Health Care Reform Debate-Megathread

[Titan76]

I figure we are way overdue for a pure health care debate thread. We have several threads that talk about health care reform, but they are mostly about the protesters. So I figure a thread that is actually about health-care reform is needed.

That, and I wasn't for sure what thread to put this article in.

http://chattahbox.com/us/2009/09/10/...s-health-plan/

(ChattahBox)—Sen. Max Baucus (D-MT), Chairman of the Senate Finance Committee, tasked with drafting health care reform legislation, finally released on Tuesday, his long promised compromise health reform bill and its drawing criticism for appeasing powerful insurance and pharmaceutical interests, as the main author is none other than a former health insurance executive.

And Sen. Baucus, acknowledging his true constituents, delivered the first copy of his health plan to Capitol Hill lobbyists, before providing President Obama and his Senate colleagues with a copy of his health plan proposal.

Max Baucus’ senior aide, Liz Fowler is a former VP for Public Policy and External Affairs at WellPoint, a health insurance company which is the largest member of Blue Cross and Blue Shield. WellPoint has aggressively lobbied against health reform, especially a public option.

The company has recently come under fire for pressuring its employees to lobby against health care reform claiming reform would cause “…tens of millions of Americans to lose their private coverage and end up in a government-run plan.”

According to Firedoglake, “the name Liz Fowler appears as the author in the document properties of the PDF file circulated by Baucus’ staff earlier this week.” However, this comes as no surprise, since Sen. Baucus’ impartiality has already been questioned during this process, as he has benefited from about $3,973,485 in campaign contributions from the pharmaceutical and health insurance industries from 2003 to 2008.

The Baucus health plan excludes a public option, which President Obama championed in his speech in a joint session to Congress Wednesday night, as an important element of health reform.

His plan is also drawing criticism for its many corporate friendly provisions, such as penalizing individuals $3,800 for not purchasing health coverage, while the penalty for businesses is only $400 per employee. The small corporate penalty is only a fraction of the full cost of providing health coverage and would not serve as an incentive to purchase employer-provided health care.

Baucus’ plan is also under fire for its high cost of $850 billion to $900 billion over 10 years, while still not providing health care to every American with a public option.

Baucus is a member of the so called “gang of six” Democrat and Republican senators working to draft a bipartisan health care bill, which has largely stalled due to Republican obstructionism.

Accordingly, Baucus announced this week he planned to proceed with or without, Republican support and introduce a chairman’s mark of his proposed health care bill next week.

So, it seems that Baucus is in the pockets of the insurance and pharmaceutical companies(no surprise) and that its going to be really hard to pass a health care bill with the public option in it in the Senate.

Obama really needs to step up the pressure on the Democrats in the Senate if he wants to get a good health care bill pass. Any bill that comes out half ass, I think is going to come back and bite him and the Democrats in the ass in the up coming elections.

[Titan76]

Despite all that has happen, 55% of America still supports a public option plan. As shown in a new poll by the Washington Post-ABC News.

http://www.washingtonpost.com/wp-dyn...091302962.html

But it is the public option that has become the major point of contention, with support for the government creation of an insurance plan that would compete with private insurers stabilizing in the survey after dipping last month. Now, 55 percent say they like the idea, but the notion continues to attract intense objection: If that single provision were removed, opposition to the overall package drops by six percentage points, according to the poll.

Without the public option, 50 percent back the rest of the proposed changes; a still sizable 42 percent are opposed. Independents divide 45-45 on a package without the government-sponsored insurance option, while they are largely negative on the entire set of proposals (40 percent support and 52 percent oppose). Republican opposition also fades 20 points under this scenario.

The decision to back away from the provision might hurt Obama among his base, but not dramatically so, as 88 percent of liberal Democrats support the reform plan as is, 81 percent without the public option.

The politics of the idea would also probably change dramatically depending on its scope: If it were limited to only those unable to get private insurance, support would rise to 76 percent.

At 55%, this should be a no brainier for Congress, yet the Democrats and Obama are still dragging their feet on this. Even with public support on their side, they still don't have the spine to do this. Is it because they don't know how to pay for the public option, or is it because they are too scare to tell the public how they would have to pay for the public option? I think its the latter rather then the former.

[Dreadstar]

I'm not going to jump into a health-reform megathread, no way.

But I wanted to add at the beginning that if this bill doesn't have a shitload of pork added in, I'll be absolutely astounded.

[Titan76]

I'm not going to jump into a health-reform megathread, no way.

But I wanted to add at the beginning that if this bill doesn't have a shitload of pork added in, I'll be absolutely astounded.

