburn and Sen. Mike Enzi, R-Wyo., who attended the summit.
The approach calls for an expert judge — not a jury — to hear the evidence and make a final determination in cases where a patient has suffered harm. Trial lawyers are strongly opposed to the concept.
Months ago, Obama budgeted $23 million for states to experiment with alternatives to malpractice litigation, but at the time he stopped short of endorsing health courts. The president now says he wants to more than double the budget for state experiments to $50 million.
Obama also agreed that health savings accounts would be offered in new markets his plan sets up for individuals and small business to purchase coverage. Sen. John Barrasso, R-Wyo., brought up the idea at the summit.
The president said he's open to the tax-sheltered accounts, which go hand-in-hand with high-deductible health insurance policies. Premiums on those policies are lower than for regular health insurance, and people who have them use the health savings accounts to pay their out-of-pockets costs.
Obama also suggested increasing reimbursements to Medicaid providers, a concern raised by Sen. Charles Grassley, R-Iowa.
"That's just one thing," Coburn said of the president's desire to incorporate his proposal. "We need to start over," Coburn said, contending the bill doesn't address underlying issues of health care costs and quality.
Grassley said Obama's willingness to include his idea didn't change his opposition to the overall legislation. "There are other things more important," like its lack of caps on liability damages and its inclusion of an individual mandate, he said.
Democrats argue that the GOP calls to scrap the existing legislation and start anew further their argument that Republicans have been unreasonably opposed to almost any compromise, justifying the White House decision to push for passage with no GOP help at all.
Sen. Bill Nelson, D-Fla., said he hadn't seen Obama's proposal to eliminate the provision he championed to let about 800,000 Florida seniors enrolled in Medicare Advantage plans keep their extra benefits. But, Nelson said, "I do not think it should be removed."
reported this about 8 mins ago
WASHINGTON – President Barack Obama said Tuesday he was open to four new Republican proposals on health care legislation, a gesture of bipartisanship meant to jump-start his stalled drive to overhaul the system.
Obama detailed the ideas, all of which were raised at a bipartisan health care summit last week, in a letter to congressional leaders. In a nod to his 2008 presidential rival, Obama also said he had eliminated a special deal for Medicare Advantage beneficiaries in Florida and other states that drew criticism at the summit from Sen. John McCain, R-Ariz.
The proposals Obama listed are: sending investigators disguised as patients to uncover fraud and waste, expanding medical malpractice reform pilot programs, increasing payments to Medicaid providers and expanding the use of health savings accounts.
"I said throughout this process that I'd continue to draw on the best ideas from both parties, and I'm open to these proposals in that spirit," wrote Obama, who will make remarks Wednesday at the White House on a path forward for his legislation.
He rejected the GOP's preferred approach of scrapping the existing sweeping overhaul bills and starting afresh with step-by-step changes.
House Speaker Nancy Pelosi, D-Calif., said Obama's letter "brings us just another step closer to passing the bill."
"We hope to incorporate some of the suggestions," she said.
Obama's announcement did not appear to win over any Republicans, who complained the underlying legislation remained fatally flawed, and the Senate GOP leader warned of reprisals in this fall's midterms elections if the Democrats go forward. But it could give wavering Democrats political cover by showing the White House has been willing to compromise in the wake of last week's summit.
"We're anxious to get health care done, which we will get done," Senate Majority Leader Harry Reid, D-Nev., said after Obama released the letter. Democrats proceed at their own political peril, said Senate Minority Leader Mitch McConnell, R-Ky.
"I want to assure our Democratic friends that if they are somehow able to pass this bill in the House, it will be the issue in every race in America," McConnell said.
At its core the Democrats' legislation would extend coverage to 30 million uninsured Americans over 10 years with a first-time mandate for nearly everyone to buy insurance and a host of new requirements on insurers and employers. However, the package soon to reach the House will be less expensive than the one the House passed in November and will contain no government-run insurance program to compete with private insurers, making it more appealing to some moderates.
But the approach infuriates Republicans, even though they've used it in the past, and makes some Democratic moderates uneasy. White House chief of staff Rahm Emanuel defended the tactic after emerging from a meeting at the Capitol with Reid and House Speaker Nancy Pelosi, D-Calif.
"Reconciliation is a vehicle that's been used many times," Emanuel said. "This is a normal procedure, nothing different out of it."
Obama said he was open to these four GOP ideas:
Conducting undercover investigations of Medicare and Medicaid providers to search for waste, fraud and abuse, an idea put forth by Sen. Tom Coburn, R-Okla., at least week's summit.
The approach calls for an expert judge — not a jury — to hear the evidence and make a final determination in cases where a patient has suffered harm. Trial lawyers are strongly opposed to the concept.
Months ago, Obama budgeted $23 million for states to experiment with alternatives to malpractice litigation, but at the time he stopped short of endorsing health courts. The president now says he wants to more than double the budget for state experiments to $50 million.
Obama also agreed that health savings accounts would be offered in new markets his plan sets up for individuals and small business to purchase coverage. Sen. John Barrasso, R-Wyo., brought up the idea at the summit.
The president said he's open to the tax-sheltered accounts, which go hand-in-hand with high-deductible health insurance policies. Premiums on those policies are lower than for regular health insurance, and people who have them use the health savings accounts to pay their out-of-pockets costs.
Obama also suggested increasing reimbursements to Medicaid providers, a concern raised by Sen. Charles Grassley, R-Iowa.
"That's just one thing," Coburn said of the president's desire to incorporate his proposal. "We need to start over," Coburn said, contending the bill doesn't address underlying issues of health care costs and quality.
Grassley said Obama's willingness to include his idea didn't change his opposition to the overall legislation. "There are other things more important," like its lack of caps on liability damages and its inclusion of an individual mandate, he said.
Democrats argue that the GOP calls to scrap the existing legislation and start anew further their argument that Republicans have been unreasonably opposed to almost any compromise, justifying the White House decision to push for passage with no GOP help at all.
Sen. Bill Nelson, D-Fla., said he hadn't seen Obama's proposal to eliminate the provision he championed to let about 800,000 Florida seniors enrolled in Medicare Advantage plans keep their extra benefits. But, Nelson said, "I do not think it should be removed."
9 Dems who voted no on health bill may reconsider
Associated Press Writer Charles Babington, Associated Press Writer
WASHINGTON – Nine House Democrats indicated in an Associated Press survey Monday they have not ruled out switching their "no" votes to "yes" on President Barack Obama's health care overhaul, brightening the party's hopes in the face of unyielding Republican opposition.
The White House tried to smooth the way for them, showing its own openness to changes in the landmark legislation and making a point of saying the administration is not using parliamentary tricks or loopholes to find the needed support.
Democratic leaders have strongly signaled they will use a process known as "budget reconciliation" to try to push part of the package through the Senate without allowing Republicans to talk it to death with filibusters. The road could be even more difficult in the House, where Speaker Nancy Pelosi is struggling to secure enough Democratic votes for approval, thus the effort to attract former foes.
The White House said Obama will outline his final "way forward" in a Washington speech Wednesday, and he is expected to embrace a handful of Republican ideas for making health care more efficient.
Few in Washington think those gestures will be enough to persuade a single House or Senate Republican to embrace the legislation. But they could give wavering Democrats political cover by showing the party has been willing to compromise, ammunition against campaign accusations this fall that they rammed the bill through Congress with no regard for other views.
The proposal would impose new restrictions on insurance companies and order health insurance coverage for as many as 30 million Americans who now lack it, among many other changes.
Persuading lawmakers to change their votes is a tough sell. Elected officials are loath to vote two ways on a controversial issue, feeling such a switch draws more resentment than support overall. Democratic leaders stress that the legislative package soon to reach the House will be less expensive than the one that passed in November and will contain no government-run insurance program to compete with private insurers.
They hope those changes will give additional cover to party moderates thinking of switching from no to yes.
