From Bloomberg.com
Twenty-seven U.S. labor unions defied White House Chief of Staff Rahm Emanuel and announced their opposition to the $829 billion health-care measure passed yesterday by the Senate Finance Committee.
The unions say in a full-page newspaper advertisement today that lawmakers need to make "substantial" changes to the bill or they will urge their members to seek its defeat on the Senate floor. Emanuel asked organized labor not to go public in opposition, said Gerald McEntee, president of the American Federation of State, County and Municipal Employees.
"He told us that we really don't want to be looked upon as the group that stopped meaningful health-care reform," McEntee said in an interview yesterday. "We would love to be on the exact same page as the White House, but we see ourselves as fighting for our members."
From John Nichols at The Nation
So it is in the U.S. Senate, where the Finance Committee finally got around to finishing its health care reform assignment.
The vote on the measure -- which does not include a public option to hold insurance companies to account -- was 14-9, with all Democrats on the committee and Maine Republican Olympia Snowe voting Tuesday to toss the measure into the legislative sausage-grinder that will eventually produce final legislation for the Senate to consider.
The important thing to remember is that for all of Tuesday's attention to the finance committee vote, the full Senate will never vote on this particular measure.
Senate Health, Education, Labor and Pensions Committee chair Tom Harkin, D-Iowa, has said throughout the process that "the bill that (the Finance Committee) proposes is just that – a proposal."
Harkin is too polite to state the obvious: The Finance Committee proposal is no more likely to become law than the slacker student's last-to-be-handed-in homework assignment is to be awarded academic honors.
That's a good thing because the Finance Committee bill falls far short of real health care reform. It steers billions of taxpayer dollars into the accounts of insurance companies while failing to provide a realistic, humane or fiscally-responsible alternative to their profiteering. The problems with the Finance Committee's proposal extend far beyond the fact that it fails to establish a government-run alternative to compete with the private insurers that will be ridiculously enriched by it.
But the lack of a "public option" should make the Baucus bill a nonstarter. As insurance-industry insider turned whistleblower Wendell Potter explained in an advertisement produced by MoveOn.org, the Baucus bill would, if enacted effectively, "kill health reform."
"Take it from me," argues Potter, "the Senate Finance bill is a dream come true of the health insurance industry. If there is no public option insurance companies aren't going to change. The choice of a public health insurance option is the only way to keep insurance companies honest." Perhaps that is why the other four congressional committees that produced health-care reform bills – three in the House and the Senate Health, Education, Labor and Pensions (HELP) Committee -- have included far more robust language with regard to alternatives to for-profit insurance companies. It is Harkin, not Baucus, who is the serious health-care reformer in the Senate.
It is Harkin, not Baucus, who has consistently promoted the public option and who continues to argue that it can and will be a part of any final legislation. "Look," says Harkin, "five committees have reported a bill out on healthcare. Four of them have a public option. One doesn't. So you would think the weight would be on the side of having a public option in the bill – and that's where it is."
And it is Harkin, the chairman who gets his work done on time and right, that we should be paying attention to now that Baucus has finally finished his silly sideshow.
AHIP - the insurance industry, has funded a new study attacking the Senate Finance Committee health reform bill, claiming it will hike family premiums.
- The White House to then issued new talking points attacking the study as a “self serving” effort to defend its “profits."
- While the study seems to help reform foes, it actually makes a good case for Single-Payer or a Medicare like Public Option and should make it easier for Dems to cast opposition to reform as orchestrated by the insurance companies.
- Even some GOP aides are worried about this.
- Ezra Klein shreds the report on the facts, as does Jonathan Cohn who got MIT economist Jonathan Gruber to review AHIP's PriceWaterhouseCoopers report and says that the AHIP Claim on Benefits Tax is "Implausible".
msnbc.com reports:
The health insurance industry has been working until recently to help draft legislation, while publicly endorsing President Barack Obama's goal of affordable coverage for all Americans. The alliance has grown strained as legislation advances toward votes in Congress.
