From ThinkProgress: "In an effort to deny more than 30 million uninsured Americans health care coverage, 26 states have filed legal action against the Affordable Care Act which passed last year. But Republican demagoguery costs money and “the [lawsuit's] cost the states have split so far amounts to $46,000.” But Florida Republican Attorney General Pam Bondi has “paid less than $6,000″ for its lawsuit. Why? Because an anti-health care lobbying group is picking up the 26-state tab" While dubbing itself “the Voice of Small Business,” NFIB has spent the past two years “yoking itself to the GOP” while simultaneously “jeopardizing billions of dollars in credit, tax benefits and other federal subsidies” at the expense of small businesses. Affiliated with both the U.S. Chamber of Commerce and the GOP “since the Reagan era,” NFIB “is run mostly by and for Republicans” and spent 93 percent of its campaign contributions on GOP candidates. It is no wonder, then, that NFIB is happy to pay to secure the top GOP priority and equally “delighted” to see the pay off.
A [Massachusetts] official may have gone off-script last week, but what he had to say is an important contribution to the state’s ongoing debate over reining in health care costs.
Terry Dougherty, director of MassHealth, the state’s Medicaid program, was addressing a budget hearing in Boston Friday, State House News Service reports. He noted a little-known fact that runs counter to the widespread assumption that government is more wasteful than the private sector.
MassHealth, which insures nearly 1.3 million Massachusetts residents, spends just 1.5 percent of its $10 billion budget on administration, Dougherty said, while private insurers spend about 9.5 percent of their revenue on administration.
“I like the market, but the more and more I stay in it, the more and more I think that maybe a single payer would be better,” Dougherty said. Under a single payer system – like MassHealth or Medicare – the government pays health care providers directly, instead of an insurance company.
Unlike private insurance companies, Dougherty said later, at MassHealth “We don’t build big buildings. We don’t have high salaries. We don’t have a lot of marketing, which makes, to some extent, some of the things that we do easier and less costly than some things that happen in the marketplace. Overall, my point is, we have individuals who work in state government in MassHealth … who are just as smart, just as tactile, just as creative as people who work in the private sector, but they work for a lot less money.” Source: The Milford Daily News
From Andrew Cohen in The Atlantic:
"U.S. District Judge Gladys Kessler didn't just endorse the constitutional legitimacy of the Patient Protection and Affordable Care Act on Tuesday evening. She used her 64-page ruling to answer some of the most basic criticisms of the new federal health care law. And she was as blunt in its defense as two of her colleagues on the federal trial bench, in Florida and Virginia, have been in striking down the contentious measure."
[...]
In a footnote, Judge Kessler wrote: "To put it less analytically, and less charitably, those who choose -- and Plaintiffs have made such a deliberate choice -- not to purchase health insurance will benefit greatly when they become ill, as they surely will, from the free health care which must be provided by emergency rooms and hospitals to the sick and dying who show up on their doorstep. In short, those who choose not to purchase health insurance will ultimately get a 'free ride' on the backs of those Americans who have made responsible choices to provide for the illness we all must face at some point in our lives."
By playing the "free ride" card, and by suggesting that those who do not purchase health insurance are making irresponsible choices that eventually harm others, Judge Kessler is reminding her readers that the dense legal issues involved in all of these cases have as their backdrop the nation's colossal health-care mess. The quote is a very pointed and unusual expression of official frustration (no wonder it's in a footnote) and it speaks not to the lawyers and the judges who will ultimately determine the fate of the new law, or to the politicians who created it in the first place, but to all the Americans out there who refuse to buy health insurance in the name of federalism and the 10th Amendment.
Then, later in her ruling, as if her initial point were not clear enough, Judge Kessler wrote: "It is pure semantics to argue that an individual who makes a choice to forgo health insurance is not 'acting,' especially given the serious economic and health-related consequences to every individual of that choice. Making a choice is an affirmative action, whether one decides to do something or not do something. They are two sides of the same coin. To pretend otherwise is to ignore reality."
Here we have a direct shot across the bow of the good ship Vinson, as in U.S. District Judge Roger Vinson, the Reagan appointee who last month tossed out the health-care law in its entirety. At the time, Judge Vinson wrote (PDF): "If Congress can penalize a passive individual for failing to engage in commerce, the enumeration of powers in the Constitution would have been in vain for it would be 'difficult to perceive any limitation on federal power.' and we would have a Constitution in name only. Surely this is not what the Founding Fathers could have intended" Expanded Medicare for All - Single Payer, would have been so much easier - and cheaper....
The Associated Press:
"A federal judge on Tuesday threw out a lawsuit claiming that President Barack Obama's requirement that all Americans have health insurance violates the religious freedom of those who rely on God to protect them.
U.S. District Judge Gladys Kessler in Washington dismissed a lawsuit filed by the American Center for Law and Justice, a Christian legal group founded by evangelist Pat Robertson, on behalf of five Americans who can afford health insurance but have chosen for years not to buy it."
During an interview with Susan Martin of the St. Petersburg Times, Charles Krauthammer was asked about health care reform:
Susan Martin: Besides being a commentator, you are a medical doctor who criticized health care reform as a “2,000-page bill that will generate tens of thousands of pages of regulations.” Isn’t that a great argument for the simplicity of Canadian-style universal health care? Charles Krauthammer: It is. But it seems to me there are two choices. We have the best medical care in world but it is the most expensive and we waste a lot. What you need to do is reduce the complexity and inefficiency. If we can’t get it right, we’re eventually going to a single-payer system. At least it doesn’t have this incredible, absurd complexity of ObamaCare. It’s the worst of the worst. It has the complexity of our (present) system and doesn’t give the universal coverage of single payer.
Dr. McCanne from Physicians for a National Healthcare Program points out, in response to Krauthammer's remark:
It’s not that we don’t understand the efficiency and effectiveness of single payer; we clearly do. The opposition has been primarily from those who, on an ideological basis, oppose any role of government in health care, other than as a safety net for the indigent. But even their icon of liberty, Friedrich Hayek, stated in his classic, The Road to Serfdom, “Nor is there any reason why the state should not help to organize a comprehensive system of social insurance in providing for those common hazards of life against which few can make adequate provision.”
The logic for single payer is there, and there is no longer any reason to perpetuate the ideological divide. The conservatives need to revisit Friedrich Hayek, and the liberals need to review again the tenets of social justice, perhaps beginning with Article 25 of The Universal Declaration of Human Rights. Once we get our respective camps in order, we should find that we have a common meeting ground.
From Washington Post's Ezra Klein:
Peter Shumlin, the newly elected governor of Vermont, has a plan for health-care reform: Rather than repeal it, he wants to supercharge it. His state will set up an exchange, and then, as soon as possible, apply for a waiver that allows it to turn the program into a single-payer system. You can read a summary of the plan here (Word file). I spoke with Shumlin this morning, and a lightly edited transcript of our conversation follows.
Ezra Klein: The report (PDF) prepared by Dr. William Hsiao offered three options for Vermont: single payer, a strong public option and a form of private-public single payer. My understanding is that you're backing the third option. What separates it from a traditional single-payer system?
Peter Shumlin: Single payer means something different to everyone. The way I define it is that health care is a right and not a privilege. It follows the individual and not the employer. And it’s publicly financed. The only difference between single-payer one and single-payer three in Hsiao's report is that in single-payer three, the actual adjudication of payment is contracted to an existing insurance entity. So the state doesn't have to set up a new bureaucracy to run it. His modeling suggests that’d be more economical. It's a minute difference.
EK: And why go to a single-payer system at all?