The House version of health care passed 220-215 in November, with 39 Democrats voting against it. Since then, defections, resignations and a death have taken away yes votes.
With four House seats now vacant, Pelosi would need 216 votes to approve the Senate-passed version, which replaces the jettisoned House bill. That's exactly the number she has now if no other members switch their votes.
In interviews with the AP, at least nine of the 39 Democrats — or their spokesmen — either declined to state their positions or said they were undecided about the revised legislation, making them likely targets for intense wooing by Pelosi and Obama. Three of them — Brian Baird of Washington, Bart Gordon of Tennessee and John Tanner of Tennessee — are not seeking re-election this fall.
The others are Rick Boucher of Virginia, Suzanne Kosmas of Florida, Frank Kratovil of Maryland, Michael McMahon of New York, Scott Murphy of New York and Glenn Nye of Virginia. Several lawmakers' offices did not reply to the AP queries.
Rep. Walt Minnick of Idaho will not change his vote from no, his spokesman, Dean Ferguson, said Monday night. Minnick had declined to state a position when contacted earlier by the AP.
Both parties have used the "reconciliation" strategy to pass big bills before, but Republicans call the health care push an unwarranted departure from standard practices.
Top Democrats are reminding colleagues and voters at home that the Senate already has passed its version of the health care bill on Christmas Eve with a super-majority of 60 votes, which squelched a GOP filibuster without resorting to reconciliation rules. The new plan calls for the House to pass that same bill and send it to Obama for his signature.
But that is contingent on a Senate promise to make several subsequent changes. Those would have to be approved under the special budget reconciliation rules, because Democrats now control only 59 of the Senate's 100 votes — one shy of the number needed to stop a bill-killing filibuster.
Democratic leaders have asked colleagues not to use the term "reconciliation" but instead to refer to the process as "majority vote," said Rep. Allyson Schwartz, D-Pa. They also are frequently using the term "up or down vote."
The political math in the House is daunting. Many lawmakers expect further defections, especially members who oppose legalized abortion and feel the Senate language is too permissive in regulating federal funds for those operations.
For every yes vote that switches to no, Pelosi and the White House must persuade one of the 39 Democrats who voted "nay" in November to switch to yes.
Obama's announcement on Wednesday is expected to be a freshened blueprint of what he wants to see in a final health care bill, updated with ideas that at least have the fingerprints of Republicans.
The plan will replace the one Obama posted one week ago, but will not be written in legislative language.
Obama's move underscores his ever-growing role in shaping what he hopes will be a far-reaching revision to the nation's health care system, a goal that has eluded other presidents dating to Theodore Roosevelt.
Politically, it would also allow him to say that he was listening to Republicans at his ballyhooed bipartisan summit last week and that he has since responded by including more areas of common ground.
But Republicans have shown no sign of backing his proposal no matter how it is changed.
Obama also will outline how he wants the process to unfold in Congress. Officials signaled it will involve Senate reconciliation rules unless there's a stunning last-minute overture from Republicans.
White House spokesman Robert Gibbs would not confirm that plan Monday. But he repeated that health care deserves an up-or-down vote and that Republicans have used reconciliation on major legislation.
When asked if the public cares about legislative process, Gibbs said: "I think the American people care about what's in the bill."
Since Thursday's summit, Obama has been involved in a series of meetings in which the new White House proposal is being shaped.
Gibbs said Obama has worked to get votes in every round of the health care debate. "I don't doubt that he will ... do the same thing this time to get the votes necessary to pass health care," Gibbs said.
Rep. Eric Cantor of Virginia, the House's second-ranking Republican, made it clear that Republicans see a Democrats-only bill as an election-year issue.
"If Speaker Pelosi rams through this bill," he said this weekend, Democrats "will lose their majority in Congress in November."
Meanwhile Monday, Obama's argument that private insurance plans serving one-fourth of Medicare recipients are significantly overpaid got support from a report to Congress by nonpartisan technical advisers. Democrats have targeted Medicare Advantage plans for a big chunk of the cuts that would free funds to cover the uninsured.
The report by the Medicare Payment Advisory Commission found that last year Medicare spent about $14 billion more for seniors enrolled in private plans than would have been the case if those beneficiaries had stayed in the traditional program. One consequence was that all Medicare recipients _whether in private plans or the traditional program_ ended up paying an additional $3.35 a month in premiums to cover the costs.
The Senate health care bill that Obama supports would replace the current payment formula for the private plans with an approach based on competitive bidding.
WASHINGTON – Nine House Democrats indicated in an Associated Press survey Monday they have not ruled out switching their "no" votes to "yes" on President Barack Obama's health care overhaul, brightening the party's hopes in the face of unyielding Republican opposition.
The White House tried to smooth the way for them, showing its own openness to changes in the landmark legislation and making a point of saying the administration is not using parliamentary tricks or loopholes to find the needed support.
Democratic leaders have strongly signaled they will use a process known as "budget reconciliation" to try to push part of the package through the Senate without allowing Republicans to talk it to death with filibusters. The road could be even more difficult in the House, where Speaker Nancy Pelosi is struggling to secure enough Democratic votes for approval, thus the effort to attract former foes.
The White House said Obama will outline his final "way forward" in a Washington speech Wednesday, and he is expected to embrace a handful of Republican ideas for making health care more efficient.
Few in Washington think those gestures will be enough to persuade a single House or Senate Republican to embrace the legislation. But they could give wavering Democrats political cover by showing the party has been willing to compromise, ammunition against campaign accusations this fall that they rammed the bill through Congress with no regard for other views.
The proposal would impose new restrictions on insurance companies and order health insurance coverage for as many as 30 million Americans who now lack it, among many other changes.
They hope those changes will give additional cover to party moderates thinking of switching from no to yes.
The House version of health care passed 220-215 in November, with 39 Democrats voting against it. Since then, defections, resignations and a death have taken away yes votes.
In interviews with the AP, at least nine of the 39 Democrats — or their spokesmen — either declined to state their positions or said they were undecided about the revised legislation, making them likely targets for intense wooing by Pelosi and Obama. Three of them — Brian Baird of Washington, Bart Gordon of Tennessee and John Tanner of Tennessee — are not seeking re-election this fall.
The others are Rick Boucher of Virginia, Suzanne Kosmas of Florida, Frank Kratovil of Maryland, Michael McMahon of New York, Scott Murphy of New York and Glenn Nye of Virginia. Several lawmakers' offices did not reply to the AP queries.
Rep. Walt Minnick of Idaho will not change his vote from no, his spokesman, Dean Ferguson, said Monday night. Minnick had declined to state a position when contacted earlier by the AP.
Both parties have used the "reconciliation" strategy to pass big bills before, but Republicans call the health care push an unwarranted departure from standard practices.
Top Democrats are reminding colleagues and voters at home that the Senate already has passed its version of the health care bill on Christmas Eve with a super-majority of 60 votes, which squelched a GOP filibuster without resorting to reconciliation rules. The new plan calls for the House to pass that same bill and send it to Obama for his signature.
But that is contingent on a Senate promise to make several subsequent changes. Those would have to be approved under the special budget reconciliation rules, because Democrats now control only 59 of the Senate's 100 votes — one shy of the number needed to stop a bill-killing filibuster.
Democratic leaders have asked colleagues not to use the term "reconciliation" but instead to refer to the process as "majority vote," said Rep. Allyson Schwartz, D-Pa. They also are frequently using the term "up or down vote."
The political math in the House is daunting. Many lawmakers expect further defections, especially members who oppose legalized abortion and feel the Senate language is too permissive in regulating federal funds for those operations.
For every yes vote that switches to no, Pelosi and the White House must persuade one of the 39 Democrats who voted "nay" in November to switch to yes.
Obama's announcement on Wednesday is expected to be a freshened blueprint of what he wants to see in a final health care bill, updated with ideas that at least have the fingerprints of Republicans.
The plan will replace the one Obama posted one week ago, but will not be written in legislative language.
