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| 11/13/2009 9:02:00 AM | Email this article • Print this article |
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| Rep. David Obey |
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| Rep. Steve Kagen |
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Kagen, Obey help pass groundbreaking health care bill
Kagen backs federally funded abortions
News Analysis
Two area Congressmen, 8th District U.S. Rep. Steve Kagen (D-Appleton) and 7th District Rep. Dave Obey (D-Wausau) were among six Wisconsin representatives to cast ballots for far-reaching health care legislation the U.S. House of Representatives narrowly passed last weekend.
The vote was 220-215 in favor of the bill, the most sweeping renovation of the nation's medical system since Medicare. Others voting for the legislation were Reps. Tammy Baldwin, Ron Kind, and Gwen Moore, all Democrats; GOP Reps. Paul Ryan, James Sensenbrenner, and Tom Petri opposed it.
Afterward, Obey hailed the vote as a "landmark day," according to media reports, while Kagen was similarly dramatic.
"Tonight, we have taken a bold step forward toward securing the health and safety of all of our families," Kagen said. "Working together, we are beginning to fix what is broken in our health care delivery system, guaranteeing that no family will lose their home or need to hold a bake sale just to pay for life-saving treatment."
The lawmaker said the bill, if enacted, would increase the number of primary care physicians, secure continued coverage for workers who have lost their jobs, provide immediate help for the uninsured, and expand community health centers.
Republicans were far less effusive. Ryan said the bill would ultimately restrict individual choice, increase the nation's debt and deficit, take coverage away from seniors, raise premiums for families, and decrease health care innovation.
"But what is worse is this bill replaces the American Idea with a European-style social welfare state," Ryan said on the Senate floor. "This bill - more than any other decision we are going to make in this body - will lead to millions of Americans becoming dependent on the state rather than being dependent upon themselves. This is not about health care policy - if it were, we could pass a bipartisan bill to fix what's broken in health care without breaking what's working in health care. This is about ideology."
In general terms, the legislation aims to extend health insurance coverage to approximately 36 million Americans who are not now covered. The most important component toward that goal would be a new government-run insurance plan, called the public option, which would compete with private insurance companies in a newly created health care exchange, a marketplace of sorts where those without insurance can shop for coverage.
The legislation would also require all Americans to buy health insurance if they are not covered by an employer-based policy - subsidies would flow to those who cannot afford it - and it would prohibit insurance companies from denying coverage because of a pre-existing condition. Caps would be placed on out-of-pocket expenses, and no co-pays would be required for preventive care.
The cost, estimated at $1.055 trillion over 10 years, would be covered by a 5.4 percent surtax on the top 0.3 percent of earners - those with incomes above $500,000 year - and by vast cuts in Medicare Advantage programs.
Abortion, public option
The prime architect of the House bill, House speaker Nancy Pelosi, very nearly did not get her victory and secured her five-vote margin by compromising with conservative Democrats on abortion.
Specifically, on a 240-194 vote, the House adopted the Stupak-Pitts amendment, which blocks anyone who gets federal insurance premium subsidies from purchasing private policies that cover abortions and which permanently eliminates elective abortion coverage from the public option.
In both instances, abortion to save the life of the mother or in cases of incest or rape would be covered.
Kagen voted against the amendment and for federally funded abortions, along with Baldwin, Moore and Kind. Voting for the amendment and against federally funded abortions were Obey, Petri, Ryan and Sensenbrenner.
As the bill heads to the Senate, the other controversial provision is the so-called public option, which would compete with private insurers in a new Health Insurance Exchange, in which those without employer-based insurance and lacking Medicare or Medicaid could comparison shop for a health plan.
All of the exchange plans would have to meet minimum standards, though those standards could range in classification from catastrophic to comprehensive.
Democratic supporters say a public option is critical to true reform because the availability of a government policy will force private companies to compete honestly. The result, they say, would be adequate coverage at a lower cost for all.
Republican critics say it pushes the nation down the slippery slope toward a completely government-run, single-payer health care system. Because it would be nonprofit, critics say, it would be able to offer the same coverage as private companies at a lower cost, ultimately driving those companies out of business and leaving the government as the only insurer.
Who's right?
Neither side, actually, according to a late October CBO analysis of the House bill. Public-option premiums would likely be higher than those offered by private insurance companies, the report stated, and would attract only about 6 million enrollees as a result.
