Blog Watch

Archive for January, 2010

Deals Taking Shape

The deals keep coming following a marathon meeting Wednesday.  Reports have also emerged of an apparent deal is taking shape, and it looks like collectively-bargained benefits will be exempt for a period of time from the new excise tax on high-value insurance plans.

The Washington Post’s Ezra Klein looks at the makeup of yesterday’s informal conference meeting between the White House and congressional leaders.

NPR’s Julie Rovner says the deal “marks the beginning of the endgame” in House and Senate negotiations. She cautions that there’s still several steps to go: “So whether or not President Obama gets to sign a bill by end of this month or the first week of February, however, is still anyone’s guess.”

Hot Air’s Ed Morrissey thinks an exemption for union-negotiated health plans runs afoul of the Constitution: “A sliding scale?  That would mean that the tax would not be applied universally to all citizens, which could run afoul of Article I, Section 8 of the US Constitution.  Specifically, that states that Congress has the power to levy taxes, ‘but all Duties, Imposts and Excises shall be uniform throughout the United States[.]‘”

Heritage’s Conn Carroll isn’t happy with what was reportedly negotiated: “Now Big Labor will get all of the big government health care spending they always wanted, but they will not have to pay for it. And Obamacare’s Big Labor handouts don’t end there. The legislation also sets aside $5 billion to subsidize the costs of employer health benefits for early retirees.”

Jay Cost of Real Clear Politics analyzes a count of undecided House Dems and says, “Still, I think it is far [too] hasty to say that this reform is inevitable. Minimally, the margin in the House is going to be razor-thin either way. We know that for sure, which in turn suggests that we shouldn’t take final passage for granted.”

Wonk Room’s Igor Volsky looks at statements from legislators pledging to overturn parts of the health overhaul bills so as not to implement them, and says, “For reform to work, lawmakers who have pledged to “roll back provisions” of reform should not be responsible for implementing it. House and Senate negotiators must adopt the House bill’s more centralized approach or develop a compromise that establishes a national exchange but allows states a certain level of flexibility.”

And the American Spectator’s Philip Klein, who says he is “absolutely in favor of any efforts to repeal” cautions that such efforts are unlikely to be successful: “At the same time, however, I think that if the health care bill gets signed into law, it’s highly unlikely Republicans will be able to repeal it, or even major portions of it. Most Democrats won’t be eager to overturn the greatest domestic achievement of their party since 1965 — and you’d need to pass the repeal through the House, through the Senate with 60 votes, and then have the President sign it. … … So, while I think it’s certainly worth aiming for, opponents of Obamacare must also be thinking about ways to reform the system if the repeal effort isn’t successful.”

Thursday, January 14th, 2010

Handicapping The Health Bill Negotiations

Bloggers are mulling over Democratic leaders’ terms of negotiation for merging the House and Senate health overhaul bills.

Wonk Room’s Igor Volsky eyes stories on whether the “ping pong” strategy is working, and thinks the talks have hit some obstacles: “But now, House negotiators are suggesting that the Senate’s excise tax, state-based exchanges, poor affordability standards and preservation of insurers’ anti-trust exemption may not have enough votes to pass the House.”

The American Spectator’s Philip Klein reacts to news that collectively-bargained agreements might be exempt from the so-called ‘Cadillac tax’: “If this policy is adopted, it would mean that there could be two Americans receiving the exact same benefits, but one American may be taxed and one wouldn’t, and the only difference would be one of them being a member of a union. This is unseemly and unfair, even by the standards of Obamacare.”

Austin Frakt mulls over what the ultimate employer “responsibility” (i.e mandate) could be in the health overhaul proposals, and concludes: “I don’t like the Senate’s employer provisions relative to those of the House, but how bad is it in absolute terms? I don’t think it is that bad. The minimum benefit standard is lower than the House’s but not tremendously lower (60% vs. 70% of actuarial value). Though there are loopholes that afford employers some wiggle room, it is a lot less wiggle room than they have now.”

Heritage’s Kathryn Nix argues that the Office of Personal Management, which oversees the Federal Employee Health Benefit Program, shouldn’t  take on the added responsibility of “sponsoring health plans to compete against private health plans in every state in the nation” in the Senate proposal.  She says that the FEHBP’s responsibilities shouldn’t change as proposed under the Senate bill: “[it] works because OPM plays the neutral role of an umpire: federal employees choose the private plan they like from a wide variety of different plans, all of which compete against each other to attract the most enrollees. The federal government provides its employees with a defined contribution towards their health costs, and it doesn’t micromanage their choices.”

A special election in Massachusetts has some worried about losing a long-time Democratic vote in Congress: the late Edward Kennedy held the Senate seat for decades. 

The Washington Post’s Ezra Klein predicts that it won’t matter for the final health reform vote if Martha Coakley, the Democratic candidate, loses the election. According to Klein, even if she loses, it would take a while for Scott Brown, her opponent, to be confirmed and sworn in.