Obama's move underscores his ever-growing role in shaping what he hopes will be a far-reaching revision to the nation's health care system, a goal that has eluded other presidents dating to Theodore Roosevelt.
Politically, it would also allow him to say that he was listening to Republicans at his ballyhooed bipartisan summit last week and that he has since responded by including more areas of common ground.
But Republicans have shown no sign of backing his proposal no matter how it is changed.
Obama also will outline how he wants the process to unfold in Congress. Officials signaled it will involve Senate reconciliation rules unless there's a stunning last-minute overture from Republicans.
White House spokesman Robert Gibbs would not confirm that plan Monday. But he repeated that health care deserves an up-or-down vote and that Republicans have used reconciliation on major legislation.
When asked if the public cares about legislative process, Gibbs said: "I think the American people care about what's in the bill."
Since Thursday's summit, Obama has been involved in a series of meetings in which the new White House proposal is being shaped.
Gibbs said Obama has worked to get votes in every round of the health care debate. "I don't doubt that he will ... do the same thing this time to get the votes necessary to pass health care," Gibbs said.
Rep. Eric Cantor of Virginia, the House's second-ranking Republican, made it clear that Republicans see a Democrats-only bill as an election-year issue.
"If Speaker Pelosi rams through this bill," he said this weekend, Democrats "will lose their majority in Congress in November."
Meanwhile Monday, Obama's argument that private insurance plans serving one-fourth of Medicare recipients are significantly overpaid got support from a report to Congress by nonpartisan technical advisers. Democrats have targeted Medicare Advantage plans for a big chunk of the cuts that would free funds to cover the uninsured.
The report by the Medicare Payment Advisory Commission found that last year Medicare spent about $14 billion more for seniors enrolled in private plans than would have been the case if those beneficiaries had stayed in the traditional program. One consequence was that all Medicare recipients _whether in private plans or the traditional program_ ended up paying an additional $3.35 a month in premiums to cover the costs.
The Senate health care bill that Obama supports would replace the current payment formula for the private plans with an approach based on competitive bidding.
Monday, March 1, 2010
Snowmageddon Can Still Kill Health Care Reform
February 26, 2010, 1:51 pm
Washington’s “Snowmageddon” may have already passed. But the storm still has the power to kill Washington’s health care reform talks, perhaps for good.
Take a look at where the health care reform process is now. Despite high hopes, Thursday’s much anticipated summit meeting did not seem to move the needle much. And yet, even with cannons to the left of them and cannons to the right of them, Democratic leadership vowed to charge forward.
“If nothing comes of this we’re going to press forward,” The Times quoted Senator Richard J. Durbin of Illinois, the No. 2 Democrat, as saying. “We just can’t quit. This is a once-in-a-political-lifetime opportunity to deal with a health care system that is really unsustainable.”
The implication is that Democrats regard the impasse as an extension; health care reform is, after all, a long-term question, and not one that had to be resolved by Thursday, per se. But how long will this “once-in-a-political-lifetime opportunity” to address the long-term issue last?
My guess: The deadline is probably one week from today, when the February jobs report comes out.
That report will probably be very, very ugly. I have seen some forecasters project job losses as high as 100,000.
The main culprit behind the expected jobs plunge is the blizzard, which closed businesses and kept people from going to work or even seeking work for days and sometimes weeks. These work stoppages probably occurred precisely when the government was collecting data for its February jobs report.
The Labor Department is of course very aware that the blizzard will distort its numbers. In fact, labor officials will probably try to isolate the effects of the storm from all the other data so economists can get a better sense of what’s going on in the economy. Offcials did this after previous major weather events like the 1996 East Coast blizzard and Hurricane Katrina.
But even though everyone will know that “snowmageddon,” and not President Obama, is really at fault for the poor report, the headline number may still be shocking enough to sufficiently discredit economic policy of Democrats. And all other economic policy debates, including health care which will be set against this backdrop of the Democrats’ failed stewardship of the economy.
Worsening economic dysfunction, at least when it comes to Main Streeters, sends a powerful message to Americans who believe that Democrats want a “government takeover of 17 percent of the United States economy.”
After all, if you were a Republican hell-bent on derailing health care reform, that's what I'd do.
Washington’s “Snowmageddon” may have already passed. But the storm still has the power to kill Washington’s health care reform talks, perhaps for good.
Take a look at where the health care reform process is now. Despite high hopes, Thursday’s much anticipated summit meeting did not seem to move the needle much. And yet, even with cannons to the left of them and cannons to the right of them, Democratic leadership vowed to charge forward.
“If nothing comes of this we’re going to press forward,” The Times quoted Senator Richard J. Durbin of Illinois, the No. 2 Democrat, as saying. “We just can’t quit. This is a once-in-a-political-lifetime opportunity to deal with a health care system that is really unsustainable.”
The implication is that Democrats regard the impasse as an extension; health care reform is, after all, a long-term question, and not one that had to be resolved by Thursday, per se. But how long will this “once-in-a-political-lifetime opportunity” to address the long-term issue last?
My guess: The deadline is probably one week from today, when the February jobs report comes out.
That report will probably be very, very ugly. I have seen some forecasters project job losses as high as 100,000.
The main culprit behind the expected jobs plunge is the blizzard, which closed businesses and kept people from going to work or even seeking work for days and sometimes weeks. These work stoppages probably occurred precisely when the government was collecting data for its February jobs report.
The Labor Department is of course very aware that the blizzard will distort its numbers. In fact, labor officials will probably try to isolate the effects of the storm from all the other data so economists can get a better sense of what’s going on in the economy. Offcials did this after previous major weather events like the 1996 East Coast blizzard and Hurricane Katrina.
But even though everyone will know that “snowmageddon,” and not President Obama, is really at fault for the poor report, the headline number may still be shocking enough to sufficiently discredit economic policy of Democrats. And all other economic policy debates, including health care which will be set against this backdrop of the Democrats’ failed stewardship of the economy.
Worsening economic dysfunction, at least when it comes to Main Streeters, sends a powerful message to Americans who believe that Democrats want a “government takeover of 17 percent of the United States economy.”
After all, if you were a Republican hell-bent on derailing health care reform, that's what I'd do.
Saturday, February 27, 2010
Obama to GOP on health care: `Let's get this done'
Associated Press -
WASHINGTON – President Barack Obama said Saturday he is ready to compromise with Republicans on health care if they are serious about it, but that an overhaul must go forward. "Let's get this done," he said.
Obama's comments in his weekly Internet and radio address, two days after an all-day bipartisan summit across from the White House, were the latest sign that Democrats are getting set to try to pass health care legislation without any Republicans on board.
Success will require colossal efforts on the part of Obama and Democratic leaders to round up votes after a year of corrosive debate and a Senate special-election upset that threw the overhaul effort into limbo last month. But Obama and the Democrats reject the piecemeal approach sought by Republicans and have no intention of scrapping their 10-year, $1 trillion bill and starting over, as the GOP demands.
"I am eager and willing to move forward with members of both parties on health care if the other side is serious about coming together to resolve our differences and get this done. But I also believe that we cannot lose the opportunity to meet this challenge," Obama said.
"The tens of millions of men and women who cannot afford their health insurance cannot wait another generation for us to act. Small businesses cannot wait. Americans with pre-existing conditions cannot wait. State and federal budgets cannot sustain these rising costs.
"It is time for those of us in Washington to live up to our responsibilities to the American people and to future generations," Obama said.
Obama's legislation would insure some 30 million more Americans over 10 years with a new requirement for nearly everyone to carry insurance and would end insurance company practices such as denying coverage to people with medical problems. Republicans generally oppose mandates that make everyone get insurance, and although they want people with health conditions to be able to buy insurance, they would try to address the problem without new requirements on insurers.
