Politics or Poppycock A Look From the Left At Politics, Politicians, Policies and Issues of National Concern

Strongest Public Option Short of 218 House Majority
House health care bill unveiled today. Cuts deficit, but includes weaker version of public option. W. Post: “The House legislation aims to provide health insurance of one form or another to almost all Americans at an expected cost just below $900 billion over 10 years, without increasing the federal budget deficit for at least 20 years, House Democrats said … Lacking the votes to pass it, House leaders abandoned an effort to include a public option backed by liberals that would establish reimbursement rates to providers based on Medicare … Instead, Pelosi is expected to offer a more moderate alternative in which rates would be negotiated between providers and federal health officials, similar to the way in which private insurance operates.”

NYT reports the bill will include a “millionaires’ tax”: “The cost would be offset by new taxes and by cutbacks in Medicare, so the bill would not increase the federal budget deficit in the next 10 years or in the decade after that. The new bill, like an earlier version, retains a surtax on high-income people, but increases the thresholds. The tax would hit married couples with adjusted gross incomes exceeding $1 million a year and individuals over $500,000 — just three-tenths of 1 percent of all households, Democrats said. Ms. Pelosi can describe the proposal as a ‘millionaires’ tax.’”

LA Times notes it will cover more people than the Baucus bill: “…after 10 years, it will boost those covered by about 35 million people, according to estimates from the nonpartisan Congressional Budget Office. That is substantially more than the more conservative bill approved by the Senate Finance Committee this month, which would have dropped the number of uninsured by 29 million.”

Politico questions if CBO will say the second decade is deficit neutral: “The CBO analysis will show that the bill runs surpluses in the first five years and deficits in the second, making it deficit neutral during the first decade. BUT those late decade deficits were raising questions about whether the CBO will be able to declare the second 10 years deficit neutral.”

HCAN flags Raleigh News & Observer report on Blue Cross and Blue Shield raising premiums while complaining about unfair competition from public option: “many customers of Blue Cross and Blue Shield of North Carolina are ticked off at the mail they’ve received recently from the state’s largest insurer. First, they learned their rates will rise by an average of 11 percent next year. Next, they opened a slick flier from the insurer urging them to send an enclosed pre-printed, postage-paid note to Sen. Kay Hagan denouncing what the company says is unfair competition that would be imposed by a government-backed insurance plan.”

Republican senators sad business lobbies don’t hate reform as much as they do. The Hill: “[Sen. Kyl] said some industries have sat on the sidelines and ‘some folks that have made some kind of a deal and may live to regret it.’”

FireDogLake challenges Sen. Blanche Lincoln: “If her opposition to a government run insurance program is truly philosophical and not just politically convenient, I look forward to all those Committee hearings on how the government can’t continue to insure Big Ag’s profits.”

Reid’s bill still needs CBO scoring on new insurance tax, “free rider” thresholds. CQ:
The bill makes an important change to a significant revenue-raiser borrowed from the Finance Committee bill (S 1796) — an excise tax on high-cost insurance plans. It was originally written as a 40 percent tax on plans costing $21,000 per year for a family, indexed to inflation plus 1 percent. Reid, D-Nev., has raised that figure to $23,000, with the same growth rate of inflation plus 1 percent. The result will be less revenue raised by the tax, which will likely have to be made up elsewhere.
Reid’s bill has been sent to the Congressional Budget Office (CBO) to be scored, but with several policy options that are still being negotiated.
One option under consideration is a fine on employers whose workers get government subsidies to buy health insurance instead of getting coverage through the workplace … The fine would be $750 for every worker. For a 100-person company, if some workers got the subsidized coverage, the employer could pay $75,000 in fines. In the original Finance bill, the penalty was either $400 per employee or the average cost of the subsidies that were going to workers in the company, whichever was smaller. Companies with fewer than 50 employees are exempt in the Finance bill…
…A lobbyist for the American Federation of State, County and Municipal Employees, Chuck Loveless, said union groups would keep pushing Reid to get rid of the tax on high-cost insurance plans, something they argue will be passed on to workers through higher premiums. “Our goal right now is to eliminate the excise tax from the bill,” Loveless said. “It’s still not adequate from our point of view, but it is an improvement,” he said of the changes. “We commend the leader for the effort he has made.”
Reid’s legislation probably will not be unveiled until the CBO scoring is complete. “That could take four days, and it could take two weeks,” Democratic Caucus Vice Chairman Charles E. Schumer of New York said Wednesday. “No one knows.”

House Hearings Today On Too-Big-To-Fail Bill
AFL-CIO to oppose House bill, reports OurFuture.org’s Mike Elk. “In an advance copy of AFL-CIO President Richard Trumka’s prepared [House] testimony that I obtained, Trumka will tesify that: ‘The discussion draft would appear to give power to the Federal Reserve to preempt a wide range of rules regulating the capital markets – power which could be used to gut investor and consumer protections … We are also deeply troubled by provision in the discussion that would allow the Federal Reserve to use taxpayer funds to rescue failing banks, and then bill other non-failing banks for the costs.’”