Yeah, I to, would be very suprise if the bill doesn't include some pork in it and how much money it will add to the bill.


A few more articles, Iowa Sen. Tom Harkin(who now chairs the Health, Education, Labor and Pensions Committee after Kenndy died) predicts that not only will there be a public option in the bill but there will be a bill by Christmas. What is it with, "We will have ____ finish by Christmas. I mean its was normally always said during wars and now it seems its being said about legislation. Weird.

Another article by Steve Chapman about how the Republicans blow their chance at health-care reform.
http://www.dallasnews.com/sharedcont...1.2ac6bde.html

Republicans fault President Obama for plans that would greatly expand federal outlays on health care, enlarge the federal role in the provision of medicine, doom private insurance and wrestle Aunt Sally into the grave. They have some valid points. But while they're heaping blame on Obama, they need to save a share for someone else: themselves.

His GOP critics in Congress, after all, have proposals to help the uninsured and curb health care costs. During his speech to Congress Wednesday, they waved their own bill at him. But for four years under President Bush, we had not only a Republican president but also a Republican Congress.

And what happened? Nothing. Republicans left health care reform to wait until the Democrats regained power, and now the Democrats have. One reason the president has a good chance of getting ambitious legislation passed this year is that so many health care failures have gone unaddressed for so long.

[Titan76]

Sen. Baucus says the Senate Finance Committee plans to Release a health care bill this week. It may even be out today.

http://www.californiahealthline.org/...This-Week.aspx

Emerging from a meeting with the panel's so-called "Gang of Six" negotiators, Baucus suggested that it is time to proceed on completing a reform bill with or without Republican support.

Baucus noted that a bipartisan deal still could be possible during the mark-up stage, slated to begin the week of Sept. 21, Roll Call reports.

In the same article, Governors have expressed concerns that their state could be burden financially but the reform bill.

On Monday, the committee is scheduled to discuss the scores with governors who have expressed concerns that the expansion could raise the financial burdens on their states (Edney, CongressDaily, 9/11).

Senate Budget Committee Chair Kent Conrad (D-N.D.), a member of the negotiating group, said that the discussion with the governors will center on the proposal to extend Medicaid eligibility to 133% of the federal poverty level.

Conrad said that the issue "is still under discussion" and noted that "the federal government will bear the overwhelming share of the cost of those who are newly eligible."

The House it seems will wait to see what the Senate does before it releases a bill of their own.

[Titan76]

Well, it seems someone finally caught on to the abortion issue with health-care reform.

http://www.usnews.com/articles/news/...re-reform.html

Antiabortion groups like the Family Research Council and Focus on the Family Action have spent the last month pummeling Democratic healthcare reform proposals over abortion coverage. They've attacked the House Democrats' healthcare bill, for instance, for leaving the door open to abortion coverage in the public health insurance option and for using federal funds to underwrite private healthcare plans that cover abortion. But conservative Christian groups have also made little secret of their opposition to the very idea of a greater government role in healthcare, the abortion controversy aside. A recent E-mail update from the Family Research Council blasted President Obama's push for healthcare reform without ever mentioning abortion. "The American people," it said, ". . . don't want healthcare delivered with the empathy of the IRS, the efficiency of FEMA, or the mismanagement of the post office."

One of the most prominent voices in the antiabortion movement, however, has carved out a much different position in the healthcare debate. The U.S. Conference of Catholic Bishops, while fiercely opposed to abortion rights, has lobbied for decades for universal healthcare coverage as a fundamental right. "We think the right to have basic healthcare is corollary to the right to life," says Richard Doerflinger, associate director of the Secretariat for Pro-Life Activities at the bishops conference, which represents the Roman Catholic Church's roughly 270 American bishops. "And that society has some obligation to help provide it."

[Iangould]

Latest poll shows most Americans agree with Obama's goals for healthcare reform and reject "death panel" paranoia.

At the same time, people are worried about the cost of reform and aren't sure he'll be able to bring it off.

link

[RolandJP]

A watered down version of the bill will pass---Just in time to see the good Ole US of A. turn old, as a fourth of the nation ages past 65 in the next 2 to 7 years..

Its a good-thing too, after they pass through the system there wouldn't be anything left for the next 4 generations if they do not reform health care now.

[Titan76]

Sen. Baucus has released his health care plan.

http://www.nytimes.com/2009/09/17/he.../17health.html

WASHINGTON — Senator Max Baucus, the Montana Democrat, on Wednesday unveiled his plan to extend health coverage to more than 30 million uninsured Americans, providing a detailed look at a legislative proposal that meets many of the requirements that President Obama laid out in his address to Congress last week.

