Final Senate healthcare bill released by Reid in drive for 60

[darrels joy]

Final Senate healthcare bill released by Reid in drive for 60


By Jeffrey Young - 12/19/09 09:45 AM ET

Senate Majority Leader Harry Reid (D-Nev.) has unveiled a final version of his healthcare reform legislation containing a plethora of changes designed to lock down the 60 votes he needs to pass the historic legislation on Christmas Eve.

The so-called manager's amendment to the bill that has been on the Senate floor for weeks contains in its 383 pages new compromise language, with many of the provisions targeted to satisfy the demands of individual senators.

Reid formally introduced the legislative language on the Senate floor Saturday morning, triggering a parliamentary delay tactic by Senate Minority Leader Mitch McConnell (R-Ky.), who insisted that clerks read the entire document aloud.

Despite the delay the bill reading will cause, Reid’s gambit strongly suggests that he has united his caucus of 58 Democrats and two independents behind a measure that would extend health insurance coverage to around 30 million people and make fundamental changes to the U.S. healthcare system.

The House passed its version of the healthcare bill last month. If Reid is able to keep his 60 Democrats in hand through a vote to approve the Senate bill scheduled for 7 p.m. on Christmas Eve, he will deliver a major victory to President Barack Obama. House and Senate Democrats would then confer during the holiday break and into January on the version that would go to Obama for a signature.

The release of the manager’s amendment marks a watershed moment for Reid’s leadership during the year-long process of drafting and debating healthcare reform legislation. Democrats have been stiffly divided on several crucial issues on ideological grounds with a handful of centrists objecting to key liberal priorities such as the creation of a government-run public option insurance program.

Numerous attempts to find a compromise acceptable to both camps failed, leading Reid to pin his hopes on siding with the centrists and counting on the liberals not to walk away from a bill that still strives for their primary goal of enacting a comprehensive healthcare reform bill that provides coverage to tens of millions of uninsured people.

Reid’s most crucial political compromise was on abortion, the biggest bone of contention for centrist Sen. Ben Nelson (D-Neb.), an abortion opponent who failed in his attempt to amend the bill on the floor with stronger language shielding federal insurance subsidy funds from paying for abortion services and rejected previous compromises offered by Reid and Sen. Bob Casey Jr. (D-Pa.), who both also oppose abortion rights.

After private talks between Reid, Nelson and other Democrats that ran late into Friday night, however, Nelson signed off on the new language and other provisions that cleared the way for him to support the healthcare bill. The language is complex but the biggest change is that states would be permitted to prohibit plans sold within their borders through the health insurance exchange from covering abortion services. “I will vote for healthcare reform because it will deliver relief from rising healthcare costs to Nebraska families, workers, rural communities and employers,” Nelson said.

The early response from abortion-rights supporters was positive, as Democratic Sens. Barbara Boxer (Calif.) and Patty Murray (Wash.) issued a joint statement saying they preserved the principle that women can use their own money to purchase abortion coverage through plans on the insurance exchange. Though the senators emphasized they preferred the original abortion language in the bill, "compromise was necessary to get a healthcare bill for the American people, and this compromise achieves that."

"We said we would not accept language that prohibited a woman from using her own private funds for her legal reproductive health care -- this compromise meets that test," Boxer and Murray said.

Nelson also won a major concession on the proposed expansion of Medicaid to everyone with incomes below 133 percent of the federal poverty level. Nelson, along with governors of both political parties, expressed anxiety that the expansion would burden state budgets. Under the manager's amendment, the federal government will cover more of the cost of the expansion than under the original bill, with special additional funding for Nebraska.

"Thanks to Sen. Ben Nelson for announcing his support for the Senate health care bill, making him our 60th vote," Reid tweeted Saturday morning.


Nelson did not win every battle, however, as Reid preserved the CLASS Act language in the bill, authored by the late Sen. Edward Kennedy (D-Mass.), to create a voluntary federal insurance program for home- and community-based long-term care services.

No trace of the public option remains in the bill but Reid does offer new provisions to appeal to liberal senators, such as additional funding for Community Health Centers and the Children’s Health Insurance Program

In addition, the amendment includes even stricter health insurance regulations and consumer protections than contained in the underlying bill, such as guaranteeing patients the right to appeal coverage denials and additional limitations on year-to-year premium increases that will take effect before the insurance exchange launches in 2014.