Obama plans to release an updated proposal in the week ahead, likely on Wednesday, according to press secretary Robert Gibbs. Gibbs suggested it would include concepts put forward by Republicans at the summit. One attendee, Sen. Tom Coburn, R-Okla., was contacted Friday by the White House and asked to submit details of suggestions he made to tackle waste and fraud in the medical system, Coburn's spokesman said.
John Hart said Coburn views Obama's legislation as a government takeover and would not be able to support it even if it includes some of his proposals.
Adding Republican ideas is not likely to win Republican votes because the GOP insists Democrats should start from scratch. But Obama would be able to say that he'd listened to Republicans and attempted to meet them part way. Moving ahead may mean using Senate rules that would let Democrats pass legislation with a simple majority instead of the 60 vote they no longer command.
The approach infuriates Republicans and is opposed by some Democratic moderates because of its partisan nature.
Coburn, in the GOP's weekly address, argued against a Democrats-only bill.
"Unfortunately, even before the summit took place the majority in Congress signaled its intent to reject our offers to work together," Coburn said. "Instead they want to use procedural tricks and back-room deals to ram through a new bill that combines the worst aspects of the bills the Senate and House passed last year."
"The American people are telling us to scrap the current bills, which will lead to a government takeover of health care, and we should start over," Coburn said.
WASHINGTON – President Barack Obama said Saturday he is ready to compromise with Republicans on health care if they are serious about it, but that an overhaul must go forward. "Let's get this done," he said.
Obama's comments in his weekly Internet and radio address, two days after an all-day bipartisan summit across from the White House, were the latest sign that Democrats are getting set to try to pass health care legislation without any Republicans on board.
Success will require colossal efforts on the part of Obama and Democratic leaders to round up votes after a year of corrosive debate and a Senate special-election upset that threw the overhaul effort into limbo last month. But Obama and the Democrats reject the piecemeal approach sought by Republicans and have no intention of scrapping their 10-year, $1 trillion bill and starting over, as the GOP demands.
"I am eager and willing to move forward with members of both parties on health care if the other side is serious about coming together to resolve our differences and get this done. But I also believe that we cannot lose the opportunity to meet this challenge," Obama said.
"It is time for those of us in Washington to live up to our responsibilities to the American people and to future generations," Obama said.
Obama's legislation would insure some 30 million more Americans over 10 years with a new requirement for nearly everyone to carry insurance and would end insurance company practices such as denying coverage to people with medical problems. Republicans generally oppose mandates that make everyone get insurance, and although they want people with health conditions to be able to buy insurance, they would try to address the problem without new requirements on insurers.
Obama plans to release an updated proposal in the week ahead, likely on Wednesday, according to press secretary Robert Gibbs. Gibbs suggested it would include concepts put forward by Republicans at the summit. One attendee, Sen. Tom Coburn, R-Okla., was contacted Friday by the White House and asked to submit details of suggestions he made to tackle waste and fraud in the medical system, Coburn's spokesman said.
John Hart said Coburn views Obama's legislation as a government takeover and would not be able to support it even if it includes some of his proposals.
Adding Republican ideas is not likely to win Republican votes because the GOP insists Democrats should start from scratch. But Obama would be able to say that he'd listened to Republicans and attempted to meet them part way. Moving ahead may mean using Senate rules that would let Democrats pass legislation with a simple majority instead of the 60 vote they no longer command.
The approach infuriates Republicans and is opposed by some Democratic moderates because of its partisan nature.
Coburn, in the GOP's weekly address, argued against a Democrats-only bill.
"Unfortunately, even before the summit took place the majority in Congress signaled its intent to reject our offers to work together," Coburn said. "Instead they want to use procedural tricks and back-room deals to ram through a new bill that combines the worst aspects of the bills the Senate and House passed last year."
"The American people are telling us to scrap the current bills, which will lead to a government takeover of health care, and we should start over," Coburn said.
Friday, February 26, 2010
White House: Announcement next week on health care
WASHINGTON – The White House says President Barack Obama will announce his plans next week for a "way forward" on long-stalled health care legislation.
White House press secretary Robert Gibbs told reporters on Friday that Obama officials and Democratic leaders in Congress will hold a few days of consultations before an announcement by the president on the next steps. Gibbs said the coming days will be a "fairly dynamic process."
Democratic leaders are also vowing to resurrect a comprehensive overhaul, with or without Republican suggestions or votes.
A Candians View of the Health Care Situation
Something no doubt many Americans reading this aren't going to register because it simply will never occur to them to pay attention to this little detail:
They're complaining that the Canadian system under-performs compared to EUROPEAN systems. They are NOT complaining that it under-performs compared to the American system, which would be insane since the Canadian system clearly outperforms the one in the US.
You might be interested in another little fact that I find shockingly few Americans have any clue about considering the fact that health care is
such a prominent subject of debate:
US public (as in tax) spending on health care: 6.85% of GDP
Canadian public spending on health care: 6.95% of GDP
(As of 2005 at least, latest figures available from the OECD online database)
For one thing, Canadians actually only pay marginally higher taxes than Americans. for another, it isn't because of their health care system, which consumes about the same proportion of government spending as the US already spends on IT'S system, but delivers, obviously, far more value for the money. what higher taxes exist are for other social services. Oh, and the fact that Canadians prefer balanced budgets (they were running budget surpluses and paying down the national debt for 12 years straight before the global recession hit) to constant irresponsible pandering tax cuts.
So, no... it's not safe to say tax increases are necessary if the US were to enact an actual, real, single payer universal coverage model. At least not any tax increases of any significant size. If the US were to do so the negotiating ability of Medicare (let's just cal the new system "medicare" expanded to the entire population) would wield ENORMOUS negotiating leverage and a corresponding ability to get prices for services back under control again. That represents massive cost savings by itself. It would be operating in a far larger risk pool, which always makes insurance operate with greater efficiency as it's ability to mitigate risk due to point failures increases, and it would allow the kinds of large scale administrative savings that a "public option" simply cannot achieve... further extending the ability to reduce cost for services. How the heck does a care provider see any administrative overhead reductions if they go from dealing with 1500 private insurers plus medicare... to dealing with 1500 private insurers plus medicare plus whatever the public option is? They don't. It's worthless to them.
Although to be blunt, tax rates are too low in the US considering the fact that they've been fighting military conflicts in two countries for the last 8 years and have been running massive budget deficits and they should be raised anyway... but screaming whining children who erupt into near riot just from hearing the words "tax increase" in the States make that a political minefield no matter how good for the nation it is. But, different debate.
It is ridiculously self evident that health care most certainly does not behave like any other market. The profit motives are all upside down and backward for one thing.
If I’m selling… let’s say cars… what does my ideal customer look like? First of all, they drive a lot. They NEED my product. And they will use it often, which translates to more service providing replacement parts and maintenance on top of the fact that they recognize that it is worth paying me for the car in the first place. and this is all a GOOD thing for me. I get individually compensated for meeting every single one of those needs. So I am going to gear my efforts towards providing the segment of the population with the greatest need for my product with what they are looking for, because that’s in my own best business interest. I make a good profit, society gets it’s needs met, everyone is relatively happy, nation ticks along relatively well. Hurray, the system works.
If I’m selling health insurance what does my ideal customer look like? Someone who USES health insurance a lot? Someone who is even likely to in the future? *Hell no*. Because they do NOT make me more money. They COST me more money… in direct proportion to how much services they use. So where is my motive to gear my business towards meeting the greatest needs of society in my business sector? It simply does not exist. My profit motive is in the opposite direction. I want to sell my services to the people who need them LEAST while doing everything in my power to avoid having the people who need my services most as my customers.
You will never, EVER, find any company providing any regular old consumer good employing an entire department of lawyers whose job is to try to figure out ways to wriggle out of a contractual obligation to deliver the services they're selling to the people who most need their product. Ever. Because that would be **insane** in the market for any regular commodity. But it makes perfect business sense to a private insurer because that market is NOTHING like the market for most other things.