The proposal is the result of more than a year of preparation by Mr. Baucus, the chairman of the Finance Committee, and three months of intense talks among a small group of Democrats and Republicans. The three Republicans in that group are so far refusing to endorse the bill but negotiations will continue in the days ahead.

In a news release accompanying his 223-page proposal, Mr. Baucus said that he had pared the 10-year cost of the bill to $856 billion, the lowest of the major health care proposals advancing in Congress so far. Other plans had come in with price tags of $1 trillion or more, and the high cost was seen as an obstacle to public support.

The legislation would vastly reshape the $2.5 trillion-a-year health care industry, which accounts for roughly one-sixth of the American economy.

The White House issued a low-key statement characterizing the Baucus plan as a positive step. “Last week, the president laid out his plan to bring stability and security to Americans who have insurance, and high-quality, affordable coverage for those who don’t,” said Dan Pfeiffer, a White House spokesman. “The Senate Finance Committee mark released by Chairman Baucus is another boost of momentum for the president’s effort to reform the health system.”

It would extend benefits to millions of people who are uninsured by broadly expanding Medicaid, the state-federal insurance program for the poor, and by offering subsidies to individuals and families with modest incomes to help them buy insurance.

The proposal would also set limits on out-of-pocket health care expenses. It would cap at 13 percent of household income — not including cost-sharing such as co-payments and deductibles — the cost of insurance premiums for middle-class Americans who just miss qualifying for the new government subsidies.

Starting in 2013, it would require nearly all Americans to obtain coverage or face a penalty of up to $3,800 a year for families.

The bill would create new state insurance marketplaces, or exchanges, where consumers could shop for insurance and compare plans.

All of the plans offered through the exchange would have to meet strict new requirements. Insurance companies could not bar coverage based on pre-existing medical conditions, and could only increase the cost of premiums based on a few factors like age, tobacco use and whether a plan is for an individual or a family.

The Baucus plan calls for the creation of private, nonprofit health insurance cooperatives to compete with private insurers, a compromise aimed at bridging the gap between Democrats who want a government-run insurance plan and Republicans who adamantly oppose that idea.

As insurers, the cooperatives could offer their coverage plans on the exchanges.

And in a nod to the stiff Republican opposition, the proposal does not include a trigger calling for the creation of a public plan if the legislation fails to make affordable health insurance widely available, a compromise step that Mr. Obama has indicated he could accept.

Instead, Mr. Baucus seems to have left the public option to the alternate health care legislation developing in the House, where more liberal Democrats strongly support the idea and the House speaker, Nancy Pelosi, has called it crucial to getting a bill adopted in her chamber.

The federal subsidies in the Baucus plan would be available to individuals and families who earn too much to qualify for Medicaid, but less than 300 percent of the federal poverty limit, or $66,150 for a family of four. Those earning between 300 percent and 400 percent of poverty, up to $88,200 for a family four, would be protected by the cap on health insurance premium costs.

Senators in both parties, however, are questioning whether at the end of the day insurance will be affordable to the people who need it most.

To pay for the overhaul, which Mr. Baucus has said he will meet Mr. Obama’s requirement that it not add to the federal debt, the proposal would impose a new, 35 percent excise tax on the most expensive group insurance plans, those costing more than $8,000 for individuals and $21,000 for families.

In many cases, these would be plans offered through employers.

The proposal would also impose new fees or taxes on various sectors of the health insurance industry, including drug-makers, medical device makers and clinical laboratories. The proposal provides an exemption from some small businesses in these areas.

While Mr. Obama had strongly endorsed the broad outlines of the Baucus plan in his speech to a joint session of Congress last week, the proposal does not exactly give Democrats a unifying proposal to rally around.

The more liberal Democrats on the Senate Finance Committee have harshly criticized the plan, and some — like Senator John D. Rockefeller IV of West Virginia — have accused Mr. Baucus of sacrificing crucial Democratic priorities in pursuit of Republican votes.

At the same time, the three Republican negotiators who for months have worked closely with Mr. Baucus on the legislation, Senator Michael B. Enzi of Wyoming, Senator Charles E. Grassley of Iowa, and Senator Olympia J. Snowe of Maine, have balked at signing on to the proposal so far, saying it still does not meet their demands.

There's another page worth reading.

I'm not really sure I like this plan and quite frankly am sick to death of Republicans not supporting any bill because it doesn't meet their demands. I honestly wish Obama and Dems. would ignore Republicans since they already have the votes in their own party to pass a bill, and should just focus on comprising with each other to pass one.

