Health Care Sausage Making: Getting Legislation Through Congress - Page 41 - Politics and Economics

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Health Care Sausage Making: Getting Legislation Through Congress

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12-18-2009 , 09:07 PM

#1001

jthegreat

veteran

Join Date: Jan 2005 Posts: 3,125

Quote:

Real health-care reform is supposed to eliminate discrimination based on preexisting conditions. But the legislation allows insurance companies to charge older Americans up to three times as much as younger Americans, pricing them out of coverage.

That's just hilarious.

12-19-2009 , 10:44 AM

#1002

Dynasty

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Senator Ben Nelson is a Yes.

Assuming no liberal hold-outs, it appears the Democrats have 60 votes.

Edit for link: Washington Post story

2nd edit: Nelson is holding a press conference. He was adamant that he reserves the right to vote against cloture after the House-Senate conference if material changes are made to the bill.

Last edited by Dynasty; 12-19-2009 at 11:07 AM.

12-19-2009 , 11:16 AM

#1003

Wynton

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I don't trust preliminary reports to give us accurate info, but the NYT website currently says this about Nelson:

Quote:

Mr. Reid’s amendment includes major restrictions on abortion that were intended to win support for the bill from Mr. Nelson. Under Mr. Reid’s proposal, health insurance plans are not required or forbidden to cover abortion services, but there is a major exemption that would give states power to prohibit abortion coverage in the insurance markets, or exchanges, where most health plans would be sold.

Mr. Reid’s amendment also includes a substantial increase in federal contributions to Nebraska’s costs of providing Medicaid coverage to the poor.

12-19-2009 , 11:21 AM

#1004

Dynasty

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I think everyone expected a Nebraska Purchase. So, I'm sure the money is flowing to Lincoln.

If there really is "major restrictions on abortion" it could be a big deal. Giving states the right to "prohibit abortion coverage in the insurance markets..." sounds like something I wouldn't expect liberals to accept. Though, it seems the liberals in the Senate have accepted the language.

12-19-2009 , 11:28 AM

#1005

Wynton

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Quote:

Originally Posted by Dynasty

If there really is "major restrictions on abortion" it could be a big deal. Giving states the right to "prohibit abortion coverage in the insurance markets..." sounds like something I wouldn't expect liberals to accept. Though, it seems the liberals in the Senate have accepted the language.

I've been saying ITT for months that I was very confident a bill would get signed (albeit I also expected it to include some kind of modified public option). And I've said that because I know that liberals would ultimately accept even a slight advance in health care over the status quo, both for political reasons and on the merits. There are some loud voices on the left who disagree, and we will see a pitched battle in the House, but I'm still confident in the ultimate outcome.

I also believe that, in the long-run, restrictions on abortion now actually help the Dems politically (just as I believe that restrictions on guns help the GOP). These kinds of defeats enrage and motivate the base of the parties.

12-19-2009 , 11:31 AM

#1006

Wynton

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Well, I'm loathe to quote anything from Kos, but occasionally more up-to-date info is available there.

From this diary:

Here are the supposed changes in the "manager's amendment." I'm not sure how many are allegedly attributable to Nelson:

Quote:

A quick review of some of the changes put forward by Senate Majority Leader Reid's manager's amendment to the health care reform bill.

* Liberal Jon's diary :: ::
*

1. Section 2711 - Annual limits are now banned after 2014, and before then, shall be set at a limit that doesn't impair "essential" health care services. This is a huge improvement over Reid's original draft of the bill, that only banned "unreasonable" annual limits (without defining such term). By the time the exchanges are set up, there won't be any annual limits on qualified health care plans.

2. Section 2718 - Medical loss ratios are set at 85% in the large group market and 80% in the small business/individual market (down from 90% initially floated by Rockefeller), with consumers refunded the difference from any health insurance provider that doesn't spend at least 85% of premiums on health care benefits.

3. Section 2719 - Stronger appeals process provided for medical denials, with the Secretary of HHS authorized to review such processes.

4. Section 1303 - States may prohibit abortion coverage on plans offered through the exchange!

5. Section 1334 - The public option is scrapped and replaced with OPM-negotiated private, non-profit (read: Blue Cross/Blue Shield) "multi-state" plans, which are also subject to state regulation? OPM's role is limited to negotiating and certifying plans that meet its qualifications with respect to: (1) medical-loss ratios, (2) profit margins, (3) premiums charged, and (4) all other terms and conditions.