The manager’s amendment also would require insurers to spend at least 80 percent of their premium income on medical claims and provide rebates to customers when they fail to meet that threshold.

RELATED ARTICLES

• Obama hails healthcare reform agreement
• Read text of Reid's manager's amendment

The legislation still contains an excise tax on high-cost, so-called Cadillac health insurance plans, which is strongly opposed by labor unions and many Democrats but is backed by the White House and is one of the biggest revenue raisers in the legislation. Opponents of the tax are looking to the House-Senate conference committee to roll it back; the Reid amendment makes minor changes, such as exempting longshoremen.

The new language boosts the increase in the Medicare payroll tax that would hit people earning more than $200,000 and families earning more than $250,000 from 0.5 percent to 0.9 percent.

The bill also reduces an annual levy on medical device manufacturers and replaces an excise tax on cosmetic surgery with a 10 percent excise tax on indoor tanning salons.

Reid retained one proposal that emerged from negotiations between liberal and centrist Democrats: the creation of multi-state, nonprofit health insurance plans that would be negotiated by the federal Office of Personnel Management, which manages the Federal Employees Health Benefits Program, as an alternative to the traditional insurance plans that would be offered under the bill.


The new language also includes vouchers for some middle-income people to purchase health coverage on the new insurance exchange rather than from their employers if they earn too much to exempt from the individual mandate to buy insurance but not enough to qualify for federal subsidies. The so-called “free choice” provisions are based on a proposal by Sen. Ron Wyden (D-Ore.).

Small-business advocates such as Sens. Mary Landrieu (D-La.) and Blanche Lincoln (D-Ark.) – who, with Nelson, were among the toughest sells in the Democratic caucus – won a concession that would provide workers at small firms with more generous and more immediate financial assistance.

A group of freshman Democratic senators, many of them also centrists, won the inclusion of more aggressive cost-containment measures based on those already in the bill. Under the manager’s amendment, cost-containment pilot projects would ramp up more quickly and the Department of Health and Human Services would have greater authority to expand those programs without additional legislation.

Reid cut provisions from the bill that would have prevented a 21.5 percent cut in doctors' Medicare fees and replace it with a one-year hike. The House-passed measure includes a fix for 2010, however, and the defense spending bill approved by the Senate Saturday postpones the cut, which would kick in on Jan. 1, for two months. Reid told reporters that physician groups requested the change on the grounds that they want a permanent fix to their payment issues enacted in separate legislation.

Walter Alarkon contributed to this report

This story was updated at 12:15 p.m.

[BLUEHAWK]

I watched today with interest as much of the 7+ hour reading as i could stand, most of it was whereas and therefore and section X of subparagraph B replacing such and such of the previously enacted so and so... but in the end, after having actually read some of the text in detail - it is an enormous vast extremely complicated overhaul of every part (except the excessive profits and earmarks parts) of the health care system as we know it.

I also read the CBO estimate of the Manager's Amendment, which is what was passed today.

It shows that an additional $35+ billion has been spent between last Saturday and today, and that in several places the CBO was careful to state that any benefits (i.e. lower premiums or lower deficit spending) would be entirely dependent upon:

a) whether the underlying assumptions of the Bill were accurate to begin with
b) whether or not things committed to in the Bill are actually accomplished

Senator Nelson (R-Neb) managed to have his high moral standing on Abortion bought off by making a deal whereby the citizens of his sovereign State will not be obliged to themselves pay for the newly mandated huge increases in the cost of Medicaid that are around the corner.

In other words, we are in deep doo doo and are being told by the Democrats that "... it is possible to pick up a turd by the clean end."

[darrels joy]

CBO: Health bill spends $871B, reduces deficit by $132B


By Jeffrey Young - 12/19/09 01:29 PM ET
Congress’s budgetary scorekeeper affirms that the Senate’s healthcare reform legislation adheres to President Barack Obama’s pledge to spend less than $900 billion and reduce the federal budget deficit through the bill, which would extend health insurance coverage to 31 million people.

According to the Congressional Budget Office (CBO), the latest version of the legislation introduced by Senate Majority Leader Harry Reid (D-Nev.) would require $871 billion over 10 years in new federal spending, most of which would take the form of health insurance subsidies for low- and middle-income people and expansions of Medicaid and the Children’s Health Insurance Program.