Late Sunday, the industry trade group America's Health Insurance Plans sent its member companies a new accounting firm study that projects the legislation would add $1,700 a year to the cost of family coverage in 2013, when most of the major provisions in the bill would be in effect. I think they make an excellent case for Single-Payer... Medicare For All:
Study: Premium increase
Premiums for a single person would go up by $600 more than would be the case without the legislation, the PricewaterhouseCoopers analysis concluded in the study commissioned by the insurance group.
"Several major provisions in the current legislative proposal will cause health care costs to increase far faster and higher than they would under the current system," Karen Ignagni, the top industry lobbyist in Washington, wrote in a memo to insurance company CEOs.
The study projected that in 2019, family premiums could be $4,000 higher and individual premiums could be $1,500 higher.
But the PricewaterhouseCoopers analysis attempted to get at a different issue — costs for privately insured individuals.
It concluded that a combination of factors in the bill — and decisions by lawmakers as they amended it — would raise costs.
The chief reason, said the report, is a decision by lawmakers to weaken proposed penalties for failing to get health insurance. The bill would require insurers to take all applicants, doing away with denials for pre-existing health problems. In return, all Americans would be required to carry coverage, either through an employer or a government program, or by buying it themselves. Other factors leading to higher costs include a new tax on high-cost health insurance plans, cuts in Medicare payments to hospitals and doctors, and a series of new taxes on insurers and other health care industries, the report said. While I do believe the Insurance Industry through AHIP is being disingenuous with this report, it does still demonstrate how current plans under review are far more complicated and expensive than they need to be. We have a historic opportunity for members of Congress to go on the record in support of single-payer legislation and we should push for those votes. A significant of YES votes helps establish a benchmark so with healthcare reform returns for debate again - as it will given the plans offered - we won't have single payer taken off the table before then negotiations begin.
Note that the text in the above forms will need a bit of revising - which you are free to do and should do. I would also urge you to ask them to request that the Congressional Budget Office score HR-676. Let Congress and the public see where the real efficiencies are.
More Info on upcoming Single Payer votes here.
BILL MOYERS: You know from the news that early next week the Senate Finance Committee is expected to vote on its version of health care reform. And therein lies another story of money and politics.
Polls show the overwhelming majority of Americans favor a non-profit alternative -- like Medicare -- that would give the private health insurance industry some competition. But if so many Americans and the President himself want that public option, how come we're not getting one?
Because, the medicine has been poisoned from day one, in part because of that same revolving door that Congresswoman Kaptur and Simon Johnson were just talking about. Movers and shakers rotate between government and the lucrative private sector at a speed so dizzying they forget who they're working for.
From TPM LiveWire:
Sen. Chuck Grassley (R-IA), formerly of the ill-fated Gang of Six senators on the Senate Finance Committee that had been charged with crafting health care reform legislation, said on Fox News this morning that his committee's health reform bill might have to be scrapped and created again from scratch.
We're expecting a preliminary cost estimate on the package from the CBO later this afternoon. But Grassley said that if CBO's analysis shows that the health care package won't be deficit-neutral and won't reduce health care inflation, then the proposal is in trouble.
"If we get figures back today that don't do that, then we're going to have to go back to the drawing board as a committee and make changes that accomplish both of those things, otherwise we've wasted a whole six months."
Grassley also took a shot at the White House, saying the Obama administration broke up the Gang of Six.
"The White House pulled the rug out from under us," Grassley said.
When the Finance Committee eventually gets around to voting on the bill they cobbled together last week, it's still not entirely certain that it will pass... To put it more directly, the exchange as set up in the Baucus bill will be open to just 25 million people, most of whom have been uninsured, un-doctored, untreated for a long time. It's enough to make one think they're setting not just the public option but the exchange to fail.