PS: In Vermont, this is all about cost containment. There are 625,000 people in Vermont. We were spending $2.5 billion on health care a decade ago. Now we’re above $5 billion. And we project we’ll be spending a billion dollars more in 2014. This is where everyone has failed in health-care reform. And this will go after three of our main drivers of costs.
First, Vermont spends 8 cents on every dollar on administrative costs, just chasing the money around. That’s a huge waste of money. Second, we’ll use technology to conquer waste. You'll get a Vermont medical card, and everyone’s medical records will be on that card, so you’ll go into a doctor’s office and they’ll know what the last doctor did to you. That helps avoid duplication of services. And the last piece, the most challenging, is remaking the payment system so providers are paid for making you healthy, not for doing the most procedures.
EK: Single-payer systems often lose on the ballot and in the legislature. No state has successfully managed to pass one into law, much less implement it. And the objection that usually stands in the way of these projects is that I'm happy with my health-care insurance, and I don't trust the government to create something new and put me into it. How do you answer that?
PS: I suspect I’m the only politician in America who won an election in this last cycle with TV ads saying I was going to try to pass the first single-payer system in America. This election was a confirmation of my judgment that Vermonters are tired of enriching pharmaceutical companies and insurers and medical equipment makers at the expense of their family members. The reality in Vermont is that there are not very many Vermonters who are happy with the current system. We’re losing our rural providers. Our small hospitals are struggling. And Vermonters are lowering their coverage and paying more and more for it.
EK: How will the funding work? Right now, a lot of money comes from employers. What happens to their share?
PS: Where health care has failed is in designing a cost containment mechanism that works. That’s the really hard part of our job. So I’m asking us to spend the next 12 months designing the tools for cost containment. Once we do, we'll figure out how to structure the way we pay for it.
EK: One of the things you asked of Dr. Hsiao was to preserve provider incomes. How can you do that while cutting costs? At some point, doesn't lower spending also mean fewer doctors or hospitals or lower incomes?
PS: The reason Vermont has the opportunity to be the lab for a different kind of change is that we don’t have a lot of high-paid physicians in Vermont. We have a lot of low-paid physicians. We have rural providers who’re making less than they did when they graduated from medical school. Our cost driver is not that we have a lot of physicians running around in Mercedes-Benzes. It’s waste in the system.
EK: How will this interact with other systems? Let's say I have Kaiser Permanente. I come to Vermont and break my leg. What happens?
PS: Nothing different than what happens right now. You’d go to one of our providers' offices, and they’d bill Kaiser for that one. No different than if you break a leg in France or Switzerland. Radical as this seems to Americans, the rest of the world has figured this out and gotten it right. We keep getting it wrong, and we’re paying for it.
The Affordable Care Act puts states in the driver's seat because they often understand their health needs better than anyone else - and that is why it is so frustrating to hear opponents of reform falsely attack the law as "nationalized health care."
The truth is that states aren't just participating in implementation of the law; they're leading it. Read the rest...
Health insurance shoppers are considering a new version of an old discount strategy that can be summed up in three words: Hold the Mayo.
Bloomington-based HealthPartners last year started marketing health plans that feature a network of hospitals and doctors that doesn't include the Mayo Clinic. In exchange for not having access with low co-payments to the iconic Rochester, Minn., clinic, subscribers pay lower premiums when they select a HealthPartners plan with Mayo as an out-of-network option.
Last year, Eagan-based Blue Cross and Blue Shield of Minnesota also started emphasizing health insurance products for individuals in which Mayo isn't in the network of providers.
Mayo has been celebrated nationally for providing high-quality and low-cost health care, but health insurance brokers say the local reputation is different as far as cost goes.
"Mayo is cheap only compared to other national care centers, but in general is a higher-cost center when compared to its Minnesota peers," said Christopher Schneeman, a health insurance broker with SevenHills Benefit Partners in St. Paul. More....
House Republicans have pledged to repeal and/or defund the health care law. Rep. Michele Bachmann (R-MN) even adopted the effort as her sole “motivation in life.” But, for at least 16 GOP lawmakers, the reality of the party’s position is coming home to roost. These Republicans, “many of whom were swept into office fueled by tea party anger over the health care law,” are now facing the same expensive, unforgiving health insurance market as middle-class Americans the GOP wantonly abandoned GOP lawmakers have struggled to explain why they deserve government-subsidized health care while ordinary Americans don’t. Rep. Aaron Schock (R-IL) said he accepted federal health care because he was “actually lowering” premiums for older lawmakers. When asked whether he’d turn down taxpayer benefits, Rep. Bill Posey (R-FL) actually said, “I don’t know. Am I a federal employee?” And Rep. Michael Grimm (R-NY) offered a more blunt — and revealing — response: “What am I not supposed to have health care?…God forbid I get into an accident and can’t afford the operation. That can happen to anyone.” Read it all at Think Progress...
Reuters: The U.S. House of Representatives is likely to vote to block funding for President Barack Obama's signature healthcare overhaul when it takes up a budget plan next week, House Republican Leader Eric Cantor said on Tuesday.
An effort spearheaded by Republicans to repeal the new health care law collapsed Wednesday evening after the Senate refused to ignore its adverse impact on the deficit.
By a vote of 47-51, the Senate sustained an objection to the legislation on the grounds that it does not comply with congressional budget rules. Because a full repeal of the law is projected to increase the deficit, waiving that point of order would have required 60 votes.
But even if Democrats had allowed a straight up or down vote on the amendment, it likely would have failed. No Democrats voted with the GOP to remove the objection, giving them fewer than the 51 they'd need to successfully repeal it. Republicans -- and, really, everyone else -- have been expecting this outcome for months. And while this blunts their head-on efforts at repeal, they've always expected that their best chances to destroy or chip away at the law will come either via the courts, spending bills or amendments to the law meant to weaken it.
One such effort, driven by Sens. Lindsey Graham (R-SC) and John Barrasso (R-WY) would allow states to opt out of the law's key provisions, which, they say, would cause the overall policy to collapse.
Top Democrats have suggested that if Republicans keep forcing votes on full repeal, they'll put the legislation on the floor, and during the debate, force votes on amendments to exempt popular aspects of the law. More....
Two days after a Republican Florida federal court judge voided the entire health care law, the multi-front Republican war against it continues in the Senate, where members will vote today on whether or not to just repeal it, full stop.
Simultaneously, Republican members are trying to sneak grenades into the heart of the law, crafting modifications which they admit are meant to destroy it.
But that presents them with a conundrum when they head back to their states and districts and face constituents who stand to benefit from the law right now -- seniors who are entitled to free checkups, and young adults, who can now stay on their parents' insurance until they turn 26, for example. Republicans can chose to help those constituents navigate the law -- answer their questions constructively, encourage them to seek those benefits -- or they can let their political agendas interfere.
More....
Shaming women is more important to Republicans than tackling the economic crisis or any of the myriad problems facing Americans. The consequences for women's health are dire. Read and weep - AlterNet:
From the White House:
On Monday, Judge Roger Vinson issued a ruling in a case challenging the constitutionality of the Affordable Care Act. The ruling comes after legal action in cases regarding the law in courts across the country. Twelve federal judges have already dismissed challenges to the constitutionality of the health reform law. Two federal judges – in the Eastern District of Michigan and Western District of Virginia – have fully upheld the law, and one federal judge in the Eastern District of Virginia ruled against the individual responsibility provision but declined to bar full, continuing implementation. The decision issued on Monday is one district court decision, and we believe it to be very wrong. The Department of Justice has made clear that it is reviewing all of its options in responding to this case, as it does in all cases. Implementation will continue.