Republicans seem to forget that they had their chance on passing health care reform and chose not to. If they honestly think they should have the majority of their ideas in any of the bills even if the Dems. have said they don't want those ideas in any of the bills, they are dumb.

[7thangel]

the maxtax should never pass and i don't think anybody but blue dog shills will vote for it. how hard is it for the msm to show the other dem bills and ignore the crap gang of six bill, antics and capitulation? i know the answer but still...

thankfully, most have called the baucuscare bill aka maxtax, a piece of dookie

[Shellhead]

Something has to change soon. Our small company was max-rated last year, and it's probably going to be the same this year. That means that our premiums went up an average of 23% at the start of 2009, and we can expect the kind of hike at the start of 2010. According the Rule of 72, that means we may be paying twice as much in 2012 as we paid in 2008.

At the moment, we are paying 100% of the premium for our employees, and 50% for dependents, and our plan is a gold-level plan from Blue Cross. But with a 23% hike in premiums, we are either going to need to get a lower quality plan, increase the deductibles or require employees to pay for part of their coverage. Probably a combination of the three.

[7thangel]

Not So Fast, Mad Max: Jay Rockefeller Wants Changes To Baucuscare Or He Won't Support It

Jay Rockefeller is actually the chair of the health subcommittee in the Senate Finance Committee. Any "Gang of Six," or really any legislation on the Committee, should at least have his input, if not his controlling hand. Yet Max Baucus froze him out of the legislation in favor of Republicans who will never sign on to the final version and worthless schemes like the Conrad co-op proposal (which is just a thin ploy to get Blue Cross of North Dakota, which controls 90% of the market in Conrad's state, the "co-op" label so it can access federal start-up funds). Rockefeller may have the last laugh when the bill moves into the full committee.

U.S. Senator John Rockefeller, a Finance Committee member and a strong backer of a government-run insurance option, said on Tuesday he will not support the panel's healthcare bill in its present form.

Rockefeller told reporters he was unhappy with the lack of a government-run "public" insurance option in the bill, which is scheduled to be made public on Wednesday, and had problems with some of its changes in children's health insurance and Medicaid, or healthcare for the poor.

In particular, Rockefeller wants a public insurance option instead of the weak co-ops, better affordability provisions so working people can actually use the bill, and changes to the way that Baucuscare deals with the Children's Health Insurance Program and Medicaid.

Rockefeller specifically said "There is no way in its present form that I will vote for it... unless it changes during the amendment process by vast amounts." Now, getting amendments through may not be an easy task. Each Rockefeller amendment in that committee would have to get the votes of all the Democrats plus at least a couple Republicans, if Baucus and Conrad hold firm on them. Considering that 10 of the 13 Democrats on the panel were completely shut out of the process during the Gang of Six talks, I'd expect a lot of support for what Rockefeller wants to do, but Baucus and Conrad can basically nullify anything meaningful on their own, should they want to.

Still, Rockefeller's advocacy is important because it sets the tone for Democrats with the full Senate, where votes like his will be needed. Jon Cohn explains.

A little over a month ago, right before the August recess, I spoke with Rockefeller at some length. And he was clearly wrestling with how to position himself.

No living senator has done as much to promote health reform as he has. It's the cause of his life and, for the first time, the goal is within reach. He admitted that voting against a package, even a flawed one, was difficult to imagine.

But Rockefeller also made clear his frustration with the compromises Baucus was making, whether it was replacing the public plan with a co-op or gradually reducing the subsidies to help people pay for insurance. He was particularly incensed about the changes to Medicaid and CHIP, programs to which he's devoted much of his time--and on which many West Virginians rely.

At the time, it seemed like Rockefeller was still on board, if only to help get a bill out of the Finance Committee and onto the Senate floor. But you got the feeling--well, I got the feeling--that he was near the breaking point.

Sometime since that interview, clearly, he's hit it.

Every vote is precious in the Senate, given that votes on the Republican side other than Olympia Snowe and maybe Susan Collins will not be forthcoming. Harry Reid has laid down the marker that anything less than 60 votes will lead him to go through the reconciliation process (and I don't think Reid's low poll numbers in Nevada will be much of a factor - the consequences of doing nothing on health care would be far graver for him). Therefore everyone in the Democratic caucus, essentially, represents an interest group to be satisfied. Rockefeller is standing up and saying that he's perfectly willing to vote against something that doesn't fulfill the promise of health care reform as he sees it. Bernie Sanders probably feels the same way. Maybe Barbara Boxer does. Or others. Max Baucus and his cronies will have to wrestle with that.

