Insurance Q&A

January 30, 2010

President acknowleges “stray cats and dogs”

Filed under: Uncategorized — rrroark @ 7:00 pm

The president admitted yesterday exactly what I’ve been saying; that his Democrats and lobbyists have crafted bills that in fact will prevent us from keeping our current insurance and/or choosing our own doctor. He said:

The last thing I will say, though — let me say this about health care and the health care debate, because I think it also bears on a whole lot of other issues. If you look at the package that we’ve presented — and there’s some stray cats and dogs that got in there that we were eliminating, we were in the process of eliminating. For example, we said from the start that it was going to be important for us to be consistent in saying to people if you can have your — if you want to keep the health insurance you got, you can keep it, that you’re not going to have anybody getting in between you and your doctor in your decision making. And I think that some of the provisions that got snuck in might have violated that pledge. [emphasis added]

January 6, 2010

Broken Promises

Filed under: Uncategorized — rrroark @ 1:42 pm

Transparency: When Speaker Nancy Pelosi (D-CA) emerged from a closed-door meeting with top House Democratic leaders, the press asked her about C-SPAN CEO Brian Lamb’s request that she permit cameras to televise the final health care negotiations between the House and Senate. After Pelosi first demurred, a reporter reminded Pelosi about President Barack Obama’s frequent promises to the American people throughout 2008 that he would ensure C-SPAN was allowed to televise exactly such negotiations, to which Speaker Pelosi quipped: “There are a number of things he was for on the campaign trail.”

Taxes on the Middle Class: Speaker Pelosi is right: President Obama’s broken health care promises are legendary. According to reports, Speaker Pelosi wasn’t even referring to Obama’s whopper from last month that he never campaigned on the public option. No, Speaker Pelosi is apparently most upset with Obama’s support for the Senate’s tax on high cost health plans, which she believes is a violation of Obama’s promise not to raise taxes on the middle class. But really, President Obama’s current health care plan breaks so many of his previous health care promises, there is no need for Pelosi to have to name just one. Here are just some more.

Individual Mandate: There were not a lot of actual policy fights in the 2008 Democratic Presidential primary, but one of the few major policy disagreements between then-Sen. Hillary Clinton (D-NY) and then-Sen. Barack Obama (D-IL) was over the individual mandate. Clinton was for it and Obama was against it. On January 31, 2008, Obama made the case against mandates in a Los Angeles, CA, debate: “Now, under any mandate, you are going to have problems with people who don’t end up having health coverage. I think we can anticipate that there would also be people potentially who are not covered and are actually hurt if they have a mandate imposed on them.” Both the House and Senate bills now contain an individual mandate. According to the President’s own Centers for Medicare and Medicaid Services, under the Senate plan, 19 million Americans would pay $29 billion in taxes/fines and still receive no health care in return.

You Will Not Lose Your Doctor: On June 15, 2009, President Obama promised the American people: “No matter how we reform health care, we will keep this promise to the American people. If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you’ll be able to keep your health care plan, period. No one will take it away, no matter what.” Again, the President’s own Centers for Medicare and Medicaid Services confirms that the current Senate health bill breaks this promise. Seventeen million Americans will be forced out of their existing health insurance. Worse, the CMS explains that continued Medicare cuts will encourage more doctors to stop seeing Medicare patients entirely, and the 18 million people added to Medicaid will also make it next to impossible for those already on Medicaid to find a doctor who will treat them.

No Tax Hikes for People Making Less than $250,000: On February 24, 2009, President Barack Obama promised the American people: “if your family earns less than $250,000 a year, you will not see your taxes increased a single dime. I repeat: not one single dime.” Speaker Pelosi believes the Senate bill’s excise tax on insurance plans breaks this promise, and she is right. But it is not the only way that Obamacare shatters the President’s no-middle-class-tax-hike pledge. There are a slew of new taxes in the Senate bill, many of which will hit the middle class, including taxes on medical devices, tanning beds, insurance user fees, and brand name drugs (not to mention the individual mandate which is enforced by a tax or the employer mandate which kills jobs and punishes the poor).

Your Health Premiums Will Be $2,500 Lower: On October 15, 2008, then-Sen. Barack Obama (D-IL) promised the American people: “The only thing we’re going to try to do is lower costs so that those cost savings are passed onto you. And we estimate we can cut the average family’s premium by about $2,500 per year.” According to the Congressional Budget Office, Americans in large-group employer-sponsored plans would, on average, see their premiums remain flat, while individuals who purchase insurance in the non-group market would see much higher premiums in 2016 under Obamacare than they would under current law. And many believe those estimates are optimistic. According to the Lewin Group, once fully implemented, health care spending per worker will increase for all employers who do not currently offer coverage — $316 per worker under the Senate bill and $800 increase per worker under the House bill.

Health Reform Reduces the Deficit: On September 10, 2009, President Barack Obama promised the American people: “I will not sign a plan that adds one dime to our deficits – either now or in the future. Period.” Even the President’s most ardent supporters are now admitting the Senate bill is full of budget gimmicks to make it appear Obamacare will reduce the deficit. When the true cost of Obamacare is considered, the final tab comes to $2.5 trillion with an honest accounting of Medicare reimbursement rates netting a $765 billion deficit all by itself.

