AFSCME calls on GOP members to drop health care

November 23, 2010 · Posted in The Capitol · Comment 

The giant public sector workers’ union AFSCME is pressing the White House’s attack on an incoming Republican member of Congress who asked that his health insurance start sooner, calling on Republican members of Congress to stay out of the Federal Employees’ Health Benefits Plan.

“These Republicans want to repeal health reform, putting the insurance companies back in charge and putting affordable coverage out of reach of millions of Americans,” says AFSCME President Gerald W. McEntee in a statement going out shortly. “If they enroll in the taxpayer-funded health care system provided to members of Congress, they deserve to be denounced as hypocrites.”

“If you campaigned for repeal, you should go without taxpayer-funded coverage first,” he says.





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Ben Smith’s Blog

No Middle Ground on Health Care

November 23, 2010 · Posted in The Capitol · Comment 

A new Public Policy Polling survey in Montana finds Sen. Max Baucus (D-MT) with an extremely low job approval at 38% with 53% disapproving.

Key finding: Nearly all of his support from Republicans has evaporated with only 13% approving of him as compared to 70% approval among Democrats.

“Baucus’ plight is similar to that of a number of other Senators who tried to have it both ways on health care, watering down the bill but still voting for it in the end. Blanche Lincoln’s stance, among other issue positions, alienated her base so much that she nearly lost her party’s nomination. And it certainly didn’t help her to win Republican votes in the fall, leading to her overwhelming defeat in November. Joe Lieberman’s actions on health care have helped to put him in a most unusual position- his approval rating is under 50% with Democrats, Republicans, and independents, one of very few Senators who’s managed to pull off that trio. And on the other side of the aisle Olympia Snowe’s vote for the health care bill at one point in committee, even though she voted against it in the end, infuriated the Republican base in the state and has many folks hankering for a primary challenge against her.”
Taegan Goddard’s Political Wire

Most Want to Keep or Expand Health Care Law

November 23, 2010 · Posted in The Capitol · Comment 

A new McClatchy-Marist poll finds a majority of Americans want Congress to keep the new health care law or even expand it, despite Republican claims that they have a mandate from the people to kill it.

Key findings: 51% of registered voters want to keep the law or change it to do more, while 44% want to change it to do less or repeal it altogether.

Said pollster Lee Miringoff: “On health care, there is a wide gap between public opinion and the political community.”
Taegan Goddard’s Political Wire

Mental Health Break

November 23, 2010 · Posted in The Capitol · Comment 

Let me introduce myself (the Darth Vader is awesome):

Go here for the full movie list. How did this incredible mashup accumulate only 5,600 hits in three months?

(Hat tip: The High Definite)





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The Daily Dish | By Andrew Sullivan

New Health Care Rule: You Get More Care for Your Money

November 22, 2010 · Posted in The Capitol · Comment 
 
    

Big insurers spent millions to try to gut a proposed new rule that requires they spend a certain amount of premium dollars on actual medical care. But American families and businesses are coming out on top.  

The U.S. Department of Health and Human Services (HHS) today issued a new rule—known as “medical loss ratio”—that will require health insurance companies to spend 80 percent to 85 percent of your health care insurance premiums on making you healthier instead of overhead costs like advertising or executive pay. 

Last month, big insurers sent more than 1,000 executives and lobbyists to the National Association of Insurance Commissioners (NAIC) meeting in Orlando to try and get the rule changed, according to the coalition, Health Care for America Now (HCAN). 

AFL-CIO state federation officers actively lobbied their state insurance commissioners to listen to working families and their unions and to not give in to the big insurers’ push to stop the regulation. Their efforts played a significant role in making the rule a reality.

HCAN Executive Director Ethan Rome says the new rule will change the way health insurance companies do business and end such unconscionable abuses as denying people coverage because they are sick. He adds:

When the Republicans call for repeal (of health care reform), they’re talking about throwing out rules like this one and putting consumers at the mercy of the insurance companies again. The Republican repeal-mongers are not only on the wrong side, they’re also just plain out-of-touch with the needs of businesses to move forward and the desires of consumers to have better care.

 Check out a White House video explaining what the new rule means here.