New Deal 2.0′s Joshua Rosner argues the bill not aggressive in preventing meltdowns: “The House draft bill written by Rep. Barney Frank (D – MA) – along with several former Fed attorneys and Treasury staff and consultants — ignores fundamental reality: You don’t employ a bomb squad to sit around and wait for a bomb to explode, you engage them to dismantle it as soon as they find one … An honest bill would recognize that any institution that is ‘Too Big to Fail’ should be given economic ‘incentives’ (through prohibitively high capital levels and insurance assessments) to shrink or sell off business units.”

Naked Capitalism not pleased: “Government Is Trying to Make Bailouts for the Giant Banks PERMANENT”

CQ reports Rep. Frank is putting some limits on Fed power, but not necessarily enough to satisfy critics: “The legislation … would create a Financial Services Oversight Council to determine which firms could pose a threat to the economy, rather than leaving the decision entirely up to the Fed … The central bank would still wield plenty of authority under the legislation. The council would hold the broad power of designating threats, but the Fed would have the ability to take drastic action against firms it deems systemically risky and critically undercapitalized. Among the Fed’s options would be firing and replacing boards of directors and senior executives and forcing the divestiture of financial institutions. The central bank also would be able to approve or deny mergers and acquisitions by identified institutions and would have the power to restrict their growth.”

Rep. Maloney backing off of her weakening amendment, HuffPost’s Shahien Nasiripour reports: “Rep. Carolyn Maloney, of New York, originally proposed that firms with market capitalization less than $75 million be exempt from a provision of the Sarbanes-Oxley Act … [now she is[ instead [calling] for a study of the costs of complying with the already-existing provision, and delaying its planned implementation by a year.”

HuffPost’s Tom Edsall reports on new poll showing great concern that policies favor Wall Street: “A paltry 13 percent of those interviewed for the September 2009 survey said that the average Joe and Jill have been ‘helped a lot or a fair amount’ — compared to 65 percent who think regular folks have gotten little or no assistance from the government. Fully 54 percent of respondents said Wall Street investment companies have been helped – and nearly two-thirds said the large banks have been taken care of.”

Alternet.org
By Joshua Holland, AlterNet. Posted August 18, 2009.

We are at a crucial moment in the health care debate — Obama needs pressure from all of us to keep the public option as part of his agenda.

Editor’s note: It’s now or never for the public option. Campaign for America’s Future has put together 4 key actions you can take to win back the health care debate. “We absolutely cannot let the far right fringe do the bidding of the insurance and drug lobbies and hijack the debate,” they write. “The battle for health care reform has moved to town halls during the August congressional recess. But the wild mobs disrupting events, intimidating lawmakers, and shouting down reform are not just expressing their views, they are doing the dirty work for corporate interests that want to cut the heart out of the Obama health plan.”As Joshua Holland explained in a recent article, this fight is about making your health care more affordable, giving you better coverage and helping people who have no coverage under the current system.

Now or never — Push for the public option:

1. Call your representative and senators to find out when and where August town halls will be in your area, using the main congressional switchboard number: (202) 224-3121. You can also check this calendar.

2. Go to the Congress.org congressional directory to get the direct phone lines of your representatives’ offices.

3. Find out when and where citizen groups will be meeting and organizing throughout August, and find out what’s happening in your area at Health Care for America Now.

4. When you’re at a town hall, communicate a simple message for your representatives to understand what their constituents want:

• I support health care reform with a strong public plan option—and most people I know do, too.
• We sent you to Washington to get health care for all—and we will support you if you work to get that done.
• Please ignore the right-wing extremists who are attacking health reform—and do what a majority of your constituents want: Vote for health care for all.

It’s Now or Never for a Public Option: Why We Need to Take a Stand Against to the Insurance Industry’s Greed

by Joshua Holland
The Obama administration took a single-payer solution to America’s health care crisis “off the table” at the outset of the debate. Since then it has cut dubious “deals” with Big Pharma and the private hospital industry. And finally, this weekend, officials signaled that the Obama team might be willing to jettison the central progressive plank of reform: the creation of a publicly run insurance program that could compete with private insurers.
On CNN, Health and Human Services Secretary Kathleen Sebelius said the public option wasn’t “the essential element” of reform, and at a town hall in Colorado on Saturday, President Barack Obama himself said of the public option: “whether we have it or we don’t have it, [it] is not the entirety of health care reform. This is just one sliver of it, one aspect of it.”
It may be just one “aspect” of health reform, but without it, the legislation promises to be a massive rip-off; a taxpayer give-away of hundreds of billions of dollars to an unreformed ‘disease care’ industry. Continue reading »