Tax Payer Funded Abortion: On September 10, 2009, President Barack Obama promised the American people: “No federal dollars will be used to fund abortions.” While the House bill’s Stupak amendment language fulfills this promise, the Senate’s Nelson compromise does not. If the Senate language were to become law, it would overturn the precedent set by the Hyde Amendment, the FEHBP (Federal Employees Health Benefits Plan), Military insurance through TRICARE, and the Indian Health Service. Your taxdollars most definitely would be paying for elective abortions.

No one expects a President to fulfill 100% of his promises. But when the failures to live up to your past pledges pile so high, it shouldn’t be any surprise that the American people have turned so strongly against President Obama’s health care plan.

What to expect when congress returns

Filed under: Uncategorized — rrroark @ 1:20 pm

On Christmas Eve, the Senate passed its health reform bill. The House had passed a very different version in November. The next step in the process, then, is for representatives from the Senate and from the House to get together and put together a third and final bill. They can do that by creating an entirely new bill, or by amending one of the bills already passed. That final bill will not be amendable by either chamber, so it must be a compromise that’s acceptable to the majority in both.

These negotiations between the House and Senate can take one of two forms. A formal conference committee could be appointed by Senate and House leaders, or negotiations could be more informal – a “ping-pong” process, where the conversation is an on-going back-and-forth between leaders of the two chambers as they work out the differences in their bills.

It’s generally known in the Capitol that the ping-pong approach will be used this time, although House leaders haven’t confirmed that’s true and may not until after a discussion with the entire Democratic caucus on Thursday. But informal discussions have already begun.

This informal approach has several advantages for Democrats: First, Republicans can be left out of the negotiations (both parties must play a role in formal conference committees). Second, the process will go faster (there are fewer procedural hurdles to overcome and fewer opportunities for opponents to slow things down). And third, there is less public scrutiny of what’s going on (by the rules, a formal conference committee must have at least one open meeting).

Meetings can be face-to-face or by phone. Likely participants are House Speaker Nancy Pelosi, House Majority Leader Steny Hoyer and Senate Majority Leader Harry Reid, plus the chairmen of the committees that have jurisdiction over health reform: Max Baucus (Senate Finance), Christopher Dodd (Senate Health, Education, Labor and Pensions), Charles Rangel (House Ways and Means), Henry Waxman (House Energy and Commerce) and George Miller (Education and Labor) – and, of course, members of their staffs.

Republicans are opposed to any approach outside of a formal conference committee. “Something as critical as the Democrats’ health care bill…shouldn’t be slapped together in a shady backroom deal,” said a spokesman for House Minority Leader John Boehner. “Skipping a real, open conference shuts out the American people and breaks one of President Obama’s signature campaign promises.”

Of course, one reason Democrats want to use the informal approach is that Republicans have signaled their intent to try to block the bill. As Senate Minority Leader Mitch McConnell said in a floor speech just before the Senate passed its bill on Christmas Eve, “This fight isn’t over. My colleagues and I will work to stop this bill from becoming law.”

As a senior Senate staffer told a writer for The New Republic, “I think the Republicans have made our decision for us. It’s time for a little ping-pong.”

Senate leaders have not yet returned from their Christmas break, but House leaders are in Washington and met Tuesday afternoon to discuss the bills. Tuesday evening they met with the President. At the Democratic caucus meeting on Thursday, priorities – as well as process – will be discussed.

Significant differences in the bills include emotional issues like the intersection of health reform with abortion and immigration; financial issues like how to pay for reforms; and whether there should be a public plan competing with private health plans. Another difference is in the size of the cuts to Medicare Advantage: $170 billion over 10 years in the House bill, $118 billion in the Senate version.

Because there wasn’t a single extra vote to spare in the Senate – and because some senators, including Joe Lieberman of Connecticut and Ben Nelson of Nebraska, were adamant that they would not vote for a final bill that differed significantly from the one the Senate passed – it is believed that the final bill will look a lot like the Senate version.

Again, Senate Majority Leader Reid will need 60 votes to end debate, so negotiations will be tricky. They are expected to go into high gear next week, when Senate leaders return. The goal is to have a final bill before the President’s State of the Union address in February.

A new analysis written by economists at the federal agency that oversees Medicare and Medicaid and published in Health Affairs says that health care spending in the U.S. was $2.3 trillion in 2008 – $7,681 per person. That represented 16.2 percent of the gross domestic product – up from 15.9 percent in 2007.

The rate of spending growth, however, was 4.4 percent – the slowest rate of growth for the last 48 years (down from 6 percent in 2007). This deceleration was experienced broadly – by nearly all payers and for nearly all health care goods and services. For example, health spending by household slowed to an increase of 4.3 percent. But spending still grew faster than the economy as a whole. Because of the recession, the report said, real GDP growth in 2008 was just .4 percent.

“This report contains some welcome news and yet another warning sign,” said Jonathan Blum of the Centers for Medicare and Medicaid Services. “Health care spending as a percentage of GDP is rising at an unsustainable rate. It is clear that we need health insurance reform now.”

Rep. Dave Camp, R-Mich., the ranking Republican member of the House Ways and Means Committee, responded, “I agree we need reform, but both the House and Senate Democrat bills make the problem worse by increasing the cost of health care. They spend $1 trillion we don’t have and bend the curve the wrong way.”

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