AFL-CIO NOW BLOG

Johanns New 1099 Pay-Fors Prove How Hard Repealing The Health Law Really Is

November 22, 2010 · Posted in The Capitol · Comment 

In August, Sen. Mike Johanns (R-NE) introduced a measure to repeal the 1099 reporting requirement in the Affordable Care Act — which requires small businesses to report any purchases over $ 600 to the IRS — and proposed paying for the $ 19 billion shortfall by eliminating $ 11 million from the Preventive Health Task Force and weakening the individual health insurance mandate. The amendment attracted seven Democratic Senators but did not receive the necessary 60 votes to move forward. Now, as the Senate prepares to re-consider repeal on November 29th, Johanns has introduced a different set of pay-fors that he hopes will attract additional Democratic support:

“My latest effort to repeal this costly mandate should easily win the support of my colleagues,” said Johanns. […]

Johanns’ amendment directs the Office of Management and Budget (OMB) to identify $ 39 billion in unspent and unobligated accounts to replace the revenue that might have been generated by the 1099 paperwork mandate. This represents only about five percent of the total funds in unspent and unobligated accounts and gives the Administration discretion to ensure these funds do not affect ongoing and necessary programs.

A spokesperson at Johanns’ office told me that the Senator is only interested in repealing the reporting mandate and is no longer interested in making waves with controversial pay-fors that take away money from the mandate or prevention. Since President Obama, Senate Finance Committee Chairman Max Baucus (D-MT), and House Speaker Nancy Pelosi (D-CA) have all come out in support of stripping the provision, Johanns sees renewed momentum on the issue and hopes to build a coalition around removing the 1099 requirement.

But it’s unclear if this pay-for will be any less controversial. First, if Senators are hesitant to vote for specific cuts because they may target their favorite programs, they would also be hesitant to delegate the task of finding cuts to another agency — out of fear that it would target their favorite programs.

Meanwhile, CAP’s Michel Linden doesn’t think that the pay-for would score as deficit neutral. “Unspent and Unobligated balances are not real money sitting in some account, they are actually ‘budget authority’ – the ability for an agency to draw down funds from the treasury to turn into actual outlays,” he told me. “While canceling unobligated balances might save a little bit, I’m pretty sure the vast majority just goes away if its not used which means that canceling it won’t save any money.”

He makes the following analogy:

A parent says to their teenager, “You can spend up to $ 100 on school supplies this year.” The child then spends only $ 80. Now if the parent has promised the child that they get to keep the difference, then canceling that promise would actually save money for the family. But if the parent hasn’t made that promise, – if instead the understanding is that the teenager can spend up $ 100 but if he or she comes in low, then any change is expected to be returned to Mom and Dad – then “taking back” that other $ 20 has no real meaning for the family’s bottom line.

The very fact that Johanns feels the only way he can repeal the 1099 is if he farms out the task of identifying pay-fors to a separate agency, however, only reiterates the difficulty of actually going through with the GOP pledge of eliminating the entire law or even going provision by provision.

Baucus — who has introduced his own 1099 repeal bill — has yet to identify any pay-fors. His office has not returned my inquiries into this matter.

Wonk Room

In 2009, Rand Paul Casually Compared Obama To Hitler, Warned Health Reform Could Lead To ‘Martial Law’

November 22, 2010 · Posted in The Capitol · Comment 

This election season, the GOP witnessed an extreme makeover of their candidates with Tea Party upstarts like Sharron Angle (R-NV), Ken Buck (R-FL), and Christine O’Donnell (R-DE) burying any form of moderation with their radical views. While they were unsuccessful, others among the crew of candidates former Bush advisor Karl Rove’s deemed “insistent, loud, and relatively unsophisticated,” were able to tap dance around extreme and unpopular policy positions and statements in their past to secure electoral victory. While Sens.-elect Marco Rubio (R-FL) and Pat Toomey (R-IL) are exemplary illustrations, no candidate provides better evidence of the strategy than Sen.-elect Rand Paul (R-KY).

During his campaign, Paul swept much of his radical history under the rug to convince Kentucky that he was a palatable choice for the national stage. However, before the spit shine, Paul sat down with prominent 9/11 truther and “aggressive Constitutionalist” Alex Jones of InfoWars to articulate his views regarding “the war for your mind.” Released 14 months after the original taping in 2009, the interview entitled “Thought Crimes USA” sheds further light on Paul’s insights on the inevitable coming of the thought police, a new Hitler, and “martial law” before he was sanitized for national consumption:

Thought control: Paul warned that “we’re doing what’s called political profiling,” which defined as discriminating against people based on their opinions. “You know people were worried about profiling people for the color of their skin, now we’re profiling people for the color of their thoughts. You know, what are you thinking? Do you believe in something scary like the Constitution. You might be a dangerous person.”