CBO Director Doug Elmendorf presented Reid with this preliminary cost estimate in a letter Saturday.

Those costs are more than offset during the 10-year budget period by $483 billion worth of spending reductions in Medicare and

$614 billion generated from an excise tax on high-cost health insurance plans, taxes on healthcare companies, penalty fees paid by employers who fail to offer insurance coverage and individuals who fail to purchase it and other tax effects of the bill.

The bill would require nearly all legal U.S. residents to obtain health coverage, extend Medicaid benefits to everyone earning up to 133 percent of the federal poverty level and provide subsidies on a sliding scale to people earning between 133 percent and 400 percent of the federal poverty level.

The legislation would bring the rate of insurance coverage for non-elderly legal U.S. residents to 94 percent by 2019, the CBO concludes. Of the 31 million newly insured people, 26 million would purchase insurance through the bill’s health insurance exchange and 15 million would join Medicaid.

Twenty-three million people would still lack insurance, most of whom would be exempt from the individual mandate because they earn too much to qualify for subsidies but too little to afford coverage. About one-third of the remaining uninsured would be illegal immigrants, who are not eligible to participate in the programs.

A relatively new proposal to task the Office of Personnel Management (OPM), which manages the Federal Employees Health Benefits Program, to contract with private insurers to create two national plans to compete with other insurance on the exchange would have little effect. These provisions were added as part of a compromise between supporters and opponents of creating a government-run public option insurance program, which is not in the Reid bill.

“Whether insurers would be interested in offering such plans is unclear, and establishing a nationwide plan comprising only nonprofit insurers might be particularly difficult,” the CBO reports. “Even if such plans were arranged, the insurers offering them would probably have participated in the insurance exchanges anyway, so the inclusion of this provision did not have a significant effect on the estimates of federal costs or enrollment in the exchanges.”

The legislation would achieve deficit-reduction during its first 10 years largely because the spending cuts and tax increases would take effect several years before most of the new spending begins.



RELATED ARTICLES

• Medicare 'doc fix' left out of Senate health bill
• Text of CBO report

The CBO, however, says that the spending reductions and additional revenue would accrue at a faster rate than new spending during the second 10 years, leading to continuing deficit reduction in the future. “CBO expects that the legislation, if enacted, would reduce federal budget
deficits over the ensuing decade relative to those projected under current law—with a total effect during that decade that is in a broad range around one-half percent of [gross domestic product],” the letter says.

Likewise, the estimate says that although the legislation would increase the federal budgetary commitment to healthcare by $200 billion over the first 10 years, “CBO expects that the proposal would generate a reduction in the federal budgetary commitment to health care during the decade following the 10-year budget window.”

As the budget office has throughout the year, it emphasizes that this will only occur if Congress allows those cuts and tax hikes to take full effect and expresses skepticism that they will. “These longer-term calculations assume that the provisions are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation,” the letter says.



http://thehill.com/homenews/senate/7...eficit-by-132b

[darrels joy]

Just wait until the people covered by the new Medicaid money that we gave the longest holdouts will have all their estate taken by the government when they die.

Old law.

Just try to get those poor people to vote for you after they take your mother's house when she dies.

Joy

[darrels joy]

CBO: Real 10-Year Cost of Senate Bill Still $2.5 Trillion

With Obamacare, you get the good, the bad, and the ugly -- except for the first part.

The Congressional Budget Office's score is in for the final Senate health bill, and it's amazing how little Americans would get for so much.

The Democrats are irresponsibly and disingenuously claiming that the bill would cost $871 billion over 10 years. But that's not what the CBO says. Rather, the CBO says that $871 billion would be the costs from 2010 to 2019 for expansions in insurance coverage alone. But less than 2 percent of those "10-year costs" would kick in before the fifth year of that span. In its real first 10 years (2014 to 2023), the CBO says that the bill would cost $1.8 trillion -- for insurance coverage expansions alone. Other parts of the bill would cost approximately $700 billion more, bringing the bill's full 10-year tab to approximately $2.5 trillion -- according to the CBO.