Legal experts agree with our assessment of Judge Vinson’s ruling. Here’s what they are saying about the ruling and the case: Boston College Law Professor Brian Galle:
“The ACA and its accompanying incentives to buy insurance overcome a collective action problem among states. Thus, the ACA is easily distinguished from the court's parade of broccoli horribles; even if one thought that the federal government should deal only with uniquely national problems, the ACA easily meets that standard.”
David Engstrom, Stanford Law School Faculty Member:
“The issue that the court has ruled on has been specifically contradicted by two other district courts. So, the idea that the Obama administration should somehow stand down from implementing the act, based on a fourth district court, doesn't have any basis in law.”
NYU Constitutional Law Professor Rick Hills:
“Consider the following train wreck of Necessary & Proper reasoning contained in Judge Vinson's opinion striking down the individual mandate:
• It is a legitimate end for Congress to regulate the insurance industry to prevent "insurers from excluding or charging higher rates to people with pre-existing conditions" (pages 60-61);
• The Individual Mandate in the ACA is "necessary" to enable Congress to regulate the insurance industry in this manner (page 63). Yet...
• "[T]he individual mandate falls outside the boundary of Congress’ Commerce Clause authority and cannot be reconciled with a limited government of enumerated powers."
Huh? How can a means that is conceded to be necessary for a legitimate end not be within Congress' implied powers to pursue that end? Judge Vinson never presents even the simulacrum of an argument: Instead, he engages in hand-waving.”
“I think Judge Vinson’s argument on the Necessary and Proper Clause is not persuasive…Rather, my point is that Judge Vinson should not have used a first principle to trump existing Supreme Court caselaw when that principle may not be consistent with existing caselaw. Either Justice Thomas is wrong or Judge Vinson is wrong, and Judge Vinson was not making a persuasive legal argument when he followed the first principle instead of the cases. Because Judge Vinson is bound by Supreme Court precedent, I would think he should have applied the cases.”
“Judge Vjavascript:void(0)inson appeared to base the total nonseverability decision partly on what he took to be Congressional intent.… Judge Vinson's approach ought to be especially unappealing to the Supreme Court's “textualists,” who don't even like to speculate about what Congress subjectively intended by the language it enacted. How much worse it should be to speculate about what Congress might have done if it had known that a provision it enacted would subsequently be found invalid.”
Greg Sargent's blog: "The office of Wisconsin Attorney General J.B. Van Hollen, one of the states suing to overturn the Affordable Care Act, sends over this statement flatly declaring the law 'dead' for his state unless it's revived by a higher court, and asserting that this relieves state government of any and all its responsibilities to implement the law:"
This hints at a new line of criticism Dems can use, should other state governments do as Wisconsin is doing. The Affordable Care Act has already resulted in nearly $40 million in federal grant funding to Wisconsin. Now that the law is "dead," will Wisconsin return the money or rebuff any other federal grant money? Will other state governments declaring the law dead do the same? If so, how much money do they stand to lose? How will this impact their consistuents? It's a pretty worthwhile line of inquiry.
Steve Benen takes a look at some of the media coverage of the four key rulings on the Affordable Care Act, and finds that the two rulings pronouncing the law unconstitutional received far more attention than the two upholding it.
Four federal district courts have heard challenges testing the constitutionality of the Affordable Care Act. Two judges concluded the law is legally permissible, two came to the opposite conclusion.
But it occurs to me the public has heard quite a bit more about the latter than the former. Indeed, it seems as if the media largely ignored court rulings that bolstered the arguments of health care reform proponents, while making a very big deal about rulings celebrated by conservatives.
Washington Post
* Steeh ruling (pro-reform): A2, 607 words
* Moon ruling (pro-reform): B5, 507 words
* Hudson ruling (anti-reform): A1, 1624 words
* Vinson ruling (anti-reform): A1, 1176 words
New York Times
* Steeh ruling (pro-reform): A15, 416 words
* Moon ruling (pro-reform): A24, 335 words
* Hudson ruling (anti-reform): A1, 1320 words
* Vinson ruling (anti-reform): A1, 1192 words
Associated Press
* Steeh ruling (pro-reform): one story, 474 words
* Moon ruling (pro-reform): one story, 375 words
* Hudson ruling (anti-reform): one story, 915 words
* Vinson ruling (anti-reform): one story, 1164 words
Politico
* Steeh ruling (pro-reform): one story, 830 words
* Moon ruling (pro-reform): one story, 535 words
* Hudson ruling (anti-reform): three stories, 2734 words
* Vinson ruling (anti-reform): four stories, 3437 words
Source: The Washington Monthly
House Republicans wasted no time in declaring their legislative priorities for the 112th Congress. The first: repeal health care for millions of Americans. The second: redefine rape. A day after repealing health care, Rep. Chris Smith (R-NJ) introduced the No Taxpayer Funding For Abortion Act, a bill that would not only permanently prohibit some federally funded health-care programs from covering abortions, but would change the language exempting rape and incest from rape to “forcible rape.”
By narrowing the Hyde Amendment language, Republicans would exclude the following situations from coverage: women who say no but do not physically fight off the perpetrator, women who are drugged or verbally threatened and raped, and minors impregnated by adults. As the National Women’s Law Center’s Steph Sterling puts it, this new standard of force “takes us back to a time where just saying no was not enough.”
And yet, 172 Republicans — including sixteen women — and lone Democrat Rep. Daniel Lipinski (IL), chair of the House Pro-Life Caucus — readily support the new standard. Appalled at such a cavalier attack on women’s rights, one House member is not taking the change lightly. Rep. Debbie Wasserman Schultz (D-FL) “fiercely denounced” her conservative colleagues for this “absolutely outrageous” dilution of victims’ rights. Enraged at the suggestion that “there is some kind of rape that would be okay,” Wasserman Schultz told The Raw Story that she considers the bill itself to be “a violent act against women”:
“It is absolutely outrageous,” Wasserman Schultz said in an exclusive interview late Monday afternoon. “I consider the proposal of this bill a violent act against women.”[...]
“It really is — to suggest that there is some kind of rape that would be okay to force a woman to carry the resulting pregnancy to term, and abandon the principle that has been long held, an exception that has been settled for 30 years, is to me a violent act against women in and of itself,” Wasserman Schultz said. More at Think Progress
Greg Sargent on Judge Vinson's ruling:
NYU law professor Rick Hills finds what looks like another gaping hole in Judge Vinson's ruling yesterday that the individual mandate -- and by extension the entire Affordable Care Act -- is unconstitutional.
Judge Vinson writes on page 62 of the ruling that the goal of "excluding or charging higher rates to people with pre-existing conditions" is clearly "legitimate" and "within the scope of the Constitution." He clarifies this by indicating that the means to that end must not be inconsistent with the "spirit" of the Constitution. But that end, he says, is valid.
Then, on page 63, Vinson writes that the defendants are right to assert that the individual mandate is "necessary" and "essential" to realizing that same end.
And yet, Vinson then goes on to conclude that "the individual mandate falls outside the boundary of Congress' Commerce Clause authority and cannot be reconciled with a limited government of enumerated powers."
Which prompts this rejoinder from Professor Hill:
Huh? How can a means that is conceded to be necessary for a legitimate end not be within Congress' implied powers to pursue that end? Now, in case you're tempted to dismiss this argument as coming from a pointy-headed east coast liberal professor, please note that conservative legal writer Orin Kerr has reached a similar conclusion about this part of Vinson's decision.
Kerr argues that there's nothing in Supreme Court caselaw that justifies Vinson's conclusion that the individual mandate falls "outside the boundary" of the commerce clause, and bluntly characterizes Vinson's argument here as the "weak link" in his decision.