The hostility among the committee's senior members, particularly those on Baucus's Gang of Six, to the Wyden Free Choice amendment just reinforces that impression. Jon Walker at FDL has the whole sordid story of how Baucus blindsided Wyden on that late night of markup, when Baucus ruled his amendment out of order because it hadn't been scored by the CBO. Except that the amendment that Wyden offered had been scored, more than a week before the markup. To put it more directly, the exchange as set up in the Baucus bill will be open to just 25 million people, most of whom have been uninsured, un-doctored, untreated for a long time. It's enough to make one think they're setting not just the public option but the exchange to fail.
The hostility among the committee's senior members, particularly those on Baucus's Gang of Six, to the Wyden Free Choice amendment just reinforces that impression. Jon Walker at FDL has the whole sordid story of how Baucus blindsided Wyden on that late night of markup, when Baucus ruled his amendment out of order because it hadn't been scored by the CBO. Except that the amendment that Wyden offered had been scored, more than a week before the markup. There are two issues at play here--Baucus's actions as committee chair which have shown him essentially incompetent to achieve a decent bill of this scope and dishonest in dealing with his colleagues. But the more important issue for the moment goes back to Rockefeller's problem with the bill--the half trillion dollar gift it is to the insurance industry, made an even bigger gift by the crippled exchange it creates.
There's going to be tremendous pressure on Wyden and Rockefeller, from Baucus, from the White House, from Reid, to vote for this crappy bill to get it out of committee so the process can move on (pressure that should have been on Baucus months and months ago, since it's his fault we're now well into October with no bill). As long as there's a Snowe-inspired delay why the CBO does it's work on the crappy bill, Wyden and Rockefeller should hold out on saying how they'll vote. They should be using this time to extract as many concessions as possible from Reid and the White House before agreeing to anything. Read it all at Daily Kos
The bill coming out of Senate Finance is far from perfect, but they finished up last night with some key improvements adopted that mean some of the worst elements have been softened, and some of the worst Republican amendments were fought off. There's still some ugly there, though, for Harkin, Reid, and Baucus to deal with as the bills are merged, and when it eventually comes to the floor.
Probably the most significant improvement on affordability came last night when Schumer and Snowe successfully lowered the "Max Tax". The bill still has an individual mandate, but the penalties have been reduced. Here's one of the uglier ones they passed, and in basic secrecy, that would give states increasing flexibility to drop Medicaid patients, starting next year. They will meet sometime next week to vote on reporting the bill out. After that, assuming that Rockefeller, Cantwell, and Wyden feel their primary objections have been met and vote for it, it's on to the merging process, where hopefully Senator Harkin will be able to prevail on a strong public option. More details here.
Thanks to the House Progressives, and to an organized and loud external progressive community, the message has finally seemingly gotten through: the bill has to have a public option. Witness today's statement from Harry Reid, that there will be a public option in the bill that goes to the Senate floor. The devil is always in the details when they start talking about the definition of a public option being "relative," but at least we've gotten to the point where they recognize it has to be there. Progress.
A lot has happened in the Senate Finance Committee with health care reform. This is a pretty good summary at Daily Kos.
Liz Fowler, a former public affairs executive for Indianapolis-based health insurance giant WellPoint, helped to craft health-care reform legislation being proposed by Senate Finance Committee Chairman Max Baucus.
It's a connection that is drawing criticism from some reform advocates who support the creation of a public health plan that would compete against commercial insurers such as WellPoint. Baucus' bill does not call for the creation of a public plan.
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"This just sounds like another example of the revolving door between government and industry," said Dr. Robert Stone, a Bloomington physician who also is director of the advocacy group Hoosiers for a Commonsense Health Plan. "We don't really know how much influence her job at WellPoint had." Read it all in The Indianapolis Star
Healthcare overhaul legislation moving through the Senate Finance Committee would put crucial rule-making authority in the hands of a private association of state insurance commissioners that consumer advocates fear is too closely tied to the industry.
The National Assn. of Insurance Commissioners currently writes model laws and regulations that individual states are free to accept or discard. Under the bill by Sen. Max Baucus (D-Mont.), it would craft a model rule governing "health insurance rating, issuance and marketing requirements" that would become "the new federal minimum standard without any further congressional action." States would be permitted to deviate from the standards only by appealing to the Department of Health and Human Services.