[Nick Soapdish]

Sen. Baucus has released his health care plan.

http://www.nytimes.com/2009/09/17/he.../17health.html


There's another page worth reading.

I'm not really sure I like this plan and quite frankly am sick to death of Republicans not supporting any bill because it doesn't meet their demands. I honestly wish Obama and Dems. would ignore Republicans since they already have the votes in their own party to pass a bill, and should just focus on comprising with each other to pass one.

Republicans seem to forget that they had their chance on passing health care reform and chose not to. If they honestly think they should have the majority of their ideas in any of the bills even if the Dems. have said they don't want those ideas in any of the bills, they are dumb.

The Republicans would seem to be in a tight spot. The Democrats don't need their votes and probably won't get any. So it's tough for them to influence the bill or get any of their provisions in.

I think that the Democrats should give them a listen, but if the Republicans aren't willing to give the bill some support, they don't need to waste their time negotiating. They shouldn't be able to say "I'm not going to vote for the bill no matter what, but if there is a bill, it should have ..."

The Democrats do need to keep talking to the Blue Dogs.

[7thangel]

http://wonkroom.thinkprogress.org/20...ucu-mark-mark/

...
So did Baucus’ mark meet Republican demands? Below is a summary of some of the most contentious issues in the Baucus bill:

Would federal dollars be used to fund abortion? No. Federal subsidies cannot be used to cover abortions that do not involve rape or incest. All abortion procedures would have to be financed through private premiums.

Are illegal immigrants eligible for coverage and government subsidies? Illegal immigrants are exempt from the mandate and would not be eligible to purchase coverage within the Exchange; they’re relegated to the individual market (which would shrink but would presumably have the same protections as the Exchange.) Legal permanent residents with incomes below 100% of the federal poverty are ineligible for Exchange subsidies and (presumably, following existing law) have to wait five years before qualifying for Medicaid. Thus, for the first five years of their residency, most legal immigrants may remain uninsured.

What are the verification requirements? To obtain coverage within the Exchange, an applicant’s “name, social security number, and date of birth will be verified with Social Security Administration (SSA) data.” “For individuals who do not claim to be U.S. citizens but claim to be lawfully present in the United States, if the claim of lawful presence is consistent with Department of Homeland Security (DHS) data then the claim will be considered substantiated”

Is tort reform part of the bill? Yes, states are encouraged “to develop and test alternatives to the current civil litigation system as a way of improving patient safety, reducing medical errors, encouraging the efficient resolution of disputes, increasing the availability of prompt and fair resolution of disputes, and improving access to liability insurance, while preserving an individual‘s right to seek redress in court.”

Who will finance Medicaid expansion? Beginning in 2014, “additional Federal financial assistance would be provided to all states to defray the costs of covering newly-eligible beneficiaries.” The Federal government would pay states on a sliding scale. “States that offer minimal or no coverage of the newly-eligible population currently would receive more assistance initially than those states that currently cover at least some non-elderly, non-pregnant individuals.” The states that already cover more than 133% FPL (like Maine, for instance) would still receive extra federal assistance, but they would see less money than states that just offer the bare minimum Medicaid coverage.

Update The Baucus bill saves money on subsidies by reducing the actuarial value of the different benefit tiers. The actuarial values actually decreased between the Baucus framework and the Baucus mark:

Bronze: 65% in framework >> 65% in mark

Silver: 73% in framework >> 70% in mark

Gold: 81% in framework >> 80% in mark

Platinum: 90% in framework >> 90% in mark

Update At his press conference unveiling the bill, Baucus explained that combined with the FMAP increase, increase in drug rebates, CHIP flexibility (states can move their CHIP applicants into the Exchange), states will see an average increase in costs of 0.89 percent.

[Paul McEnery]

Despite all that has happen, 55% of America still supports a public option plan. As shown in a new poll by the Washington Post-ABC News.

http://www.washingtonpost.com/wp-dyn...091302962.html

At 55%, this should be a no brainier for Congress, yet the Democrats and Obama are still dragging their feet on this. Even with public support on their side, they still don't have the spine to do this. Is it because they don't know how to pay for the public option, or is it because they are too scare to tell the public how they would have to pay for the public option? I think its the latter rather then the former.

This looks to me like the media framing the article in a lying way.

It seems to me that we've got 70% of people in the country (according to previous polls) who back healthcare reform; and the only reason progressives back away from this particular reform is that it doesn't go far enough.