A new Hitler: Paul casually compared President Obama to Hitler. “I think times of crisis is when we have to worry the most about things. You know, Rahm Emanuel, who’s chief adviser to President Obama, said ‘let no good crisis go past without allowing government to grow, these are our chances for government to grow stronger and for more security at the expense of liberty.’ And it’s happened before. When you have severe crisis, that’s when sometimes strong leaders arise. You had the money destroyed in Germany in 1923 and out of that chaos came Hitler who promised that these awful people were the ones doing this to you and we need to round them up and put them in camps. And the liberties just went out the window. But people actually democratically voted in a Hitler. And I worry about that again in our country.” Later in the interview, he jokingly asked if Obama supporters were wearing “brown shirts,” a reference to the Nazi’s paramilitary units.

Health reform, martial law, and vaccines: Paul warned that the mandate that everyone have health insurance contained in Obama’s health care reform legislation could lead to “martial law.” He also delved into a long conspiracy theory vaccines. “Well I mean, the first sort of thing you see with martial law is mandates, and they’re talking about making it mandatory. Um, I worry because the last flu vaccine we had in the 1970s, more people died from the vaccine than from the swine flu. I think you have to use your brain but I think every individual should be able to make that choice.”

Watch part 2 here:

Paul’s elaborate conspiracy theories mirror many other extreme, unpopular, and downright ridiculous viewpoints he harbored before contorting into an electable candidate. Paul has stated that he wants to abolish the Department of Education so kids don’t have to learn about “two mommies,” that Medicare is socialism, and that Social Security a Ponzi scheme that should be privatized. Last May, Paul even told a local editorial board — and then again on NPR and MSNBC — that his belief in a “free society” means that whites-only lunch counters are the right of private businesses — a statement he later learned to dodge, but not refute entirely.

But regardless of actual views of Paul and his fellow freshmen, the GOP establishment is working hard to make sure that their fall into line, appointing old hands and insiders to staff these anti-establishment outsiders.

ThinkProgress

Health Reform and Accountable Care Organizations

November 22, 2010 · Posted in The Capitol · Comment 

Critics of the ACA have frequently complained that the legislation does not do enough to improve quality or to cut costs. However, the Act did create incentives for new alliances of hospitals and doctors, known as “Accountable Care Organizations.” Now provider lobbies are demanding some pretty dramatic changes to health care regulation in order to implement ACOs. In this post, I want to explain what ACOs are, and why they challenge traditional health care regulatory models.

What’s an ACO?

Elliott Fisher, director of the Center for Health Policy Research at Dartmouth Medical School, describes the “three key attributes” of ACOs: “organized care, performance measurement, and payment reform.” Fisher has argued that insurers are not well-positioned to improve the quality of health care because they “have largely focused on negotiating favorable prices within relatively open networks of providers” instead of trying to improve the health care their members received. (Private insurers have little incentive to keep current subscribers healthy over the long term, since at least half of subscribers on average churn into different plans within three years of signing up with a given plan.) He believes that a “virtual network” of physicians could do a better job, if they teamed up with hospitals. ACO refers to this legal alliance, which would be entitled to receive payments in exchange for cutting costs or improving quality.

In an ACO, an “extended hospital medical staff” (or “a hospital-associated multi-specialty group practice”) can join forces with a hospital and agree to be compensated via a lump sum payment. If the group manages to keep overall costs beneath the lump sum payment, it can share the gains among its members. Each part of the team also has an incentive to work together to keep those they care for healthy. In an ideal world, the ACO responds to the concerns about fragmentation discussed in last month’s symposium on the volume edited by Einer Elhauge recently released by Oxford University Press.

ACO Skeptics

But there are skeptics. Jeff Fisher worries about shadowy new pressures on providers that patients won’t be aware of:

Consumers would not be aware that they were being treated by ACOs. Rather, they would be “attributed” to them: virtual patients of virtual organizations. Aggregate health spending for attributed patients would be tracked, and increases in that spending would be capped using a form of “shadow capitation.” ACOs that lived within the caps would get their fees increased. Those that overspent would see their fees reduced or frozen.

Read more

Snowe Backs Challenge to Health Care Law

November 22, 2010 · Posted in The Capitol · Comment 

Sen. Olympia Snowe (R-ME) has co-signed an amicus, or friend of the court, brief to be submitted to the federal court in Florida that will hear a constitutional challenge of the individual mandate included as part of the health care reform law, the Portland Press Herald reports.

“Snowe was the only Republican to support any version of health care reform, but ultimately voted against the final bill. The version Snowe supported did include an individual mandate, but her aides said she opposed that provision and hoped to change it through the amendment process.”
Taegan Goddard’s Political Wire

Mental Health Break

November 21, 2010 · Posted in The Capitol · Comment 

The work of sculptor İlhan Koman as intrepreted by digital artist Candaş Şişman. Give it time:

F L U X from candas sisman on Vimeo.





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