In effect, the bill would allow the group to write many of the new rules on issuing and marketing insurance to millions of uninsured Americans who would be required to purchase policies.
"The NAIC is clearly an organization that is dominated by the insurance industry," said California Lt. Gov. John Garamendi, a former state insurance commissioner. Read it all at latimes.com
While the Senate Finance Committee is slogging through more than 530 amendments to Sen. Max Baucus’ flawed health care reform bill, more than 2,700 lobbyists are working overtime to protect the private health insurance industry and other health care corporations. Yesterday, AFL-CIO President Richard Trumka called for an investigation into the connection between the millions of dollars that health insurance companies are spending on lobbying expenses to kill health care reform and soaring premiums. Today, Bloomberg News reports that more than half of the health care industry’s hired-gun lobbyists are former congressional staffers, White House employees or government agency veterans—55 are former members of Congress. Sen. Jay Rockefeller (D-W.Va..) and Sen. Chuck Schumer (D-N.Y.) each plan to offer a public option amendment next week. Says Rockefeller:
A health-care plan without a public option is a much weaker health plan because insurance companies continue to rule. [A public option] is going to force other companies to bring down costs over time.
All 10 committee Republicans will oppose the amendments and it may not win enough of the 13 Democratic votes. If it fails in committee, Schumer says he will take the fight to the floor when the full Senate votes. Read it all here.
In a late-game push to pass the public option, progressive groups are trying to convince Democrats that it would be political suicide to pass a bill requiring people to buy insurance coverage but not giving them the choice of a government-run plan.
A memo making the rounds on Capitol Hill makes the case that the current construct of the Senate Finance Committee's legislation - which includes an individual mandate but no public option - will be resoundingly opposed by the American public.
Commissioned by the progressive-leaning Health Care for America Now - and obtained by the Huffington Post - the piece is based on three new polls conducted by reputable polling firms in swing House districts and the state of Maine.
"Nationally," the memo reads, "voters oppose a mandate to purchase private insurance by 64% to 34% but support a mandate with a choice of private or public insurance by 60% to 37%... Each [survey] found that likely 2010 voters oppose 'requiring everyone to buy and be covered by a private health insurance plan' but support 'requiring everyone to buy and be covered by a health insurance plan with a choice between a public option and private insurance plans.'"
In a not-so-subtle message to Senate Democrats, the memo concludes with a warning shot at the Senate Finance Committee's legislation - which seems unlikely to include a public plan.
"All of the health care reform proposals that have passed Congressional committees to date, including three House committees and the Senate HELP Committee, include an individual mandate and the choice of private or public health insurance," the HCAN memo reads. "The Chairman's mark introduced into the Senate Finance Committee includes the individual mandate without the choice of a public health insurance option." Source: Huffington Post
I am told that Senators Chuck Schumer and Jay Rockefeller will force a roll-call vote tomorrow morning in the Senate Finance Committee on two amendments that would create a government-run insurance program – a top priority for liberal Democrats that was left out of the bill drafted by Finance Chairman Max Baucus. Read it all in The Note
Reacting to an amendment proposed by Sen. Jon Cornyn (R-Texas) during the Senate Finance Committee's markup of health care reform legislation on Thursday, committee member Jay Rockefeller (D-W.Va.) called his colleague a pawn of the health insurance industry.
"This is a very, very important amendment and it's a very, very bad amendment," said Rockefeller. "If there's anything which is clear, it's that the insurance industry is not running this markup, but is running certain people in this markup." Source with Video
Senator Rockefeller pointed out that there was a gigantic loophole in the Baucus bill that would leave half of Americans subject to potential discrimination by private insurers. Apparently due to existing federal law, large companies can call themselves "self-insurers" even though they provide coverage through a major insurance company. These sort of self-insurance plans are mostly exempt from state regulations and are allowed to deny coverage based on pre-existing conditions. Read it all at Campaign
Senate Majority Leader Harry Reid (D-Nev.) gave Republicans his most direct warning to date that he is prepared to use a procedural maneuver to pass healthcare reform with a simple majority.