The private sector, to put it bluntly, sucks at providing insurance. It is very very good at making a profit doing it, but not by utilizing any business model that optimizes the benefit to society gained by their operating within that society. Government is far better geared towards providing insurance than the free market is if the goal of having the insurance exist in the first place is supposed to be to maximize the security of the society it is being provided to.
If on the other hand the only purpose you see for insurance is to create a mind bogglingly profitable insurance industry and the welfare of sick people simply isn't a priority in your decision making... well, then the free market is your way to go.
They're complaining that the Canadian system under-performs compared to EUROPEAN systems. They are NOT complaining that it under-performs compared to the American system, which would be insane since the Canadian system clearly outperforms the one in the US.
You might be interested in another little fact that I find shockingly few Americans have any clue about considering the fact that health care is
such a prominent subject of debate:
US public (as in tax) spending on health care: 6.85% of GDP
Canadian public spending on health care: 6.95% of GDP
(As of 2005 at least, latest figures available from the OECD online database)
For one thing, Canadians actually only pay marginally higher taxes than Americans. for another, it isn't because of their health care system, which consumes about the same proportion of government spending as the US already spends on IT'S system, but delivers, obviously, far more value for the money. what higher taxes exist are for other social services. Oh, and the fact that Canadians prefer balanced budgets (they were running budget surpluses and paying down the national debt for 12 years straight before the global recession hit) to constant irresponsible pandering tax cuts.
So, no... it's not safe to say tax increases are necessary if the US were to enact an actual, real, single payer universal coverage model. At least not any tax increases of any significant size. If the US were to do so the negotiating ability of Medicare (let's just cal the new system "medicare" expanded to the entire population) would wield ENORMOUS negotiating leverage and a corresponding ability to get prices for services back under control again. That represents massive cost savings by itself. It would be operating in a far larger risk pool, which always makes insurance operate with greater efficiency as it's ability to mitigate risk due to point failures increases, and it would allow the kinds of large scale administrative savings that a "public option" simply cannot achieve... further extending the ability to reduce cost for services. How the heck does a care provider see any administrative overhead reductions if they go from dealing with 1500 private insurers plus medicare... to dealing with 1500 private insurers plus medicare plus whatever the public option is? They don't. It's worthless to them.
Although to be blunt, tax rates are too low in the US considering the fact that they've been fighting military conflicts in two countries for the last 8 years and have been running massive budget deficits and they should be raised anyway... but screaming whining children who erupt into near riot just from hearing the words "tax increase" in the States make that a political minefield no matter how good for the nation it is. But, different debate.
It is ridiculously self evident that health care most certainly does not behave like any other market. The profit motives are all upside down and backward for one thing.
If I’m selling… let’s say cars… what does my ideal customer look like? First of all, they drive a lot. They NEED my product. And they will use it often, which translates to more service providing replacement parts and maintenance on top of the fact that they recognize that it is worth paying me for the car in the first place. and this is all a GOOD thing for me. I get individually compensated for meeting every single one of those needs. So I am going to gear my efforts towards providing the segment of the population with the greatest need for my product with what they are looking for, because that’s in my own best business interest. I make a good profit, society gets it’s needs met, everyone is relatively happy, nation ticks along relatively well. Hurray, the system works.
If I’m selling health insurance what does my ideal customer look like? Someone who USES health insurance a lot? Someone who is even likely to in the future? *Hell no*. Because they do NOT make me more money. They COST me more money… in direct proportion to how much services they use. So where is my motive to gear my business towards meeting the greatest needs of society in my business sector? It simply does not exist. My profit motive is in the opposite direction. I want to sell my services to the people who need them LEAST while doing everything in my power to avoid having the people who need my services most as my customers.
You will never, EVER, find any company providing any regular old consumer good employing an entire department of lawyers whose job is to try to figure out ways to wriggle out of a contractual obligation to deliver the services they're selling to the people who most need their product. Ever. Because that would be **insane** in the market for any regular commodity. But it makes perfect business sense to a private insurer because that market is NOTHING like the market for most other things.
The private sector, to put it bluntly, sucks at providing insurance. It is very very good at making a profit doing it, but not by utilizing any business model that optimizes the benefit to society gained by their operating within that society. Government is far better geared towards providing insurance than the free market is if the goal of having the insurance exist in the first place is supposed to be to maximize the security of the society it is being provided to.
If on the other hand the only purpose you see for insurance is to create a mind bogglingly profitable insurance industry and the welfare of sick people simply isn't a priority in your decision making... well, then the free market is your way to go.
After healthcare summit: What's next?
Washington
After a day-long White House summit on healthcare, Republicans returning to the Senate said that President Obama and the Democrats appear ready to go it alone on this issue.
“They’re not interested in putting a 2,700-page bill on the shelf,” said Senate Republican leader Mitch McConnell of Kentucky, referring to GOP demands that the president start over with a step-by-step approach, focusing on issues on which there is broad agreement.
At the end of the summit, Mr. Obama said, “I did not propose something complicated just for the sake of being complicated.” He added, “The reason we didn’t do it is it turns out baby steps don’t get you to the place where people need to go.”
To get a bill without 41 Senate Republicans means resorting to a process called reconciliation. The process allows measures that meet certain budget criteria to pass by a simple majority, instead of the 60 votes now typical for major bills.
In the dictionary, “reconciliation” means bringing together, conciliation, or fence mending. But on the floor of the US Senate, it’s pure procedural warfare.
Liberal activists are urging Democrats to get back to the principle of majority rule in the Senate, now seen as the graveyard for much of the Obama agenda. But moderate Democrats are wary of a move that could further alienate the public from a comprehensive healthcare reform.
A new Gallup poll, released Thursday, reports that most Americans oppose using reconciliation, by a margin of 52 percent to 39 percent. Nine percent were unsure.
On Feb. 23, Sen. Robert Byrd (D) of West Virginia, the leading in-house defender of the Senate traditions, urged his colleagues to allow filibusters to run their course and not change rules to block them.
“The Senate is the only place in government where the rights of a numerical minority are so protected. Majorities change with elections. A minority can be right, and minority views can certainly improve legislation,” he wrote in a letter to his Senate colleagues.
“Extended deliberation and debate – when employed judiciously – protect every senator, and the interests of their constituency, and are essential to the protection of the liberties of a free people,” he added.
Sen. Kent Conrad (D) of North Dakota, who chairs the Senate Budget Committee, says that there could be a role for reconciliation in the healthcare debate, but only “in a very limited way”: First, the House must pass the Senate bill, then use reconciliation procedures to “fix” the bill. “You cannot do the whole healthcare bill through reconciliation. It will not work,” he adds.
If Democrats opt to push healthcare reform through the Senate using reconciliation, “the opposition to it would be bipartisan,” said Senator McConnell after the summit.
After a day-long White House summit on healthcare, Republicans returning to the Senate said that President Obama and the Democrats appear ready to go it alone on this issue.
“They’re not interested in putting a 2,700-page bill on the shelf,” said Senate Republican leader Mitch McConnell of Kentucky, referring to GOP demands that the president start over with a step-by-step approach, focusing on issues on which there is broad agreement.
At the end of the summit, Mr. Obama said, “I did not propose something complicated just for the sake of being complicated.” He added, “The reason we didn’t do it is it turns out baby steps don’t get you to the place where people need to go.”
To get a bill without 41 Senate Republicans means resorting to a process called reconciliation. The process allows measures that meet certain budget criteria to pass by a simple majority, instead of the 60 votes now typical for major bills.
In the dictionary, “reconciliation” means bringing together, conciliation, or fence mending. But on the floor of the US Senate, it’s pure procedural warfare.
Liberal activists are urging Democrats to get back to the principle of majority rule in the Senate, now seen as the graveyard for much of the Obama agenda. But moderate Democrats are wary of a move that could further alienate the public from a comprehensive healthcare reform.