"That estimate of enrollment reflects CBO's assessment that a public plan paying negotiated rates would attract a broad network of providers but would typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges," the report states. "The rates the public plan pays to providers would, on average, probably be comparable to the rates paid by private insurers participating in the exchanges. The public plan would have lower administrative costs than those private plans but would probably engage in less management of utilization by its enrollees and attract a less healthy pool of enrollees."
In effect, because the legislation would negotiate payments with medical providers rather than aligning payment rates with those of Medicare, as Pelosi wanted, the payments and thus the premiums are likely to be higher.
That undercuts both the liberal argument that a public option would provide a more affordable insurance option and the conservative argument that it would drive everyone to the government plan.
Still, the CBO analysis is guesswork - in July it estimated public-option premiums would be 10 percent lower than comparable private premiums - so it is unknown what actual costs might be. In addition, conservatives fear government will force premiums lower, as a matter of policy, no matter the payment costs.
Heading to the Senate
The House version now heads to the Senate, where it will face tough sledding. Indeed, Senate passage of a health care bill, while still likely in some form, might not happen this year.
Connecticut independent Sen. Joe Lieberman has told Fox News he could not support a bill that includes the public option "as a matter of conscience" and would not allow such a bill to come to a vote.
Republican Sen. Lindsey Graham of South Carolina told CBS News the House bill was "dead on arrival" in the Senate. Senate Majority Leader Harry Reid of Nevada has yet to schedule a floor debate.
Senate moderates and conservatives opposed to the bill, or to segments of it, will have an easier time derailing the legislation in the Senate because, unlike in the House, where the majority prevails, the threat of a filibuster means 60 votes are needed - the number required to invoke cloture and cut off debate.
If the deal killer is the public option, a compromise on that issue in the Senate, as the House did on abortion, could be in order, and already alternatives are making the rounds.
One idea, proffered by Republican Sen. Olympia Snowe of Maine, is to allow a government plan as a last resort, to be triggered if premiums keep rising and insurance coverage does not expand. Reid himself has floated a plan to include the public option but allow individual states to opt out of it.
The CBO is working on a cost and coverage estimate of Reid's proposal.
Besides the public-option controversy, there are other differences between the bill passed by the House and pending Senate legislation. The House bill, for instance, requires employers with a $500,000 payroll to provide coverage, while the Senate is more lenient, requiring employers with 50 or more employees to provide coverage.
The Senate version would also pay for the bill's cost with multiple taxes and fees, including a tax on high-cost insurance plans, rather than relying on Medicare cuts and a tax on the highest income earners, as the House does.
The Senate plan would also be cheaper - not quite $900 billion over 10 years, compared to $1.05 trillion for the House plan.
Richard Moore can be reached at rmmoore1@verizon.net.
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Reader Comments
Posted: Friday, November 13, 2009
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Thank ror information
Posted: Friday, November 13, 2009
Article comment by:
jacksmith
Urgent!! Robert Reich on your healthcare http://bit.ly/SAQ7a
Why A Strong Public Option Is Essential - By jacksmith - Working Class
Robert Reich explains the pubic option: http://bit.ly/dDYSJ
Hollywood Supports The Public Option :-) http://bit.ly/3XLwPi
Beautiful HEATHER GRAHAM http://bit.ly/12sRYD :-)
It's not just because more than two thirds of the American people want a single payer health care system. And if they cant have a single payer system 77% of all Americans want a strong government-run public option on day one (86% of democrats, 75% of independents, and 72% republicans). Basically everyone.
It's not just because according to a new AARP POLL: 86 percent of seniors want universal healthcare security for All, including 93% of Democrats, 87% of Independents, and 78% of Republicans. With 79% of seniors supporting creating a new strong Government-run public option plan, available immediately. Including 89% of Democrats, 80% of Independents, and 61% of Republicans, STUNNING!!
It's not just because it will lower cost. Because a strong public option will dramatically lower cost for everyone. And dramatically improved the quality of care everyone receives in America and around the World. Rich, middle class, and poor a like.
It's not just because it will save trillions of dollars and prevent the needless deaths of millions more of YOU, caused by a rush to profit by the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX!