In theory, the OPM director could establish greater consumer protections than are required elsewhere on the exchange. That's in theory, though. In reality, he'll probably just negotiate a standard-issue plan with similar protections provided elsewhere on the exchanges. People in this plan are NOT in the FEHBP risk pool, so there goes those cost savings. Apparently if insurers declined to participate, there's no fallback?

6. Section 10108 - Free choice vouchers: It would seem that Reid has accepted the Wyden amendment, that employees can receive a voucher in the amount of the employer's contribution and go out onto the exchange (with certain income qualifications)? I'm not sure about interpreting this provision.

7. Section 10201 - Ol' Benny got some more money for Nebraska Medicaid (and perhaps certain other rural states will qualify)

8. Section 500B - New 10% tax on indoor tanning!

9. Plenty of provisions on tax credits for adoption, help for pregnant teenagers, etc. to discourage abortion (per compromise).

10. Section 10901 - The inaptly named "Cadillac tax" is still intact, with some additional exceptions for high risk occupations (longshore workers?). Now, if I were a cynic, I'd suspect a provision in the manager's amendment specifically exempting longshore workers from the tax could be aimed at the lovely Senators from MAINE... or more probably, West Coast liberals.

11. Medicaid expansion still at 133% FPL.

12. It goes without saying that there is no expansion of Medicare (although the Department of Justice is given additional authority to crack down on Medicare fraud).

12-19-2009 , 11:32 AM

#1007

Sholar

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Yeah, it will be interesting to see what's in the final bill, now. Sausage making, indeed.

Thanks for the update, Wynton.

12-19-2009 , 12:51 PM

#1008

Brian J

TOTP Master

Join Date: Nov 2007 Posts: 10,650

Quote:

Originally Posted by Wynton

I also believe that, in the long-run, restrictions on abortion now actually help the Dems politically (just as I believe that restrictions on guns help the GOP). These kinds of defeats enrage and motivate the base of the parties.

The reason that guns help the gop is that it is a majority issue and cuts across deep into the voters in the democrat party as well. Healthcare, not so much...

12-19-2009 , 02:31 PM

#1009

rjoefish

Got Out the Vote

Join Date: Feb 2006 Posts: 31,086

Quote:

Originally Posted by Brian J

The reason that guns help the gop is that it is a majority issue and cuts across deep into the voters in the democrat party as well. Healthcare, not so much...

Healthcare obviuosly has been a contentious issue but either way I believe he was speaking specifically about the abortion part of the HC debate.

12-20-2009 , 11:57 PM

#1010

Brian J

TOTP Master

Join Date: Nov 2007 Posts: 10,650

jeez, when you have to bribe them with sex...

Quote:

The political advocacy group “Rock the Vote” has a new video out encouraging young people to abstain from having sex with folks opposed to healthcare reform.

Sadly, this isn’t your run of the mill call for celebacy, for the video also instructs youth to use sex to get people to change their minds on this issue.

The group’s YouTube posting asks: “What would you withhold from someone who opposes health care reform? Cookies, a Christmas gift, sex?”

Pretty racy for an organization whose mission is to “give young people the tools to identify, learn about, and take action on the issues that affect their lives, and leverage their power in the political process[.]”

12-21-2009 , 12:04 AM

#1011

ErikTheDread

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Two can play that game.

12-21-2009 , 12:51 AM

#1012

Brian J

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Join Date: Nov 2007 Posts: 10,650

Quote:

Originally Posted by ErikTheDread

Two can play that game.

you've been bribing people with sex to support obamacare?

12-21-2009 , 12:54 AM

#1013

TomVeil

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Quote:

Originally Posted by Brian J

you've been bribing people with sex to support obamacare?

That's why it's failing so badly.

Spoiler:

12-21-2009 , 02:13 AM

#1014

rjoefish

Got Out the Vote

Join Date: Feb 2006 Posts: 31,086

First of the 3 votes going right now. Last time they did anything at 1am on a Sunday?

12-21-2009 , 03:51 AM

#1015

Chips Ahoy

help me help you

Join Date: Apr 2007 Posts: 28,869

Quote:

Originally Posted by rjoefish

Last time they did anything at 1am on a Sunday?

UIGEA, IMO

(note, this is one of those made up facts)

checking the record:

Quote:

Originally Posted by wikipedia

The UIGEA was added in Conference Report 109-711 (submitted at 9:29pm on September 29, 2006), which was passed by the House of Representatives by a vote of 409-2 and by the Senate by unanimous consent on September 30, 2006. Due to H.RES.1064, the reading of this conference report was waived.

Added Friday night, vote Saturday.