A new Gallup poll, released Thursday, reports that most Americans oppose using reconciliation, by a margin of 52 percent to 39 percent. Nine percent were unsure.
On Feb. 23, Sen. Robert Byrd (D) of West Virginia, the leading in-house defender of the Senate traditions, urged his colleagues to allow filibusters to run their course and not change rules to block them.
“The Senate is the only place in government where the rights of a numerical minority are so protected. Majorities change with elections. A minority can be right, and minority views can certainly improve legislation,” he wrote in a letter to his Senate colleagues.
“Extended deliberation and debate – when employed judiciously – protect every senator, and the interests of their constituency, and are essential to the protection of the liberties of a free people,” he added.
Sen. Kent Conrad (D) of North Dakota, who chairs the Senate Budget Committee, says that there could be a role for reconciliation in the healthcare debate, but only “in a very limited way”: First, the House must pass the Senate bill, then use reconciliation procedures to “fix” the bill. “You cannot do the whole healthcare bill through reconciliation. It will not work,” he adds.
If Democrats opt to push healthcare reform through the Senate using reconciliation, “the opposition to it would be bipartisan,” said Senator McConnell after the summit.
Thursday, February 25, 2010
Obama, GOP fail to reach accord on health bill
Associated Press -
WASHINGTON – Giving no ground, President Barack Obama and Republican leaders fought forcefully for their competing visions of historic health care reform Thursday in an exhausting, often-testy live-on-TV debate. Far from any accord, Obama signaled the Democrats were prepared to push ahead for an all-or-nothing congressional vote.
The marathon, 7 1/2-hour session did reveal narrow areas of agreement on the topic that has vexed Congress for months and defied U.S. leaders for decades. But larger ideological differences overwhelmed any common ideas, all but cementing the widely held view that a meaningful bipartisan health care bill is not possible as time grows short in this election year.
Obama rejected Republican preferences for starting over, discussing the issue much longer or dealing with it in a limited, step-by-step fashion.
"We cannot have another yearlong debate about this," Obama declared. "I'm not sure we can bridge the gap."
Party officials said March is probably the last chance to act.
It has been more than a year since he proposed his overhaul, which would be important to virtually all Americans in remaking the way they receive and pay for health care. The version he embraces, basically tracking legislation passed by the Senate, would expand health coverage to some 30 million people who lack it and stop insurance companies from dropping people for questionable reasons or denying coverage to people who have certain illnesses.
Obama and the Democrats portray the current situation as a major crisis, with tens of millions of people left with no health insurance at all and health care costs threatening to bankrupt the nation. The Republicans see problems as well, but seek more modest steps to deal with them and say Obama's plan would run up the federal deficit — despite his claims to the contrary.
Obama strongly suggested that Democrats will try to pass a sweeping overhaul without GOP support, by using controversial Senate budget rules that would disallow filibusters. And then, he said, this fall's elections would write the verdict on who was right.
Democratic leaders tried to portray Republicans as hypocrites for denouncing parliamentary tactics they, too, have used. Democratic leaders hope to embolden colleagues who worry about re-election races in the face of polls showing substantial dislike for the party's approach.
The Democrats-only strategy could face particularly strong resistance in the House, where 39 party members voted against an Obama-backed health care bill last year.
Democratic officials confirmed Thursday that the White House has developed a slimmed-down health care plan as a possible "Plan B" fallback.
But that contingency also faces problems, including possible defections from House liberals who insist the overhaul must be expansive. Democratic officials conceded it's possible that no health care legislation will pass this year, which would leave their candidates with little to show while Republicans claimed a big win.
At Thursday's summit, Rep. Eric Cantor, the No. 2 House Republican, agreed with Obama that "we have a very difficult gap to bridge here." But he differed strenuously about resolving it. "We just can't afford this," he said of the $1 trillion, 10-year proposal. "That's the ultimate problem."
Cable news networks carried long portions of the summit, which featured 38 lawmakers sitting around a square table heaped with documents and notepads. They spoke of arcane issues such as insurance "rescissions" between sharp partisan exchanges. Moderator Obama, looking annoyed at times, interrupted Republicans fairly often, and a few of them interrupted him back.
At one point, Senate Republican leader Mitch McConnell of Kentucky accused him of shortchanging the GOP on opportunities to speak.
With the conversation veering between mind-numbing detail and flaring tempers, the two sides held onto long-entrenched positions.
Sen. Lamar Alexander, R-Tenn., derided Obama's plan. "This is a car that can't be recalled and fixed," he said, "and we ought to start over."
Alexander challenged Obama's claim that insurance premiums would fall under the Democratic legislation. "You're wrong," he said. Responded Obama: "I'm pretty certain I'm not wrong."
Democratic officials said House and Senate leaders will confer with colleagues in coming days or weeks to see if they have enough votes to push a far-reaching bill through both chambers with no GOP help.
Republicans repeatedly pressed Obama to renounce the possibility of using "budget reconciliation" rules to push the Democratic plans through the Senate without allowing GOP filibusters. Obama brushed them off, saying they seemed more interested in process than substance.
Americans want a decision on health care, the president said, and most of them think "a majority vote makes sense." Democrats control 59 of the Senate's 100 seats, one vote short of the number needed to halt bill-killing filibusters.
Top Democrats described the summit as the beginning of the end of their long push to overhaul health care, a bid rocked by raucous, conservative-dominated forums last summer that threw Democrats on the defensive. Eyeing the November elections, rank-and-file Democratic lawmakers are desperate to resolve the debate and focus on jobs and economic revival.
"If nothing comes of this, we're going to press forward," Democratic Senate Whip Richard Durbin told reporters during a break in the summit. "We just can't quit."
One of the sharpest exchanges occurred between Obama and Sen. John McCain, the Arizona Republican he defeated for the presidency. As McCain criticized numerous provisions in the Democrats' plan, Obama said, "we're not campaigning anymore. The election is over."
McCain laughed and said, "I'm reminded of that everyday."
At another point, McCain refused to yield to Obama, saying, "Can I just finish please?"
Obama ribbed Cantor, the House GOP whip, for bringing to the table the 2,400-page Senate bill, which the Virginia congressman described as too costly, bureaucratic and intrusive. Obama called it a political prop, and said health care is a complex issue that can't be reduced to snippets.
Republicans repeatedly noted that polls suggest Democrats are on the wrong track. A USA Today/Gallup survey released Thursday found Americans, by 49 percent to 42, lean against Democrats forging ahead without any GOP support. Slightly more than half oppose the idea of Senate Democrats using budget rules to bar filibusters to stop the bill.
Congressional aides said top Democrats will take a few days to gauge the summit's impact on the public and, perhaps more importantly, on moderate House members who are likely to determine whether any health care bill will pass.
If the effort fails, Democrats may try a scaled-back plan to insure about 15 million more Americans, rather than 30 million. Among other things, the plan would require insurance companies to let people up to age 26 stay on their parents' health plans.
The summit participants noted a handful of areas where the two parties seem largely to agree. They include barring insurers from dropping customers who become sick, ending annual and lifetime monetary limits on health insurance benefits and letting young adults stay on their parents' health policies to their mid-20s or so.
But Republicans stuck to their main talking points. "The American people want us to scrap this bill," said House GOP Leader John Boehner of Ohio, reaching over and touching the massive Senate legislation.
As darkness neared, McConnell also urged Obama to "start over with a blank piece of paper."
Tuesday, February 23, 2010
Democrats Cling to Reconciliation as Option to Pass Health Care Reform
Democrats increasingly have looked to reconciliation as viable option since Republican Scott Brown won a special election last month in Massachusetts to become the state's new U.S. senator, depriving Democrats of their 60-vote supermajority and sidelining the health care reform bills passed both the House and Senate late last year.
Faced with no other viable option, Democrats are vowing to use a parliamentary process called reconciliation, if necessary, to complete President Obama's yearlong effort to reform the U.S. health care system.