********************************************************
UPDATE, 3:03 p.m.: Let me try to be a bit clearer about Kerr's argument. He's saying that Vinson's contention that the means (the mandate) to a legitimate end is outside the boundary of the commerce clause, and therefore not legitimate, is based on "first principles," and not on existing Supreme Court caselaw.
That seems to dovetail with Professor Hill's argument: That Vinson's contention that the mandate is not legitimate, even though it's necessary to accomplish a constitutionally legitimate end, is wholly arbitrary.
From Ezra Klein: The legal theory currently in vogue in conservative circles holds that the Constitution's vision of "a central government with limited power" -- to use Judge Vinson's phrase -- permits the government to establish a single-payer health-care system that every American pays into through payroll taxes and that wipes out the private insurance industry but forbids the government from administering a regulated market in which individuals purchase private insurance plans and pay a penalty if they can afford coverage but choose to delay buying it until they're sick.
There's a chance conservatives will come to seriously regret this stratagem. I think it's vanishingly unlikely that the Supreme Court will side with Judge Vinson and strike down the whole of the law. But in the event that it did somehow undermine the whole of the law and restore the status quo ex ante, Democrats would start organizing around a solution based off of Medicare, Medicaid, and the budget reconciliation process -- as that would sidestep both legal attacks and the supermajority requirement.
The resulting policy isn't too hard to imagine. Think something like opening Medicare to all Americans over age 45, raising Medicaid up to 300 percent of the poverty line, opening S-CHIP to all children, and paying for the necessary subsidies and spending with a surtax on the wealthy (which is how the House originally wanted to fund health-care reform). That won't get us quite to universal health care, but it'll get us pretty close. And it'll be a big step towards squeezing out private insurers, particularly if Medicaid and Medicare are given more power to control their costs.
"U.S. District Judge Roger Vinson, who ruled Monday that the health care reform law is unconstitutional, holds financial investments in health and medicine worth as much as $75,000."
Read more at The Ham Report:
AP Exclusive: : "Private health insurance plans catering to Medicare recipients are making millions by taking money the government sends in advance — but isn't immediately needed — and using it to make investments, federal investigators say in a report obtained by The Associated Press."
Read more...
Let’s assume the state attorneys general are able to get the courts to agree that the mandate to purchase insurance is unconstitutional. Does that automatically mean that the court will declare the entire Act unconstitutional? Not necessarily. After declaring a section of an Act unconstitutional, the courts determine whether the remainder of the Act remains valid. The guiding principle is this according to a report on statutory interpretation from the Congressional Research Service quoting a ruling in Alaska Airlines, Inc. v. Brock, 480 U.S. 678, 684 (1987) (quoting Buckley v. Valeo, 424 U.S. 1, 108 (1976)). “Unless it is evident that the Legislature would not have enacted those provisions which are within its power, independently of that which is not, the invalid part may be dropped if what is left is fully operative as a law.”
In other words, if the individual mandate to purchase health insurance is declared unconstitutional, then the issue will become whether Congress would have enacted the rest of the ACT if there were no individual mandate. We can be fairly certain that four members of the Supreme Court (Scalia, Thomas, Alito, and Roberts) will rule that the entire Act is unconjavascript:void(0)stitutional if they can find any piece of the Act unconstitutional such as the individual mandate. The question then becomes how the remaining five members of the court will rule. It should be very interesting. Read more here....
From ThinkProgres
From the page: "The most surprising part of Judge Roger Vinson’s ruling was his argument that the individual mandate was not severable from the health care law as a whole and must therefor bring down the entire Affordable Care Act. “In sum, notwithstanding the fact that many of the provisions in the Act can stand independently without the individual mandate (as a technical and practical matter), it is reasonably ‘evident,' as I have discussed above, that the individual mandate was an essential and indispensable part of the health reform efforts, and that Congress did not believe other parts of the Act could (or it would want them to) survive independently,” Vinson writes.
But a closer read of his analysis reveals something peculiar. In fact, as Vinson himself admits in Footnote 27 (on pg. 65), he arrived at this conclusion by "borrow[ing] heavily from one of the amicus briefs filed in the case for it quite cogently and effectively sets forth the applicable standard and governing analysis of severability (doc. 123)." That brief was filed by the Family Research Council, which has been branded as a hate group by the Southern Poverty Law Center (SPLC). "
[...]
"Vinson's conclusion is peculiar because Congress usually defers to Congress on questions of severability. In fact, even Judge Henry Hudson - the Virginia Judge who also found the individual mandate to be unconstitutional - left the whole of the law intact noting, "It would be virtually impossible within the present record to determine whether Congress would have passed this bill, encompassing a wide variety of topics related and unrelated to health care, without Section 1501. Therefore, this Court will hew closely to the time-honored rule to sever with circumspection, severing any "problematic portions while leaving the remainder intact.""
As Chief Justice John Roberts noted in Free Enterprise Fund et al. v. Public Company Accounting Oversight Board, Because [t]he unconstitutionality of a part of an Act does not necessarily defeat or affect the validity of its remaining provisions," Champlin Refining Co. v. Corporation Comm of Okla. , 286 U. S. 210, 234 (1932) , the "normal rule" is "that partial, rather than facial, invalidation is the required course.""
Currently, the federal government denies taxpayer monies to be used to pay for abortions, except in cases when pregnancies result from rape or incest or when the pregnancy endangers the woman's life.
However, if the 173 mainly Republican co-sponsors of the "No Taxpayer Funding for Abortion Act" have their way, that would all change. Instead of keeping the 30-year-old definition of rape in federal law, the bill would modify it to "forcible rape," thereby severely limiting the health care choices of millions of American women and their families.
In other words, rape would not be rape unless violence were involved; however, the term "forcible rape" was left undefined, leading some to speculate its meaning since it is also not defined in the federal criminal code or in some state laws.
"This would rule out federal assistance for abortions in many rape cases, including instances of statutory rape, many of which are non-forcible," Nick Baumann of Mother Jones wrote recently.
He continued, "For example: If a 13-year-old girl is impregnated by a 24-year-old adult, she would no longer qualify to have Medicaid pay for an abortion."
If the bill becomes law, parents of minors would also be banned from paying for pregnancy termination for their daughters with tax-exempt health savings accounts. Also, the cost of the private health insurance that covered the treatment would not be able to be deducted as a medical expense for tax purposes.
The bill introduced by Rep. Chris Smith (R-NJ) was the second major piece of legislation filed by the Republicans after its attempt to repeal "The Affordable Care Act." Speaker of the House John Boehner (R-OH) hailed Smith's bill as "one of our highest legislative priorities."
The Hill's Healthwatch: The White House and congressional Democrats are vowing to aggressively fight back against any efforts to dismantle their signature healthcare reform law despite a State of the Union promise to work with Republicans on improvements.
MSNBC Reports: "The day after the Congressional Budget Office released its new estimate of a $1.5 trillion budget deficit for this fiscal year, CBO chief Douglas Elmendorf told the Senate Budget Committee that health care is the biggest driver of the budget problem."
Great piece from Single Payer Action: All throughout the Arab world, the despots are on the run.
Fueled by Facebook and Twitter, the Arab street is aflame.
In the United States, instead of fueling the resistance, social media is like a hypnotic drug.
A young Arab in Tunisia gets slapped around – the story goes – by a police officer.
He lights himself on fire.
And the whole Arab world is engaged.
Here in the United States, we get slapped around daily by the corporate elite.
And we take it sitting down in front of our computers.
Case in point.
Ronald Flanagan is a Vietnam Vet in Thornton, Colorado.