In those real first 10 years (2014 to 2023), Americans would have to pay over $1 trillion in additional taxes, over $1 trillion would be siphoned out of Medicare (over $200 billion out of Medicare Advantage alone) and spent on Obamacare, and deficits would rise by over $200 billion. They would rise, that is, unless Congress follows through on the bill's pledge to cut doctors' payments under Medicare by 21 percent next year and never raise them back up -- which would reduce doctors' enthusiasm for seeing Medicare patients dramatically.

And what would Americans get in return for this staggering sum? Well, the CBO says that health care premiums would rise, and the Chief Actuary at the Centers for Medicare and Medicaid Services says that the percentage of the Gross Domestic Product spent on health care would rise from 17 percent today to 21 percent by the end of 2019. Nationwide health care costs would be $234 billion higher than under current law. How's that for "reform"?

Even MoveOn.org says that the bill is "a massive giveaway" to private insurance companies. The CBO estimates that, from 2015-25, private insurers would receive $1.0 trillion in subsidies from the American taxpayer -- the insurers' apparent price for giving up their freedom and being controlled by the government. Congress would mandate that Americans buy the insurers' product and would redirect massive sums of taxpayer money to make that mandate more feasible. So, if insurance companies are your idea of a worthy object of philanthropy, then Obamacare is for you.

And this is the bill that Ben Nelson has decided to support?

One hopes that Nebraska voters -- and all other voters in other states who have sent Democrats to Washington -- are making a list and checking it twice, keeping track of votes on Obamacare.

As Harry Reid keeps senators in session rather than letting them go home to be with their families and celebrate Christmas, it's important to remember that this bill would not go into effect in any meaningful way until more than an Olympiad from now. Thus, it is the American voters -- and not the current Democratic Congress or the current president -- who will ultimately decide its fate. Providing reminders to representatives in both chambers of that in the coming days will be crucial to beating back the onslaught of proposed legislation that, even if it passes the Senate, would at least have to passed again by the House and would likely have to go back through both chambers in compromised form.



http://www.weeklystandard.com/weblog..._of_senate.asp

[darrels joy]

Democrats Break Ground

By Philip Klein on 12.21.09 @ 6:10AM

"This is not the end of health care reform," Sen. Tom Harkin declared on the Senate floor after midnight this morning. "This is the beginning of health care reform."

Harkin was attempting to convince restive liberals that even a scaled back health care bill that did not include their beloved public option was still worth passing. But his comments, along with those made by other Senate Democrats in the week leading up to this morning's 1 a.m. vote to advance the Senate health care bill, confirmed what critics have been saying throughout the health care debate.

The point isn't that this one piece of legislation, on its own, will impose a Canadian-style, government-run health care system on the United States immediately. The point is that Democrats are putting infrastructure in place that will allow them to implement a government-run system over time.

By voting in the middle of the night to block a Republican filibuster attempt, Democrats took a big step toward passing health legislation, which is now expected to pass the Senate on Christmas Eve. To be sure, they'll still encounter a number of obstacles before President Obama can sign it into law.

The version of the bill that passed the House of Representatives has both a public option and stronger abortion language. Liberals and pro-life Democrats in the House are promising a fight during the conference that will merge the two bills, and any concessions to them could upset the delicate balance in the Senate that allowed Majority Leader Harry Reid to cobble together 60 votes. With that said, so far Democrats have proven willing to cut whatever deals they need to in order to get a health care bill across the finish line, and that same dynamic is likely to play out during the remaining negotiations.

As written, the Senate health care bill will force every American to purchase a government-approved insurance policy or pay a tax. It will expand Medicaid by 15 million people. It will create a new government-run long-term care insurance entitlement, called the Class Act, that even Democratic Sen. Kent Conrad called "a Ponzi scheme of the first order, the kind of thing that Bernie Madoff would have been proud of." And it will create new government-run insurance exchanges on which individuals would use government subsidies to buy government-designed insurance policies.

Taken together, this legislation enables to federal government to get its hands on every aspect of the health care system -- and it's only a matter of time before it tighten its grip. Just listen to what Democrats are saying now.

"What we need to do is lay a strong foundation," Sen. Ron Wyden said in an interview with MSNBC's Rachel Maddow last week. "A foundation that we can build on in the years ahead. We are not going to get everything we want in round one, but we are going to get a foundation that we are going to build on in the years ahead."

