The politics and economics of healthcare -
in this Washington and that one
As the vote on healthcare reform in the House draws near, both caucuses are looking to nail down votes. House Minority Whip Eric Cantor (R-VA) has vowed to ensure that all House Republicans vote against the bill, leaving the passage of the bill up to the 258 House Democrats.
Pelosi and the Democrats have yet to ensure the 218 votes necessary to pass the bill. Some moderate Democrats have already come out opposed to the bill, and some of them remain undecided due to language regarding public funding of abortion and limited coverage for undocumented immigrants.
The House is scheduled to vote on the healthcare reform bill tomorrow – we will have to wait and see whether the Democrats will pass the bill, or if there will be a bi-partisan defeat.
Below is a statement from Representative Rick Larsen’s (D-2nd) Chief of Staff Kim Johnston, received via email by The Bellingham Herald:
After reading the section of the bill containing the public option, Rep. Larsen has come to the conclusion that he supports the public option in this bill. This new public option will work for Washington state. In the original bill (H.R. 3200) payment rates in the public option would have been based on Medicare, which would have shortchanged Washington state. But the payment rates in this new public option (H.R. 3962) will be negotiated between doctors and the Secretary of Health and Human Services. This will ensure that doctors and hospitals are paid closer to market rates. Paying doctors fair market rates will ensure that they are able to accept patients covered by the public plan.
Rep. Larsen has also said that he believes any public option must compete under a “level playing field” with the private health insurance market. The public option in this bill will do just that: it will be subject to the same rules that private insurance plans are subject to, and it will not be subsidized by the government.
Representative Larsen previously stated he was likely to support the bill, but wanted to read it before making further comments.
The Politico published a piece this morning, summarizing which members of the House and Senate will have the most say regarding the fate of healthcare reform. This article does a great job of not only identifying “who’s who” in the healthcare debate, but also shows how just a handful of legislators can determine the outcome of important legislation.
Last week, I wrote about Sen. Joe Lieberman’s (I-CT) opposition to the public option – here’s what the Politico article had to say about it:
Lieberman’s pledge last week to vote against any bill with a government insurance option sent a reminder — as if one were needed — that any single senator has the power to cast passage of health care legislation into doubt. As long as Reid sticks to his 60-vote strategy, the majority leader will need to meet an endless list of demands from his Democratic Caucus. Lieberman was just the latest wild card. Indeed, Sen. Roland Burris (D-Ill.) has threatened to oppose any bill that lacks a public option.
Read the entire article here.
One of the significant criticisms of the Senate Finance healthcare reform bill is the tab. According to the nonpartisan Congressional Budget Office (CBO), the bill will cost $829 billion, increase federal spending on healthcare by $85 billion over the next decade, and reduce the federal deficit by $81 billion over the next decade.
There is a balancing act that takes place when dealing with 1/7 of the federal budget, which is what the United States spends on healthcare. By spending money in ways that will reduce costs in the long-term, the budget deficit can be reduced. This is especially true when considering the costs of healthcare are increasing faster than inflation based on the Consumer Price Index, and many of the reforms reign that in.
The CBO projects the new House bill, which will cost $1.055 trillion, will increase federal spending on healthcare by almost $600 billion while reducing the deficit by $104 billion over the next decade.
Breaking down some of these numbers can get more complicated. The Senate Finance bill will cost $829 billion, but reducing spending on Medicare and Medicaid and creating a 40% tax on expensive, employer-based health insurance plans combine to reduce the total cost by over $600 billion.
According to the Washington Post, “Other tax changes that serve to reduce tax breaks for health care would produce another $138 billion.” And that is how the CBO reaches the $85 billion projection.
The House bill does not include taxes on high-cost, employer-based plans, which means it increases federal spending on healthcare by seven times as much as the Senate Finance bill at $598 billion versus $85 billion.
James C. Capretta, of the conservative magazine National Review, wrote a piece last night responding to the House healthcare bill, saying that the bill is “a total fiscal and health policy disaster.”