"Well, the avenue exists if one wants to pursue it," White House spokesman Robert Gibbs said Monday.
Rep. James Clyburn, the House majority whip, noted to Fox News that former President George W. Bush used the tactic to get his controversial tax cuts passed in 2001 and 2003.
Republicans acknowledge that reconciliation has a legitimate purpose but "it is not to pass a bill which is going to change 16 percent of the way our economy functions and everybody's health care delivery system," Sen. Judd Gregg of New Hampshire said.
Congress created reconciliation in 1974 to make it easier to raise taxes or cut spending to "reconcile" with a previously approved budget resolution.
For example, if Congress was running a higher budget deficit at the end of the year than projected, it could use reconciliation to quickly raise taxes or cut spending with just 51 votes in the Senate -- not the 60 votes it usually takes to avoid a filibuster.
Sen. Robert Byrd, D-W. Va., -- one of the original authors of the reconciliation rule created an additional hurdle in 1985 called the Byrd rule, preventing reconciliation's use for any "extraneous issue" that does not directly change revenue or expenditures.
But here's what would have to happen: The House would have to pass the Senate health care bill as it exists now -- with no changes. Then the House would simultaneously have to create a reconciliation vehicle -- a second bill -- that would make changes to send back to the Senate.
But this could only deal with taxes or budgetary changes. The following could not be changed by reconciliation:
Creation of health insurance rate authorities
Health care consumer protections
Changing individual or employer mandates
No social policy changes (i.e. abortion).
All are key elements in the new White House plan.
The Senate would have to then pass the additional bill with a simple majority of 51 votes.
But back to that first House vote on the existing Senate bill before any changes are made. The House passed health care reform by a vote of 220-215, and since then, Democrat John Murtha of Pennsylvania has died, Democrat Robert Wexler of Florida retired, Democrat Neil Abercrombie of Hawaii retired this week and Republican Joseph Cao of Louisiana has said despite a yes vote last time he will not vote for the bill this time.
That could make the vote 216-216, and ties fail in the House. Then there are 52 Bluedogs -- or fiscally conservative Democrats, 49 of them from districts won by John McCain in 2008. The numbers are not adding up yet for House passage.
Courtesy of FOXNews.com
Faced with no other viable option, Democrats are vowing to use a parliamentary process called reconciliation, if necessary, to complete President Obama's yearlong effort to reform the U.S. health care system.
"Well, the avenue exists if one wants to pursue it," White House spokesman Robert Gibbs said Monday.
Rep. James Clyburn, the House majority whip, noted to Fox News that former President George W. Bush used the tactic to get his controversial tax cuts passed in 2001 and 2003.
Republicans acknowledge that reconciliation has a legitimate purpose but "it is not to pass a bill which is going to change 16 percent of the way our economy functions and everybody's health care delivery system," Sen. Judd Gregg of New Hampshire said.
Congress created reconciliation in 1974 to make it easier to raise taxes or cut spending to "reconcile" with a previously approved budget resolution.
For example, if Congress was running a higher budget deficit at the end of the year than projected, it could use reconciliation to quickly raise taxes or cut spending with just 51 votes in the Senate -- not the 60 votes it usually takes to avoid a filibuster.
Sen. Robert Byrd, D-W. Va., -- one of the original authors of the reconciliation rule created an additional hurdle in 1985 called the Byrd rule, preventing reconciliation's use for any "extraneous issue" that does not directly change revenue or expenditures.
But here's what would have to happen: The House would have to pass the Senate health care bill as it exists now -- with no changes. Then the House would simultaneously have to create a reconciliation vehicle -- a second bill -- that would make changes to send back to the Senate.
But this could only deal with taxes or budgetary changes. The following could not be changed by reconciliation:
Creation of health insurance rate authorities
Health care consumer protections
Changing individual or employer mandates
No social policy changes (i.e. abortion).
All are key elements in the new White House plan.
The Senate would have to then pass the additional bill with a simple majority of 51 votes.
But back to that first House vote on the existing Senate bill before any changes are made. The House passed health care reform by a vote of 220-215, and since then, Democrat John Murtha of Pennsylvania has died, Democrat Robert Wexler of Florida retired, Democrat Neil Abercrombie of Hawaii retired this week and Republican Joseph Cao of Louisiana has said despite a yes vote last time he will not vote for the bill this time.
That could make the vote 216-216, and ties fail in the House. Then there are 52 Bluedogs -- or fiscally conservative Democrats, 49 of them from districts won by John McCain in 2008. The numbers are not adding up yet for House passage.
Courtesy of FOXNews.com
Monday, February 22, 2010
LAST DITCH HEALTH CARE PLAN PUT FORTH BY OBAMA
WASHINGTON – Making a last-ditch effort to save his health care overhaul, President Barack Obama on Monday put forward a nearly $1 trillion, 10-year compromise that would allow the government to deny or roll back egregious insurance premium increases that infuriate consumers.
The White House immediately demanded an up-or-down vote in Congress on the plan, or something close to it. But it's highly uncertain that such sweeping legislation can pass. Republicans are virtually unanimous in opposing it, and some Democrats who previously supported a health care remake are having second thoughts in an election year. After a year in pursuit, Obama may have to settle for a modest fallback version of what once was his top domestic priority.
Release of the plan on the White House Web site comes just four days before Obama's one-of-a-kind, televised health care summit with Democrats and Republicans. The White House said the plan would provide coverage to more than 31 million Americans now uninsured without adding to the federal deficit.
On Capitol Hill, Democrats cautiously welcomed the plan, while Republicans gave a thumbs down.
House Speaker Nancy Pelosi, D-Calif., said in a statement she looks forward to reviewing the plan and discussing it at the summit. "We must pass comprehensive, affordable health insurance reform, and I am hopeful that Thursday's meeting will help us achieve this goal," she said, reaffirming her commitment.
House Republican Leader John Boehner of Ohio dismissed the proposal, saying, "the president has crippled the credibility of this week's summit by proposing the same massive government takeover of health care based on a partisan bill the American people have already rejected."
The plan is Obama's most detailed proposal since he took up the health care overhaul effort a year ago. At the time, he sought to avoid the problems former President Bill Clinton encountered when he issued Congress a detailed prescription in the 1990s. Now Obama is being criticized for having been too deferential to lawmakers.
White House spokesman Dan Pfeiffer said the plan is an "opening bid" going into Thursday's summit. It would cover more than 31 million Americans now uninsured — but also includes a new tax on investment income that Republicans object to.
"The president is coming into the meeting with an open mind," said Pfeiffer. "If the Republicans do, too, our hope is that we can find some areas of agreement. If the Republicans bring good ideas to the table we will find ways -- look for ways to incorporate those into our proposals."
Weeks ago, the president and congressional Democrats were on the verge of an historic step — a long-sought remake of the nation's health care system after a half-century of unsuccessful attempts by scores of politicians. Then Republican Scott Brown stunned Washington with an upset win in the Massachusetts Senate race, denying Democrats their 60-seat majority and reversing any political momentum.
Now, Obama may have to settle for a scaled-down plan that smooths some of the rough edges from the current health insurance system, but stops well short of providing coverage for all Americans. It could include ideas Democrats and Republicans have both supported, such as federal funding for high risk pools that would extend coverage to people denied because of medical problems, and a new insurance marketplace for small employers and individuals buying their own policies.
Determined not to abandon Democratic bills that took a year of arduous effort, Obama's plan builds on them. That's no guarantee that it won't run into problems.
The plan conspicuously omits a government insurance plan sought by liberals and viewed as a nonstarter by conservatives and some congressional moderates. It includes Senate-passed restrictions on federal funding for abortion that have been adamantly opposed by abortion foes as well as abortion rights supporters.
The new White House plan would give the federal government the power to regulate the health insurance industry much like a public utility. The Health and Human Services Department — in conjunction with state authorities — would be able to deny substantial premium increases, limit them or demand rebates for consumers.