HEALTH CARE

Beyond The Public Option
Tonight, ABC News will host “Prescription for America,” a discussion with President Obama about his plans to reform the health care system. Critics have charged that Obama’s proposal to enact a new public health insurance plan to compete directly with private insurers would lead to a “government takeover” of the health care system. During yesterday’s White House news conference, Obama defended the plan, but stopped short of calling it “non-negotiable.” “If private insurers say that the marketplace provides the best quality health care, if they tell us that they’re offering a good deal, then why is it that the government, which they say can’t run anything, suddenly is going to drive them out of business? That’s not logical,” the President said. Progressives have long argued that a public health insurance option is essential to controlling skyrocketing health care costs and expanding the choice of coverage. Moreover, a recent CBS News/New York Times poll found that “a clear majority of Americans — 72 percent — support a government-sponsored health care plan to compete with private insurers.” The Tri-Committee health care reform legislation in the House includes a robust public option and the Senate’s Health, Education, Labor and Pensions (HELP) Committee bill is expected to include a similar provision. Sens. Chuck Schumer (D-NY), Dick Durbin (D-IL), and Patrick Leahy (D-VT) have started Citizens for a REAL Health Care Reform and a Public Option, a petition in support of a public health insurance plan. But while a public option is certainly an essential element of health care reform, any overhaul of the health care system must also include a host of other progressive reforms, including robust affordability standards, shared responsibility principles, and payment reform.

ENSURING AFFORDABILITY: Health reform that fails to make insurance more affordable is at best an incremental improvement. The problem of affordability is most apparent for the nearly 47 million Americans who lack health insurance. The Agency for Healthcare Research and Quality found that while “15.8 percent of adults spent more than 10 percent of their family income on health care services in 1996, by 2003 the proportion of adults bearing what has historically been considered catastrophic financial burdens had increased to 19.2 percent of the population, or 48.8 million individuals.” According to the Center for Studying Health System Change, one in five Americans had trouble paying their health care bills in 2007. In fact, even moderate levels of out-of-pocket spending — spending that is well below the 5 or 10 percent of family income — created difficult financial hurdles. Health care reform must expand safety net programs like Medicaid and the State Children’s Health Insurance Program (SCHIP) for low-income families and provide help with premiums for middle-class families. While both the House and Senate health care proposals provide subsidies to families on a sliding scale of income up to nearly 400 percent of the federal poverty level (FPL), Karen Pollitz, a professor at the Georgetown University Health Policy Institute, insists that health reform must also include “a maximum out-of-pocket limitation” for both in network and out of network coverage. Moreover, “depending on what premiums are charged for qualified health benefit plans, subsidies capped at 400 percent of FPL may prove to be insufficient to ensure affordable health care for all Americans,” Pollitz explained in yesterday’s testimony to the House Education and Labor Committee. “The Committee might consider instead a rule that no individual or family will have to pay more than 10 percent of income on health insurance premiums….cutting subsidies off entirely at an arbitrary income level can leave families vulnerable.”

SHARED RESPONSIBILITY: Health reform must also build on the principle of “shared responsibility,” an approach that envisions “joint contributions by the public sector, individuals and employers.” While individuals should be responsible for purchasing health insurance coverage — with a waiver for those who cannot afford to do so — “firms that do not directly provide health care to their employees” should be required to pay into a public pool to help finance their employees’ coverage. As UC Berkeley Labor Center chair Ken Jacobs and Berkeley professor Jacob Hacker explain, an employer mandate enhances the existing system of employer-based coverage, levels the playing field between employers “that provide insurance and those competing with them that do not,” reduces “crowd-out of private coverage by new public programs,” and preserves the employer contribution — an important source of funding for health care reform. And while critics charge that an employer mandate to provide coverage would lead to fewer jobs or mass layoffs, especially for low-wage workers, Hacker contends that “these concerns are overstated when it comes to the play-or-pay proposals currently under consideration, with their relatively modest employer requirements.” A study of the impact of the Hawaii health care mandate, for instance, “found no evidence of reduced employment.” In Massachusetts, where employers with more than 10 employees are required to provide coverage or pay a fine, “few firms reported making changes as a result of health reform.” Moreover, “it is also important to keep in mind that health reforms with employer requirements promise new benefits for firms and workers as well as new costs,” Hacker explained in testimony to the House Education and Labor Committee. “All firms would benefit from the reduction in unpaid medical bills incurred by the uninsured. Firms would further benefit from any savings due to a reduced rate of health-care cost growth,” Hacker said.

REFORMING THE PAYMENT SYSTEM: As RAND economist Melinda Beeuwkes Buntin and Harvard University professor David Cutler explain in a new paper, to bend the curve on health care spending, we must reform the way we pay for medical services. Currently, ”the U.S. health care system, with our ‘fee-for-service’ payment system, pays for the volume and intensity of services, giving short shrift to primary care, prevention, or wellness.” Health care reform should “pay for value, not volume,” and “move us toward value-based systems that pay for entire episodes of care, stressing prevention and not just acute treatment.” Not only will these reforms improve the quality of care, but they could also lead to federal savings of about $299 billion over the next decade. In fact, payment reform that “is based on the idea that good care should be rewarded more than just more treatment…could save about 8 percent of projected spending over the next decade.” To hasten these savings, Center for American Progress experts Ellen-Marie Whelan and Judy Feder are recommending — in another report out today — allowing the Centers for Medicare and Medicaid Services (CMS) to “implement these reforms more broadly without additional legislation.”