Capretta claims that the bill attempts to mislead the public into thinking that the bill is worth less than $1 trillion by ignoring the repeal of the sustainable growth rate (SGR) formula. Capretta also objects to the increase in Medicaid eligibility from 133% of the federal poverty line to 150%, due to the increase in taxes that will be incurred from this. In effect, Capretta says that the bill plays into the continuing liberal attempt to increase the size and scope of the federal government:
To sum it up, the House bill is nothing but a massive, uncontrolled federal entitlement expansion — at a time when the central, looming threat to the nation’s long-term prosperity is the unaffordable health-care entitlements already on the federal books.
Rep. Mike Pence (R-IN)
Capretta’s article comes after the House Republican Conference Chair, Rep. Mike Pence (R-IN), said in an interview with CNN that the House healthcare bill “really is a government takeover of health care in America.” House Minority Leader John Boehner (R-OH) and House Minority WHIP Roy Blunt (R-MO) expressed similar concerns toward an expansion of government involvement in healthcare.
There seems to be a consensus among conservatives in opposition to the House healthcare bill, citing their fundamental opposition to increasing the reach of the federal government. And, it is true that this bill will increase the scope of federal oversight in healthcare – but, as Evan McMorris-Santoro at Talking Points Memo points out, Republicans (and specifically conservative Republicans) have yet to offer any alternative. Rep. Pence did say that he would like to see bipartisan efforts to cover those with preexisting conditions – beyond that we have heard almost no alternative ideas from the right, just opposition.
We will have to wait and see if liberals, moderates, and conservatives in Congress will work out a compromise bill as negotiations unfold.
After months of deliberations, the House Democrats have put together a healthcare bill that looks to bring real reform to the system. The bill is set to be formally announced on Thursday morning.
After months of talk on health care reform, many want to know what the substance of the bill is. The AP has the story:
The final product in the House, reflecting many of President Barack Obama’s priorities, includes new requirements for employers to offer insurance to their workers or face penalties, fines on Americans who don’t purchase coverage and subsidies to help lower-income people do so. Insurance companies would face new prohibitions against charging much more to older people or denying coverage to people with health conditions.
The price tag, topping $1 trillion over 10 years, would be paid for by taxing high-income people and cutting some $500 billion in payments to Medicare providers. The legislation would extend health coverage to around 95 percent of Americans.
Members of Congress hope to have the bill completed by November 11th, bringing healthcare reform a step closer.
The Democrat-turned-Independent Senator Joe Lieberman (I-CT) has announced his opposition to current Senate healthcare legislation and will join Senate Republicans in stopping a final vote on the legislation.
Lieberman, a Connecticut independent who caucuses with the Democrats, told reporters Tuesday that he would vote in favor of a procedural motion allowing debate of the bill. But he said that, unless the bill changes substantially, he would vote with Senate Republicans against a motion to allow a vote on final passage of the bill.
His opposition to the bill centers around its inclusion of a government-run health insurance plan that states could choose not to carry. Senate Majority Leader Harry Reid, (D., Nev.) announced Monday that he intended to include a public plan in Senate health-care legislation.
“I think that a lot of people may think that the public option is free. It’s not,” Lieberman said. “It’s going to cost the taxpayers and people that have health insurance now, and if it doesn’t, it’s going to add terribly to our national debt.”
Reid will need 60 senators to vote in favor of a motion to move to a vote on final passage to avoid a Republican filibuster. While there are 60 senators who are part of the Democratic caucus, including Lieberman, several moderate senators have expressed ambivalence about including a public option in the legislation.
Today Senator Max Baucus (D-MT), Chair of the Senate Finance Committee, released the first draft of that committee’s long-awaited healthcare reform bill.
You can read the entire draft of the bill here.
If you do not want to read the 223 page draft of the bill, read Baucus’ 18 page “Framework for Comprehensive Health Reform.”