Obama, who deferred to Congress on the specifics for more than a year, has finally put forward a detailed plan of his own. By and large, it follows the bill passed by Senate Democrats on Christmas Eve, with changes intended to make it acceptable to their House counterparts.
It would require most Americans to carry health insurance coverage, with federal subsidies to help many afford the premiums. Insurance companies would be barred from denying coverage to people with medical problems or charging them more.
The plan dramatically scales back a Senate tax on high-cost health insurance plans objected to by House Democrats — and labor unions. Instead of raising $150 billion over 10 years, it would bring in just $30 billion, the administration said. A Medicare payroll tax increase on upper-income earners would help plug the revenue gap. For the first time, Medicare taxes would be assessed on investment income, not just wages.
Like the Senate bill, the Obama plan would create competitive insurance markets in each state for small businesses and people buying their own coverage. But it would strip out special Medicaid deals the Senate bill granted to certain states, including Louisiana and Nebraska, that have drawn public scorn. It also would gradually close the Medicare prescription coverage gap, make newly available coverage for working families more affordable. Those changes move in the direction of the House bill.
Estimated to cost about $1 trillion over 10 years, Obama's plan would be paid for by a mix of Medicare cuts, tax increases and new fees on health care industries.
Oversight of insurance companies has traditionally been a state responsibility. Obama's proposal for a new federal role calls for setting up a seven-member Health Insurance Rate Authority to monitor insurance industry practices and issue an annual report. States that beef up their consumer protection programs would be eligible for a share of $250 million in federal grants.
House Majority Whip James Clyburn, D-S.C., declined to say that House leaders have the votes now to pass the new plan, but said some of the concerns of House members were addressed by the changes Obama is proposing.
"So I do believe that there is more fertile soil today than when we first took this up," Clyburn said.
Democrats, who now hold 255 of the House's 435 seats, drew only one GOP ally when the House passed its health care bill, 220-215, last November. Since then, one Democrat who voted for the bill has resigned, one has died and a third plans to leave office Feb. 28.
The White House immediately demanded an up-or-down vote in Congress on the plan, or something close to it. But it's highly uncertain that such sweeping legislation can pass. Republicans are virtually unanimous in opposing it, and some Democrats who previously supported a health care remake are having second thoughts in an election year. After a year in pursuit, Obama may have to settle for a modest fallback version of what once was his top domestic priority.
Release of the plan on the White House Web site comes just four days before Obama's one-of-a-kind, televised health care summit with Democrats and Republicans. The White House said the plan would provide coverage to more than 31 million Americans now uninsured without adding to the federal deficit.
On Capitol Hill, Democrats cautiously welcomed the plan, while Republicans gave a thumbs down.
House Speaker Nancy Pelosi, D-Calif., said in a statement she looks forward to reviewing the plan and discussing it at the summit. "We must pass comprehensive, affordable health insurance reform, and I am hopeful that Thursday's meeting will help us achieve this goal," she said, reaffirming her commitment.
House Republican Leader John Boehner of Ohio dismissed the proposal, saying, "the president has crippled the credibility of this week's summit by proposing the same massive government takeover of health care based on a partisan bill the American people have already rejected."
The plan is Obama's most detailed proposal since he took up the health care overhaul effort a year ago. At the time, he sought to avoid the problems former President Bill Clinton encountered when he issued Congress a detailed prescription in the 1990s. Now Obama is being criticized for having been too deferential to lawmakers.
White House spokesman Dan Pfeiffer said the plan is an "opening bid" going into Thursday's summit. It would cover more than 31 million Americans now uninsured — but also includes a new tax on investment income that Republicans object to.
"The president is coming into the meeting with an open mind," said Pfeiffer. "If the Republicans do, too, our hope is that we can find some areas of agreement. If the Republicans bring good ideas to the table we will find ways -- look for ways to incorporate those into our proposals."
Weeks ago, the president and congressional Democrats were on the verge of an historic step — a long-sought remake of the nation's health care system after a half-century of unsuccessful attempts by scores of politicians. Then Republican Scott Brown stunned Washington with an upset win in the Massachusetts Senate race, denying Democrats their 60-seat majority and reversing any political momentum.
Now, Obama may have to settle for a scaled-down plan that smooths some of the rough edges from the current health insurance system, but stops well short of providing coverage for all Americans. It could include ideas Democrats and Republicans have both supported, such as federal funding for high risk pools that would extend coverage to people denied because of medical problems, and a new insurance marketplace for small employers and individuals buying their own policies.
Determined not to abandon Democratic bills that took a year of arduous effort, Obama's plan builds on them. That's no guarantee that it won't run into problems.
The plan conspicuously omits a government insurance plan sought by liberals and viewed as a nonstarter by conservatives and some congressional moderates. It includes Senate-passed restrictions on federal funding for abortion that have been adamantly opposed by abortion foes as well as abortion rights supporters.
The new White House plan would give the federal government the power to regulate the health insurance industry much like a public utility. The Health and Human Services Department — in conjunction with state authorities — would be able to deny substantial premium increases, limit them or demand rebates for consumers.
Obama, who deferred to Congress on the specifics for more than a year, has finally put forward a detailed plan of his own. By and large, it follows the bill passed by Senate Democrats on Christmas Eve, with changes intended to make it acceptable to their House counterparts.
It would require most Americans to carry health insurance coverage, with federal subsidies to help many afford the premiums. Insurance companies would be barred from denying coverage to people with medical problems or charging them more.
The plan dramatically scales back a Senate tax on high-cost health insurance plans objected to by House Democrats — and labor unions. Instead of raising $150 billion over 10 years, it would bring in just $30 billion, the administration said. A Medicare payroll tax increase on upper-income earners would help plug the revenue gap. For the first time, Medicare taxes would be assessed on investment income, not just wages.
Like the Senate bill, the Obama plan would create competitive insurance markets in each state for small businesses and people buying their own coverage. But it would strip out special Medicaid deals the Senate bill granted to certain states, including Louisiana and Nebraska, that have drawn public scorn. It also would gradually close the Medicare prescription coverage gap, make newly available coverage for working families more affordable. Those changes move in the direction of the House bill.
Estimated to cost about $1 trillion over 10 years, Obama's plan would be paid for by a mix of Medicare cuts, tax increases and new fees on health care industries.
Oversight of insurance companies has traditionally been a state responsibility. Obama's proposal for a new federal role calls for setting up a seven-member Health Insurance Rate Authority to monitor insurance industry practices and issue an annual report. States that beef up their consumer protection programs would be eligible for a share of $250 million in federal grants.
House Majority Whip James Clyburn, D-S.C., declined to say that House leaders have the votes now to pass the new plan, but said some of the concerns of House members were addressed by the changes Obama is proposing.
"So I do believe that there is more fertile soil today than when we first took this up," Clyburn said.
Democrats, who now hold 255 of the House's 435 seats, drew only one GOP ally when the House passed its health care bill, 220-215, last November. Since then, one Democrat who voted for the bill has resigned, one has died and a third plans to leave office Feb. 28.
Tuesday, February 9, 2010
Obama,healthcare reform 02-09-10
Obama,healthcare reform
New York Times (blog) Republicans have made a tactical decision not to cooperate and they've even called health care reform Obama's Waterloo." Mr. Weiner, who is a champion of a ... | ||
| On Health Bill, GOP's Road Is a New Map New York Times "It is arrogant to imagine that 100 senators are wise enough to reform comprehensively a health care system that constitutes 17 percent of the world's ... | ||
| Bills Stalled, Hospitals Fear Rising Unpaid Care New York Times By REED ABELSON President Obama says he aims to keep trying. But what happens if the health care legislation cannot be revived, and tens of millions of ... | ||
| Obama Hasn't Ruled Out NY Trial for 9 / 11 Planner New York Times In a pre-Super Bowl interview with CBS' Katie Couric, Obama also said that passing health care reform remained the key to bringing down America's ... |
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