Ronald and his wife Frances have health insurance from Ceridian Cobra Services.
Their month premium – $328.69.
Frances went on line to pay their monthly premium.
By accident, she types in $328.67.
Two cents short.
Guess what our pals at Ceridian did?
Exactly.
Dropped the policy.
It came at a bad time for the Flanagans.
And a good time for Ceridian.
Ron has been fighting multiple myeloma – a cancer of the bone marrow – since September 2008.
“The nurses were just getting ready to do the biopsy when my wife popped into the office and told them, ‘Stop. We don’t have any insurance,’” Ron told ABC News 7 in Denver.
“And that’s when they let me know that we no longer had insurance on account of the two cents, and they canceled us,” Frances said. “Since then, I’ve been depressed. I haven’t been able to hardly do anything. As you can see, we still have our Christmas decorations up. So it’s been hard on me.”
Because of the two-cent mistake, Ceridian Cobra Services will not pay for the procedure.
We know that Ron is not alone.
We know that 45,000 Americans die every year due to lack of health insurance.
We know a person in our community in West Virginia who was diagnosed recently with a life threatening illness.
This person was six months away from being eligible for Medicare.
This person had no health insurance.
So, this person waited until reaching Medicare eligibility – 65 – before beginning treatment.
Apparently there are thousands of Americans between 60 and 65 in this dilemma.
They wait.
And many of them die as a result.
Earlier this month, we called a community meeting at the Earth Dog Cafe in Berkeley Springs, West Virginia to talk about the corporate control over our lives.
To discuss – among other things – getting rid of the health insurance corporations.
And replacing them with a single payer system.
Everybody in.
Nobody out.
About 75 people showed up on a Wednesday night.
It wasn’t Facebook or Twitter that brought people out.
It was about 100 phone calls.
Talking person to person about Americans dying from lack of health insurance.
Talking person to person about $700 million dollars a day being spent on wars that the majority of Americans don’t want.
Talking person to person about the need for community action.
To stand up against the corporate slapdown of the American people.
We agreed to meet regularly – at least once every month.
Person to person.
Face to face.
Together.
No sooner did the Republicans revive their crusade against Democratic health care reform than the law's biggest boogeyman made a comeback as well. With the Senate unlikely to take up the repeal bill that passed the House last week any time soon, the GOP has started going after individual parts of the legislation. Among the first targets is a little-known provision creating an independent Medicare panel whose purpose, Republican critics insist, is to ration care and could speed patients to an early death—in other words, the 2011 incarnation of Sarah Palin's "death panels."
Under federal health reform, the Medicare Independent Payment Advisory Board (IPAB) will be a new, White House-appointed commission with the authority to change what Medicare pays for and how it pays for it—all without direct congressional approval. Many of health reform's biggest supporters have celebrated IPAB, which starts in 2015, as central to the entire law's ability to rein in ballooning Medicare spending. "It's absolutely critical. It's the centerpiece of the bill—the major way that you begin to control costs," Sen. Jay Rockefeller (D-W.Va.) tells Mother Jones. But Republicans say the board embodies the most pernicious and outrageous faults of "Obamacare," delegating authority to unelected bureaucrats who could deny care to patients at their most critical moments More at Mother Jones.
The anti-women, anti-choicers will use any trick - go to any extreme to try and harm the people and institutions attempting to help women with safe reproductive choices and care. AlterNet reports: In what is perhaps one of the most craven actions of a deeply craven movement, anti-choice scam artists apparently affiliated with Live Action Films and Lila Rose of undercover 'gotcha film-fame' appear to have attempted an 'ACORN-like' hoax on Planned Parenthood Federation of America by sending people into Planned Parenthood health centers in six states posing as sex traffickers seeking health care for young girls who were 'part' of their supposed sex trafficking rings.
In response, Planned Parenthood president Cecile Richards sent a letter to U.S. Attorney General Eric Holder describing the visits and asking for an investigation. AP reports that Rose, Live Action's founder and president, declined to confirm or deny that the clinic visits were part of a Live Action operation, but did indicate in a telephone interview with AP that an undercover videotape project of some sort was in the works. In December, Crary writes, Live Action announced that it was preparing to launch several major new investigations during 2011 and said it had received a $125,000 gift to finance the operations. It did not identify the source of that gift. A gift of $125,000 to try and bring down Planned Parenthood. Disgusting.
The goal, according to Rose, is to "unnerve Planned Parenthood employees and eventually put them out of business."
"We will work to de-fund them in every state wherever it is possible, to de-license them and to expose them," she told the conservative Value Voters Summit in October.
"The other part of it, too, is to create controversy within the organization, keep them on their toes," she said. "We need to help them feel that fear." Planned Parenthood helps hundreds of thousands of women get economical reproductive health care every year. Physical exams, birth control advice and prescriptions and offered at low cost. Any yeah, they do a few safe, legal abortions, too. Another healthcare need many women have.
Shutting down safe abortion options for women will not stop abortion. Ask any of us who lost friends to illegal abortions before Roe v. Wade.
Never Again!
Smart stuff from Ezra Klein: If the Democrats' legislation fulfilled its goal of covering almost every American and also managed to pay for itself, it was suddenly much harder to oppose. So last week, as the Republicans sought to make their case that the health-care bill should be repealed, a lot of their arguments were aimed at undercutting the numbers coming out of the CBO.
The agency's product is nothing more than "budget gimmicks, deceptive accounting, and implausible assumptions used to create the false impression of fiscal discipline," conservative wonks Douglas Holtz-Eakin, Joseph Antos and James C. Capretta wrote in the Wall Street Journal. Rep. Paul Ryan (R-Wis.) says the CBO's numbers are based on "smoke and mirrors." Rep. Louie Gohmert (R-Tex.), angry that the CBO thinks tax cuts reduce tax revenue - no doubt the agency has also been known to say that the sun rises in the east - has called for the CBO to be abolished.
The sad reality is that it's not hard to discredit budget estimates in 30-second sound bites: You just say whatever you want and trust that your opponent doesn't have anywhere near enough time to explain the issue. Take Republican criticisms that the "doc fix" isn't included in the CBO's scores, and that if it were, the health-care bill would increase the deficit. It's absurd. In 1997, congressional Republicans capped the rate at which Medicare could increase payments to physicians. But their cap was too low. Now they want Democrats to fix it for them and pile the costs onto the bill. It's a little like saying that the cost of the war in Iraq should be added to health-care reform.
But you'll notice it took a moment to explain that. It's easier to just say that the score is full of "smoke and mirrors" and then make some authoritative-sounding point about Medicare payments. Who's got the time to check it out?
You can play whack-a-mole with this stuff all day. But beneath it is something more insidious: an effort to discredit the last truly neutral, truly respected scorekeeper in Washington. The facts don't support the particular case the Republicans want to make, so they're trying to take down the people who supply the facts. But once that's done, it can't easily be undone. And the true loser will be the very thing Republicans claim to care most about: the deficit.
If getting the CBO's seal of approval ceases to matter, then political parties will cease to try. That's when the "smoke and mirrors" will really begin: when bills just have to sound good rather than pencil out. When there are no skeptical budget experts sending legislation back to the authors with a note that says "Sorry, not there yet." When policy debates are decided by who can yell the loudest rather than who can write the best bill.
The bargain that both parties have struck with the CBO is that they'll accept the short-term setbacks the agency imposes on them because, in the long run, it's better for the system to have someone keeping score. Right now, Republicans are breaking that bargain. They're not merely saying that the CBO's guess is bad, or that the CBO is right but the bill is bad for other reasons, but that the CBO's whole system is, in the words of Rep. Tom Price (R-Ga.), "Garbage in, garbage out." Civil? Maybe. Wise? Definitely not. Pay attention, folks.