Reid told Republicans that he would prefer to pass healthcare reform under regular order but warned that he would not hesitate to use budget reconciliation if the legislation stalled in committee. The Senate Finance Committee began marking up a sprawling healthcare reform bill on Tuesday morning. Read it all at TheHill.com
The Wonk Room has done a good job explaining many of the more important modifications made to the Baucus bill. Sen Max Baucus (D-MT) has just released a Chairman’s amendment to his mark. The new amendment enhances the bill’s affordability measures and increases the threshold on so-called Cadillac health care plans for ‘high-risk’ Americans. The modified amendment also preserves a subsidy to certain Medicare Advantage plans. Read more at the Wonk RoomFiredog Lake list improvements to the Baucus bill some amendments created: Better Ombudsman Office Baucus decided to significantly strengthen the new ombudsman office by basically adopting the Bingaman amendment I discussed the other day. Originally the consumer would need to fully exhaust all internal appeals before being able to seek help from the ombudsman's office. Now, if the appeals last longer than three months, they can get professional help from the ombudsman's office. Access to the ombudsman's services still needs to be improved, but this is a step in the right directions.
No Multiple Exchanges The bill would no longer allow states to create multiple exchanges. Originally, states could allow “other entities” to operate multiple exchanges in the state. This was a bad provision that would not only dilute the bargaining power of individuals using the exchanges, but could easily have become a way for insurance companies to game the system.
National Plans Restricted Baucus's bill would have allowed insurance companies to sell “national plans,” which would be exempt from state benefit mandates. This has been a long time goal of the health insurance industry, and would have effectively gutted most states' insurance regulations. Fortunately, this provision has be changed to allow individual states to opt-out of allowing national plans to be sold in their state. States with very good benefit mandates can now at least prevent their state from being flooded with lower quality “national plans.”
The first big fight over the Senate Finance Committee’s health care legislation erupted Tuesday night: a rollicking brawl over a deal that the Obama administration cut with the pharmaceutical industry to achieve $80 billion in savings on drug costs over 10 years, money that would help pay for the legislation.
Top House Democrats have hated the deal from the get-go. Senate Democrats are now bitterly divided. And Senate Republicans are eagerly jumping into the fray to needle the Democrats over their divisions. The fight over the deal with PhRMA actually stems from the legislative battle over the Medicare prescription drug legislation that Republicans successfully pushed through Congress in 2003. As a result of that legislation, about 6 million elderly Americans who had been receiving drug benefits under Medicaid, the government insurance program for the poor, were instead shifted into the new Medicare drug program, resulting in the government paying far high prices for drugs.
Representative Henry Waxman, Democrat of California, and now the powerful chairman of the House Energy and Commerce Committee, has long complained about that switch. And the House health care legislation, of which Mr. Waxman is a main author, seeks to reverse the arrangement and to recoup the extra money that the government has been spending by restoring the old Medicaid drug discounts or “rebates” as they are known.
That would save the government at least $86 billion over 10 years, but would potentially cost the drug industry far more. The White House has said that its deal with PhRMA would help narrow a gap in Medicare coverage of prescription drugs that is know as the doughnut hole, which forces people to pay some of their drug costs after a certain level. But there are also questions about the extent to which the drug industry also benefits, because the increased drug coverage for seniors means that the government will pay for more medication on their behalf, particularly brand-name drugs. In some cases, seniors now stop taking medication or switch to generics when they reach the doughnut hole.
Since the White House reached its deal with PhRMA in June there has been some disagreement between the industry and the administration over the precise terms of the arrangement. PhRMA has insisted that the White House agreed not to seek any additional concessions from drug manufacturers and to block Mr. Waxman’s plan in the House legislation. And the industry said that its support of the health overhaul was specifically aimed at Mr. Baucus’s proposal.
Mr. Baucus had previously announced that the first votes on amendments would not take place until Wednesday, so a final outcome of the fight was postponed. Read it all at NYTimes.com
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