Sen. Jay Rockefeller told the New Republic "that liberal advocates could try again another year to push for the reforms that didn't make it into the current bill." He said, "You know we're going to be back next year, and the year after that, and the year after that."

And in comments on the Senate floor on Friday, Sen. John Kerry argued that Democrats shouldn’t even wait that long. Kerry recalled how Sen. Ted Kennedy regretted he never accepted a deal President Richard Nixon offered that would have forced employers to insure everybody, with some help from government.

"The lesson Teddy learned is this," Kerry explained. "When it comes to historic breakthroughs in America, especially in social policies, you make the best deal that you can, and immediately, you start pushing for ways to improve the deal."

Kerry said Kennedy applied that lesson after successfully fighting for a minimum wage increase in 1996, only to turn around and immediately call for another increase while at a victory rally.

"He was in the victory moment, and he turned to Congresman George Miller, and he said, 'I'm introducing a bill to raise the minimum wage,'" Kerry recounted. "And George Miller said, 'What do you mean? You haven't even let the dust settle?' And (Kennedy) said, 'We've gotta move on this.'"

The same logic, Kerry said, should apply to passing health care legislation.

And as evidence, he noted that Medicare and Medicaid have greatly expanded over time.

If this health care legislation becomes law, Democrats will attempt to use the new infrastructure they built to add stricter regulations, more subsidies, and additional mandates. They will continue to incrementally expand existing government-run programs such as Medicaid. And as health care spending spirals out of control, instead of faulting government intervention, liberals will blame the absence of a public option.

All along, opponents of the pending legislation have argued that it was just one step on the long march to a government takeover of health care.

And now, with victory in sight, Democrats are proving their critics'point.

"I know a lot of my progressive friends have been upset that certain things weren't in it," Harkin said of the Senate bill on Saturday. "But I put it this way. What we're building here is not a mansion, it's a starter home.… It has room for expansions and additions in the future."

They may not have their dream house just yet. But this morning, while America slept, the Democrats broke ground.

http://spectator.org/archives/2009/1...s-break-ground

[BLUEHAWK]

I am marginally heartened by the simple reality that:

a. The final Bill has yet to be written, passed or signed

b. No matter what outrageous measures are finally included, a goodly number of them have zero chance of being implemented

c. There is an election coming in 2010, and if we do have ANY sense remaining, we will rise up and put the Democrats out of office

They had their chance, and chose to abuse.

[SuperScout]

Is anybody surprised about how many senators are actually posing as whores for their respective states? And now the chief pimp, Harry Reid, says that any senator who hasn't sold his vote isn't acting like a good senator should. Guess our resident liberals are really happy.

[BLUEHAWK]

Originally Posted by SuperScout

Is anybody surprised about how many senators are actually posing as whores for their respective states? And now the chief pimp, Harry Reid, says that any senator who hasn't sold his vote isn't acting like a good senator should. Guess our resident liberals are really happy.

Not in the least surprised... and today those most closely involved are referring to their ignominious thievery as being necessitated by "compromise" - which pretty much defines how sincerely, for example, Senator Nelson of Nebraska was devoted to the Right to Life.

[reconeil]

In the vein of laughing is more pleasurable than crying over America's quite obviously current Political Supremacist Dictates, I just have to laugh at: "The chief (Obama/Marxist) pimp, Harry Reid" (Excellent Description, Brice!).

Though, calling the Buying of Votes with Hundred$ of Million$ of MY/YOUR/OUR Money for dictating or shoving European/Socialist style Healthcare down MY/YOUR/OUR collective throats: "Compromise",...is about as absurd as it gets.

Senator Reid must actually believe (just like Obama) all Americans are just stupid morons.

Hell,...I didn't even think such was possible. But, let's give credit given where credit due.
Old Harry quite obviously lies with a straight face,...BETTER EVEN than Barack & Nancy.

Sure Reid doesn't lie like some wild-eyed offended little girl, as Pelosi typically does.
But, so what?

Still, Harry unarguably lies just as well as all rest of Corrupt Chicago Ruling Elite Gang gone National & International daily lie. Sure,...he'll never be as smooth at lying as Obama. But again,...so what?

Hey, whatever works well for Reid's Master: "I pray to Jesus every night" or honestly; "Allah is Great" "His Barackness". For rest of US (both ways),...just screw: "We The People".

Neil