Reuters: "More than half of those surveyed -- 62 percent -- said they did not approve of lawmakers cutting off funds needed to implement changes, which range from new rules for health insurance companies to tax credits for small businesses and state grants."
From TPMDC: "In a letter delivered to House Majority Leader Eric Cantor Sunday, Sens. Chuck Schumer (D-NY) and Robert Menendez (D-NJ) demand an answer to a question now at the center of the Republican party's top legislative priority: Will repealing the health care law force seniors to reimburse the government for the $250 check they received in 2010 to help them pay for prescription drugs?
'We are particularly concerned that repeal would reverse the course of making prescription drugs more affordable for seniors,' Schumer and Menendez write. 'The [repeal] legislation approved by the House could require seniors to repay the government.'
One of the major goals of the Affordable Care Act is to close the Medicare prescription drug coverage gap, better known to most as the 'donut hole.' The law will fill that hole over a decade, and in 2010, that meant many seniors received a $250 rebate check."
From NPR:
The Necessary And Proper Clause
Koppelman, who teaches law at Northwestern University, says that the Constitution's 'necessary and proper clause' cannot be factored out of this debate.
'When somebody goes without health insurance, we can argue about whether they are or are not part of interstate commerce, but it doesn't matter,' Koppelman says.
Koppelman says that in order to carry out its responsibilities, Congress can enact policies that are not among its enumerated powers in the Constitution.
From Rick Ungar in Forbes: "In July of 1798, Congress passed – and President John Adams signed - “An Act for the Relief of Sick and Disabled Seamen.” The law authorized the creation of a government operated marine hospital service and mandated that privately employed sailors be required to purchase health care insurance.
Keep in mind that the 5th Congress did not really need to struggle over the intentions of the drafters of the Constitutions in creating this Act as many of its members were the drafters of the Constitution.
And when the Bill came to the desk of President John Adams for signature, I think it’s safe to assume that the man in that chair had a pretty good grasp on what the framers had in mind."
From NPR: One of the criticisms of the health care reform bill enacted last year is that it expanded coverage without doing enough to control rising health care costs. Surgeon and journalist Atul Gawande says there are hopeful signs that costs can be contained — not by cutting back, but by providing more intensive services to chronically ill patients who incur huge costs with long stays in hospital rooms and intensive care units.
From PNHP's Official Blog:
"Although advocates of the pure single payer model will find some problems with this report on a reform proposal for Vermont, there is very good news in this analysis. The report emphatically confirms the superiority of the single payer model in ensuring that everyone is included while containing health care costs." Full report – William Hsiao, Steven Kappel and Jonathan Gruber (138 page PDF):
Read William Hsiao's statement and PNHP's analysis here.
Way to go Vermont!
FOR IMMEDIATE RELEASE
January 18, 2011
10:18 AM
MONTPELIER, VT - January 18 - Flanking Gov. Peter Shumlin at a Statehouse press conference, the Vermont congressional delegation today announced federal legislation to let states in 2014 provide better health care at less cost.
A provision by U.S. Sen. Bernie Sanders (I-Vt.) in the new federal health care law allows states to propose pilot programs in 2017. Now Vermont's congressional delegates – Sen. Patrick Leahy (D), Sanders, and Rep. Peter Welch (D) – have drafted a bill to authorize federal waivers three years sooner. Sanders will introduce the bill in the Senate for himself and Leahy, and Welch will introduce the bill in the House.
Sanders said, “At a time when 50 million Americans lack health insurance and when the cost of health care continues to soar, it is my strong hope that Vermont will lead the nation in a new direction through a Medicare-for-all single-payer approach. The goal is clear: quality, cost-effective health care for all Vermonters. This is essential not only for the wellbeing of all Vermonters but for job creation. We must do all we can to lower the crushing costs of health care that are now devastating Vermont businesses and their employees. I look forward to working with Sen. Leahy and Rep. Welch to get the appropriate waivers and flexibility for us to go forward toward a single-payer system.”
Welch said, “When Vermont innovates, the nation often follows our lead. Providing Vermont and other states with the flexibility to build upon health care reform will result in better care and greater access at a lower cost. Allowing us to become a laboratory for innovation and excellence will help Vermonters, while once again allowing us to lead the way.”
Leahy said, “While some in Washington are trying to turn the clock back on health reform, Vermont instead is moving forward. This state waiver bill will give Vermont and other states the choice to go above and beyond what the federal health care law does by devising their own reforms. Vermont has always been a leader in health care quality and access, and this bill will give our state the flexibility we want to offer Vermonters the best care and coverage while controlling costs.”
Shumlin said The Affordable Care Act “will bring Vermont critical money to make our health care system work better and to cover some of the uninsured. We want to do it better and faster than the federal law contemplates. We want to control costs and cover everyone. I am so pleased that our congressional delegation supports us in this effort, and I thank them for introducing this important legislation. This is just the beginning of this process, and there are other waivers we will need to get it done. If we work together, I am convinced we can persuade the federal government they should not stand in our way."
This press conference came one day before a report is to be delivered to the state Legislature by William Hsiao, the Harvard University economist, outlining health care options for Vermont that could require a federal waiver to be implemented.
The new national health law will provide insurance for 32 million more Americans and make other significant strides, but Leahy, Sanders and Welch said Congress and the Obama administration should let states make additional improvements.
Under their bill, states would be able to seek U.S. Health and Human Services Department approval to implement pilot health care systems beginning in 2014. To qualify, state plans would have to be at least as comprehensive and affordable as the federal model and cover at least as many people. States could not offer lower quality or less affordable coverage. A single-payer system like Vermont is considering or any other state initiative could not cause the federal government to incur more costs.
The waiver provision also requires HHS to create a coordinated process so states in a single application also could seek waivers already available under Medicare, Medicaid, and the children’s health insurance program.
A fact sheet on the new "State Leadership in Healthcare Act" is available here.
Source: Common Dreams
"Rather than waste time on debating how much reform insurance companies will permit - - if any - - -it is time to change the debate" - Kucinich Kicks off Health Care Debate with Renewed Call for Single-Payer
Source
GOP claims 650,000 lost jobs from "ObamaCare," and cites the nonpartisan Congressional Budget Office as the source. But the CBO never produced the number. What follows is a story of how statistics get used and abused in Washington.
Read it all at Yahoo! News
Rick Ungar - The Policy Page - Forbes:
"The Republican case is laid out in a document published on January 6th, under the authorship of the House GOP leadership and named, “Obamacare: A budget-busting, job-killing health care law.”
It’s an interesting document and well worth reading.
Indeed, the GOP arguments put forth in the study would be truly compelling were it not for the fact that the claims made are so astonishingly dishonest that it takes but a few hours of research to disprove and discredit virtually every substantial claim they make. If you question this, and I know many of you will, I have carefully provided links to each and every document and report the GOP has relied upon so that you may read these authorities for yourself." Well worth the time to read the rest, where Mr. Ungar does the work for you.
PBS:
"As the House of Representatives gears up to vote this week on a proposed repeal of the health care reform bill, public support for the move is falling.
Only 25 percent of people polled now support repealing the health care law, according to an Associated Press-GfK poll out Monday, compared to 46 percent on Jan. 7..."
“Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.” ~Dr. Martin Luther King, Jr.
From CNN.com: "Emergency room wait times a national problem
According to a 2009 report from the Government Accountability Office, emergency department wait times continue to increase. The report says the average wait time to see a physician is more than double the recommended time in some cases.