Last edited by Chips Ahoy; 12-21-2009 at 03:58 AM.

12-21-2009 , 08:52 AM

#1016

Chips Ahoy

help me help you

Join Date: Apr 2007 Posts: 28,869

Megan McArdle reacts:

Quote:

No bill this large has ever before passed on a straight party-line vote, or even anything close to a straight party-line vote. No bill this unpopular has ever before passed on a straight party-line vote. We're in a new political world. I'm not sure I understand it.

The irony of this is that this bill is great for me personally. I'm probably uninsurable, and I'm in a profession where most people now end up working for themselves at some point in their career. So mandatory community rating is great news for me and mine. But I think that it's going to be a fiscal disaster for my country, because the spending cuts won't be--can't be--done the way they're implemented in the bill. We've just increased substantially the supply of unrepealable, unsustainable entitlements. We've also, in my opinion, put ourselves on a road that leads eventually to less healthcare innovation, less healthcare improvement, and more dead people in the long run. Obviously, progressives feel differently, and it will never be possible to prove the counterfactual.

So there you are. Alea iacta est. I sure hope I'm wrong.

I have doubts about the "less innovation" part because healthcare is already pretty screwy. Otherwise she has good points.

12-21-2009 , 09:55 AM

#1017

ErikTheDread

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Quote:

more dead people in the long run

I see dead people.

Meh. As lame as this bill might be, it's not as if continuing the status quo is a very palatable option. And after saying again and again for 8 years that "elections have consequences," having Republicans now complain when the winners actually accomplish something with their votes is pretty funny.

12-21-2009 , 10:15 AM

#1018

Chips Ahoy

help me help you

Join Date: Apr 2007 Posts: 28,869

Quote:

Originally Posted by ErikTheDread

She's not a Republican.

The recent wars did not come out of Congress on party line votes.

12-21-2009 , 10:27 AM

#1019

ErikTheDread

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Quote:

Originally Posted by Chips Ahoy

She's not a Republican.

No, but she is a "small l" libertarian whose work has been praised by David Brooks and John Podhoretz.

12-21-2009 , 11:18 AM

#1020

jogsxyz

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Join Date: Mar 2005 Posts: 6,362

Quote:

more dead people in the long run

Quote:

7. Section 10201 - Ol' Benny got some more money for Nebraska Medicaid (and perhaps certain other rural states will qualify)

Move to Nebraska.

12-21-2009 , 11:49 AM

#1021

pvn

Guest

Posts: n/a

More dead people in the long run isn't in and of itself a bad thing.

12-21-2009 , 11:55 AM

#1022

Brian J

TOTP Master

Join Date: Nov 2007 Posts: 10,650

Quote:

Originally Posted by ErikTheDread

No, but she is a "small l" libertarian whose work has been praised by David Brooks and John Podhoretz.

does david brooks really qualify as a republican? think he supported obama

12-21-2009 , 12:09 PM

#1023

istewart

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Join Date: Dec 2004 Posts: 15,910

By that line of logic, Democrats only have 59 seats in the Senate.

12-21-2009 , 12:19 PM

#1024

ErikTheDread

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At least we can be certain that if things were the other way around (there was a Republican president and 60-vote caucus in the Senate), they'd respect the wishes of the minority.

12-21-2009 , 12:20 PM

#1025

istewart

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As I've stated before, Megan McArdle couldn't be more of an idiot if she tried. She tries to play up her independence or "libertarianism" (pretty sure she was in favor of invading Iraq, so lol @ that) by saying "I'm pro-choice, but pro-choice liberals are dumb" or "I voted for Obama, but the stimulus and health care reform and soda taxes and financial regulation are all pretty stupid." In reality she's completely without principle and only has a job because she's a female conservative and attracts a decent number of hits, which is all that matters to David Bradley.

She's essentially never worth listening to. I admit I read her fairly frequently, because it's almost astonishing how well she has perfected the art of concern trolling Democrats. Even more astonishing than how completely bad she is at political predictions:

McArdle, a week ago:

McArdle, Saturday:

Quote:

So there's now about a 90% chance that the health care bill will pass.

At this point, the thing is more than a little inexplicable. Democrats are on a political suicide mission; I'm not a particularly accurate prognosticator, but I think this makes it very likely that in 2010 they will lost several seats in the Senate--enough to make it damn hard to pass any more of their signature legislation--and will lose the house outright. In the case of the House, you can attribute it to the fact that the leadership has safe seats. But three out of four of the Democrats on the podium today are in serious danger of losing their seats.

At least she can admit she doesn't have any idea what she's doing!

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