It's not just because every expert in every field, including economist, and Nobel laureates all agree that free market based healthcare systems don't work. Never have and never will. The US has the only truly free market based healthcare system in the World. And as you all know now, IT IS A DISASTER!
It's not just because providing or denying medically necessary care for profit motivations is wrong. Because it is WRONG! It's professionally, ethically, and morally REPUGNANT!, Animalistic, VILE and EVIL.
THE REASON THE PUBLIC OPTION IS ESSENTIAL:
The public option is ESSENTIAL because over 200 million of you are trapped in the forest of the wolves. Which is the forest of the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX! With no way out except through needless inhumane suffering, and DEATH. While the wolves tear at your flesh, and rip you limb from lib. Then feast on your lifeless bodies like a dead carcase for transplant parts.
At the most vulnerable times of your lives (when you were sick and hurting), millions of you have had to fight and loose cruel, but heroic battles. Fighting against the big guns of the DISGRACEFUL, GREED DRIVEN, PRIVATE FOR PROFIT MEDICAL INDUSTRIAL COMPLEX! in the forest of the wolves. All because you have no place else to go. You have no other CHOICE!
But the PUBLIC OPTION will give you someplace safe to go. And it will give us someplace safe to take you. The public option will be your refugium (your refuge). Where the wolves cannot get at you when your down, hurting, and vulnerable. Where everyone who needs it can find rest, security, comfort and the care they need. Protected by the BIG GUNS of We The People Of The United States. THE MOST POWERFUL PEOPLE AND COUNTRY ON EARTH.
This is why it is so critical that we do not lead another 50 million vulnerable, uninsured Americans into the forest of the wolves, without the protections of a Strong Government-run MEDICARE like public option. We The People Of The United States MUST NOT LET THAT HAPPEN to any more of our fellow Americans. If healthcare reform does not contain a strong MEDICARE like public option on day one. YOU MUST! KILL IT. Or you will do far more harm than good. And millions more will die needlessly. Rich, middle class, and poor a like.
To those who would continue to obstruct good and true healthcare reform for the American people, and who seek to trap millions more vulnerable Americans in the forest of the wolves. We will continue to fight you. We are prepared to wage all out war against you, and will eagerly DESTROY! you. Time...is...UP! YOU HAVE BEEN WARNED! No Co-op's! No Triggers! NO INDIVIDUAL MANDATES! without a Strong MEDICARE like public option on day one.
Healthcare reform can be the GREATEST! Accomplishment of our time and century. A time when future generations may say of us, that we were all, AMERICAS GREATEST GENERATIONS.
BUT WE MUST ACT!
I therefore call on all my fellow Americans and the peoples of the World. To join us in this fight so that we may finish becoming the better America that we aspire to be for everyone.
SPREAD THE WORD!
I have been privileged to be witness as many of you fought, and struggled to take your first breath, and your last breath on this earth. Rich, middle class, and poor a like. Life is precious.
Whatever the cost. WE! MUST SUCCEED.
God Bless You My Fellow Human Beings
jacksmith - Working Class
ATTENTION!! Congress Has The Votes Needed To Pass A Public Option - TODAY http://bit.ly/TCq7O
Things You Can Do To Help NOW! http://www.everydaycitizen.com/2009/09/tired_of_watching_people_die_n.html
A majority of voters would rather have a Democrats only bill with a Public Option. Than a bipartisan bill without a Public Option.
A state based insurance plan is NOT!! a Public Option. Nor is it a Strong, National, Medicare like Public Option.
No Triggers! http://www.huffingtonpost.com/jason-rosenbaum/a-trigger-for-the-public_b_277910.html
Triggers http://www.huffingtonpost.com/david-sirota/weve-seen-these-triggers_b_283583.html
Krugman on heathcare (http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/)
Senator Bernie Sanders on healthcare (http://www.youtube.com/watch?v=RSM8t_cLZgk&feature=player_embedded)
John Garamendi on the Public Option and the Grassroots: http://bit.ly/TJMty
Howard Dean on the Public Option http://www.youtube.com/watch?v=8SKfW2dUnow&feature=player_embedded
We're Number 37! in quality of health care http://www.youtube.com/watch?v=yVgOl3cETb4&feature=player_embedded
Twitter search (#welovethenhs #NHS #hc09 #hcr #healthcar #obama #p2 #topprog #) Check it out.
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