Research from Press Ganey Associates, a group that works with health care organizations to improve clinical outcomes, finds that in 2009, patients admitted to hospitals waited on average six hours in emergency rooms. Nearly 400,000 patients waited 24 hours or more." These types of stories - where a 2 year old winds up losing her limbs because the ER staff was too busy to take care of her - would diminish, not grow, if it was affordable for the average citizen to have a primary care physician they were able to build a relationship with.
With the House preparing to vote this week on whether to repeal the health-care law, the chamber's new Republican majority is confronting a far more delicate task: forging its own path to expand medical coverage and curb costs.
The House's GOP leaders have made clear that they regard the repeal vote, scheduled to begin Tuesday, as the prelude to a two-prong strategy that is likely to last throughout the year, or longer.
They intend to take apart some of the sprawling law, which Democrats pushed through Congress last year, piece by piece before major aspects of it go into effect. At the same time, Republicans say, they will come up with their own plan to revise the health-care system, tailored along more conservative lines.
On the cusp of undertaking this work, the GOP has a cupboard of health-care ideas, most going back a decade or more. They include tax credits to help Americans afford insurance, limiting awards in medical malpractice lawsuits and unfettering consumers from rules that require them to buy state-regulated insurance policies. In broad strokes, the approach favors the health-care marketplace over government programs and rules.
House Republicans have termed their strategy "repeal and replace." But according to GOP House leaders, senior aides and conservative health policy specialists, Republicans have not distilled their ideas into a coherent plan. More at the Washington Post
The Plum Line:
Today brings a new Marist poll: "More registered voters want the law expanded than fully repealed, with the latter category amounting to less than a third. A total of 49 percent want to let it stand or change it so it does more, versus 43 percent who want to scale it back or get rid of it entirely. " Which one of the following comes closest to your opinion about what Congress should do with the 2010 health care law:
Let it stand: 14
Change it so it does more: 35
Change it so it does less: 13
Repeal it completely: 30
Ezra Klein:
"There's no 'job-killing' health-care law. There's only the health-care bill. And my problem with the modifier 'job-killing' isn't that it's uncivil, though perhaps it is. It's that it's untrue."
The GOP lifted the claim from this Congressional Budget Office report (pdf) -- but the report never says the bill will kill jobs. What it says, rather, is that the law will slightly reduce labor. It's not that employers will fire workers. It's that potential workers -- particularly older ones -- will retire somewhat earlier. "The expansion of Medicaid and the availability of subsidies through the exchanges will effectively increase beneficiaries’ financial resources. Those additional resources will encourage some people to work fewer hours or to withdraw from the labor market."
Guess what happens when a congressional town meeting audience isn't created by the Koch brothers or fueled by Fox News? There's a different kind of confrontation. Here's what happened at a meeting earlier this week at Ohio's Walsh University, with GOP Rep. Jim Renacci (OH).
Source: Daily Kos
From the latimes.com: "Rejection of a challenge to a federal law on body armor for felons suggests a reluctance to rein in Congress' powers under the Constitution's commerce clause."
Great news from Harry Reid this morning on Meet The Press.
From Crooks and Liars:
HARRY REID: One of the things that always troubles me is when we start talking about the debt, the first thing people do is run to Social Security. Social Security is a program that works. And it's going to be-- it's fully funded for the next forty years. Stop picking on Social Security. There're a lotta places--
DAVID GREGORY: Senator are you really saying --
HARRY REID: --where you can go to save money.
DAVID GREGORY:-- the arithmetic on Social Security works?
HARRY REID: I'm saying the arithmetic in Social Security works. I have no doubt it does.
DAVID GREGORY: It's not in crisis?
HARRY REID: The ne-- no, it's not in crisis. This is-- this is-- this is something that's perpetuated by people who don't like government. Social Security is fine. Are there things we can do to improve Social Security? Of course.
DAVID GREGORY: Means testing. Raising the --
DAVID GREGORY:--retirement age--
HARRY REID: --don't--
DAVID GREGORY: --do you--
HARRY REID: --I'm--
DAVID GREGORY: --agree with either of those?
HARRY REID: --I'm not going to go to with any of those backdoor methods- you know, to whack Social Security recipients. I'm not going to do that. We have a lot of things we can do with-- this debt. It's a problem. But one of the places where I'm not going to be part of picking on is Social Security.
While there are a wide array of opinions about health care reform and its impact, it is indisputable that our nation's children, especially low-income children and those with special health care needs, are better off today because of the new law. Repealing health reform would be devastating for these the millions children and families who already are or soon will benefit from this historic legislation. Why? Here are 10 key reasons:
1. If health reform were repealed, insurers would go back to denying coverage for children with pre-existing conditions. Parents of children with cancer, children born with a birth defect, children with asthma, special-needs kids, among others, would once again be unable to get coverage for their kids without the Affordable Care Act.
2. Insurers would return to the practice of placing lifetime limits on coverage so that if a child is fortunate enough to beat leukemia when they are 8 they would be uninsurable if they face another serious illness later in life.
3. Dependent children through age 26 would not be guaranteed access to coverage on their parents' policy, leaving scores of young adults, including recent high school and college grads, back among the ranks of the uninsured.
4. Insurers would not have to cover vision care services or eyeglasses for children even if it is impossible for a child to be successful in school if they can't see.
5. Insurers also would not be required to cover dental care, a horrible return to the days when lack of coverage could cause a child to die from an infected tooth that could have been addressed for about 100.
6. Repealing health reform would jeopardize the future of the successful Children's Health Insurance Program (CHIP), a federal-state program that offers low or no-cost coverage for families who earn too much to qualify for Medicaid but not enough to buy their own coverage. CHIP and Medicaid have been crucial for families during this recession, ensuring that coverage for kids has remained stable despite the downturn in the economy.
7. Children with terminal illnesses would be returned to the days when they would not be able to get compassionate end-of-life hospice care unless they agreed to forgo looking for a cure for their illness.
8. Insurers would be allowed to resume the practice of charging co-payments for preventive health services, including essential well-baby and well-child visits, and vaccinations, creating financial disincentives for parents to get care for their children that keeps them healthy.
9. Children in foster care would no longer qualify for Medicaid beyond age 18.
10. New efforts to eliminate bureaucratic red tape and streamline enrollment processes for children who are already eligible but not enrolled in public health coverage would suffer if health reform was repealed. Nearly two-thirds of children who are uninsured actually qualify for coverage but face significant barriers that make it difficult for them to sign-up or re-enroll for coverage. Read it all here.
Now This Is What a 'Death Panel' Looks Like: "'It let's you make your own choice,' says Barbara Aplin, shouldering an oxygen tank on her way to the lunch line here at the senior Community Center in Green Bay, Wisconsin. She is speaking not of her meal options in 2011 but of so-called 'death panels,' the more colloquial name for the new Medicare rule now paying doctors to counsel this seventy-six-year-old ('and three-quarters!') and her fellow senior citizens about end-of-life care. If you listen to the new fear merchants from the right, the rule pushes seniors to opt out of medical treatment that might prolong their lives. But take an afternoon to listen to the actual grandmas, and you get a much different kind of scare. If her children don't listen to an end-of-life plan, Aplin says, 'I'll come back to haunt them.'" What's getting Fox News's granny panties in a twist comes down to a new billing code — "voluntary" instead of "v66.7" — that the Obama administration added back in to Medicare regulation on New Year's Day after dropping it from the rather contentious Section 1233 of the health-care bill. But we couldn't find a single elderly American on Medicare who was against the provision.
"Death panels," now that they're going down in a slightly different way, don't strike those a bit closer to actual death as particularly deadly — and certainly not as anything new. Here's something Fox News won't tell you: While the controversial billing code for an end-of-life conversation did not exist on Medicare forms until January 1, many doctors had the chat anyway — uncompensated. One primary-care physician told us that others found a way to bill "for the disease, and then add a v66.7 'encounter for palliative care.' And then I bill by time and code them usually a 99215, as it is usually forty-plus minutes."
With the new health-care regulation, she says she'll simply bill for "voluntary advance care planning." A different check box, as it were. See also: Anatomy of the Right Wing's Death-Panel Meme
Open Letter to the Vermont Legislature: Physicians to the Vermont Legislature - Enact a single-payer health care system
Krugman debunks the GOP lies about the health care costs.
NYTimes.com: How an insurance company let a teenager die, then spared no expense to save itself.
From Forbes we learn: "The first statistics are coming in and, to the surprise of a great many, Obamacare might just be working to bring health care to working Americans precisely as promised.
The major health insurance companies around the country are reporting a significant increase in small businesses offering health care benefits to their employees.
Why?
Because the tax cut created in the new health care reform law providing small businesses with an incentive to give health benefits to employees is working."
A Little Good News: "As Peter Shumlin was officially sworn in as governor of Vermont, there was and is great hope that at least in one state we may see passage and implementation of a truly universal, single-payer healthcare system."
From Change.org:
For transplant patients in Arizona, the warnings about death panels and health care rationing have come true, but they have nothing to do with health care reform. Instead, a Republican Governor and her allies are standing in the way of patient care, declining requests to reinstate funding for a critical, life-saving program.
Facing state budget problems, Arizona Governor Jan Brewer slashed funding for the state's Medicaid program that covered organ transplants. As a result some patients that were covered by the state and waiting for a transplant were cut from the program effective October 1st, leading to what some doctors are calling "death by budget cuts." [...]
The $1.4 million cut has had a dramatic impact on the lives of the patients and their families, but it could've been avoided. According to the Sentinel, projects that were funded include a $20 million renovation to a roof of the Arizone Veterans Memorial Coliseum and a $2 million grant for algae research.
Budget cuts have to come from somewhere, but cutting funding from a program that is integral in saving lives and preventing death? Tell Governor Brewer that her cuts to the transplant program were unconscionable and that she should immediately reinstate the $1.4 million in funding.
From Think Progress we learn some more about what repealing the Affordable Care Act would cost us:
– 32 million Americans will lose coverage compared to current law: “Under H.R. 2, about 32 million fewer nonelderly people would have health insurance in 2019, leaving a total of about 54 million nonelderly people uninsured. The share of legal nonelderly residents with insurance coverage in 2019 would be about 83 percent, compared with a projected share of 94 percent under current law (and 83 percent currently).” (p. 8-9)
– Increases deficit by $230 billion over 10 years: “Consequently, over the 2012–2021 period, the effect of H.R. 2 on federal deficits as a result of changes in direct spending and revenues is likely to be an increase in the vicinity of $230 billion, plus or minus the effects of technical and economic changes to CBO’s and JCT’s projections for that period.” (p. 5)
– Huge deficit increases over next decade: “Correspondingly, CBO estimates that enacting H.R. 2 would increase federal deficits in the decade after 2019 by an amount that is in a broad range around one-half percent of GDP, plus or minus the effects of technical and economic changes that CBO and JCT will include in the forthcoming estimate. For the decade beginning after 2021, the effect of H.R. 2 on federal deficits as a share of the economy would probably be somewhat larger.” (p. 7)
– Individuals would pay more for health insurance: “Although premiums in the individual market would be lower, on average, under H.R. 2 than under current law, many people would end up paying more for health insurance— because under current law, the majority of enrollees purchasing coverage in that market would receive subsidies via the insurance exchanges, and H.R. 2 would eliminate those subsidies.” (p. 9-10)
– Average health care benefits would be worse: “In particular, if H.R. 2 was enacted… the average insurance policy in this market would cover a smaller share of enrollees’ costs for health care and a slightly narrower range of benefits.” (p.9)
– Premiums for employer-sponsored insurance would increase: “Premiums for employment-based coverage obtained through large employers would be slightly higher under H.R. 2 than under current law, reflecting the net impact of many relatively small changes.” (p. 10)
Raw Story:
"On Wednesday, the first day of the 112th Congress, Rep. Lynn Woolsey (D-CA) introduced a measure to establish a robust public health insurance option as a supplement the Patient Protection and Affordable Care Act.
The California congresswoman argued the measure would lower insurance costs and address deficit concerns, pointing to a Congressional Budget Office report saying it would cut the deficit by $68 billion."
While the provision -- controversial in Congress but popular among the public -- is extremely unlikely to gain any traction in the Republican-controlled House, it serves to illustrate flaws in GOP's budget-related arguments regarding repeal of the health care law.
Republicans have argued that the health reform law would explode the deficit, but the CBO has said it would do the opposite. The nonpartisan scorekeeper has also said repealing the measure would add $143 billion to the deficit.
A copy of the 17-page bill was provided to Raw Story [ .pdf].
Way to go Debbie.....
From Think Progress:
WASSERMAN-SCHULTZ: The Republicans will take away a 50 percent cut in brand name drugs that seniors got…it will mean that children and in a few years everyone will be dropped or be denied coverage for the pre-existing condition that they might have. It will mean that young adults will no longer be able to stay on their parents’ insurance until they’re 26. …. What we’re going to do is put insurance companies and profit-driven decision making back in the driver’s seat, instead of decision making between doctors and their patients.
PRICE: That’s the kind of policy that was rejected on November 2nd.
WASSSERMAN-SCHULTZ: Really? Really? You think that people want insurance companies, Tom. You think that Americans want insurance companies to make decisions about whether or not they get coverage for a pre-existing condition? That is absolutely not what November 2nd was about.
Wonk Room:: "These so-called “mandatory” or “entitlement” programs are permanent and have permanent funding authority. Furthermore, the Department of Health and Human Services has the ability to fund related provisions without seeking additional appropriations from Congress."
Florida Independent: "Think Progress has discovered that recent television commercials featuring Florida resident and former Gov. Mike Huckabee rallying viewers to sign a repeal petition against Obama’s health care reform measures are part of a campaign managed by 949 Media Group, a firm run by a notorious scam artist known for bilking struggling homeowners seeking to renegotiate their mortgages.
According to a representative from Restore America’s Voice, a PAC headed by a friend of Huckabee’s, Derek Oberholtzer has been the man behind the group’s campaign since it formed in October."
AlterNet:
"With the 112th Congress set to convene on Wednesday, the new Republican House majority has come out swinging, threatening to un-do key Obama administration victories -- namely healthcare reform -- as soon as possible."
The Washington Monthly: "The more important element is that the conventional wisdom, driven in large part by Republican talking points, is deeply flawed. We've been told repeatedly that Americans just don't like the Affordable Care Act because they consider it excessive government overreach and some kind of liberal boondoggle.
But for months we've seen results like those from the CNN poll -- opponents of the health care law don't all agree with the conservative Republican line. On the contrary, only 37% of the country actually endorses the right's line and sees the Affordable Care Act as being 'too liberal.'
So, when you see the top-line results and see that 54% oppose the law, this is not to say that 54% have bought into the right-wing demagoguery and think Republican criticisms have merit. On the contrary, one could look at the same results and say that a 56% majority either support the law or want it to be even more ambitious in a liberal direction.
When Republicans try to gut the Affordable Care Act next year, insisting that the country is with them, it's worth remembering a pesky detail: they're wrong."
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