And Hot Air’s Ed Morrissey, looking at reports that longtime Senator Russ Feingold, D-Wisc., was heckled over the issue of health care at a recent constituent meeting in Wisconsin, says: “The town hall meeting phenomenon has not dissipated at all.  Perhaps the media isn’t giving it quite as much coverage as before — and perhaps Democrats aren’t holding town-hall meetings because of the certainty of this kind of reception.  But that is bigger news than whether Harry Reid retains his position as Majority Leader, at least in terms of policy and governance.”

Wednesday, January 13th, 2010

Election Year Meets Health Care Debate

Pundits and bloggers are closely watching how the health overhaul debate could affect local races across the nation.

The brand new political Web site founded by Tucker Carlson, The Daily Caller, is covering health care politics, reporting today that “President Obama’s chief of staff, Rahm Emanuel, said Monday [on MSNBC's Daily Rundown] that the White House has inadequately communicated with Americans about health-care reform.”

DC’s Jon Ward writes: “Pressed on why poll numbers show such low support for the administration’s reforms, Emanuel said that “part of it is the message not getting through, part of it is people not watching the legislative process very good.”

The Washington Independent’s David Weigel writes that Rep. Larry Kissell, D-N.C., is faring well so far in a reelection campaign in his swing district, in part because of his ”no” vote: “Kissell’s advantage, according to Public Policy Polling, is his vote against the health care bill.”

And Huffington Post’s Glen Johnson and Liz Sidoti report: “The race to succeed the late Sen. Edward M. Kennedy has turned into a proxy battle over the fate of President Barack Obama’s health care overhaul.” 

Elsewhere, others continue to look at the shape of a final bill.

The Washington Post’s Ezra Klein says his sources are tracking with E.J. Dionne’s column Monday, where Dionne reported that the final health bill are likely to dump the public option entirely, but opt for a national health insurance exchange.  Klein adds, “The precise mix of insurance regulations might shift as well, as the House has a stronger set than the Senate does. But broadly speaking, people aren’t expecting much in the way of surprises.”

Heritage’s Rob Bluey reports on comments from AFL-CIO President Richard Trumka opposing the ‘Cadillac tax’ and notes there are other issues that could strain relationships with labor leaders:

The tax issue is just one factor that could sour Big Labor’s relationship with the White House. Trumka clearly favors the more liberal House bill, which includes a public plan and employer mandate. But for House and Senate leaders to strike a deal, lawmakers would almost certainly need to make concessions that agitate leaders like Trumka. Other major issues up for negotiation include penalties of an individual mandate, expansion of the Medicaid entitlement and taxpayer funding for abortion.

Merrill Goozner doesn’t like the ‘Cadillac tax’ either.  He looks at the number of Americans likely to be affected by the tax and concludes, “If the Democrats adopt this plan, a political disaster of epic proportions awaits them.”

And on a different note, Insure Blog’s Hank Stern wonders if the Amish will receive a religious exemption to the individual mandate, noting that they purchase vehicle insurance.

Tuesday, January 12th, 2010

Proposed Tax Continues To Rise Before Becoming Law

Health policy faded into the background this weekend as political gossip led the news cycle, but there’s still some items of interest.

The American Spectator’s Philip Klein looks at reports that a proposed Medicare payroll tax that would help fund a health overhaul may be increased again. Klein notes:

This would actually follow the historical pattern of payroll taxes. The Social Security tax has been raised 20 times since first being implemented in 1935, from 1 percent to 6.2 percent, while the Medicare tax has gone up seven times since 1966, from 0.35 percent to 1.45 percent. Taking into account that employers must match the payroll tax contributions of their employees, the combined tax went from 2 percent when introduced in 1935, to 15.3 percent today.

National Journal’s Marilyn Werber-Serafini asks her ‘experts’ what they think of the ‘Cadillac’ tax — and so far respondents Paul Fronstin John Goodman, Sally Pipes, and Jason Rosenbaum have weighed in. 

Wonk Room’s Igor Volsky examines the differences between proposals for a national  and state-based health insurance exchanges.

Health Beat’s Maggie Mahar examines the case of a Buffalo hospitals system, Kaleida, which has been advertising its services across the border in Canada.

Jaan Sidorov of the Disease Management Care Blog disagrees with a New England Journal of Medicine piece from Harvard researchers who argue “current protections are inadequate to ensure fairness” in these workplace wellness programs.

And Reason Magazine has a new tongue-in-cheek video about transparency in health legislation, calling the process “Real World: DC” (via Cato):

Monday, January 11th, 2010

Wonk It Out

Congress hasn’t returned to the Capitol yet, but bloggers have been busy detecting the fault lines in the House and Senate health overhaul bills.

Hot Air’s Ed Morrissey looks at a news report that House Democrats gave a chilly reception to the the idea of including the Senate’s ‘Cadillac tax’ in the  final  health overhaul bill, and predicts trouble if different source of funding  comes into play: “It’s another opportunity to kill the bill, and given the political damage the last round did to red-state Democrats in the upper chamber, Harry Reid may not be able to bargain his way around those cloture votes again.  The unions may wind up killing the bill, thanks to their self-serving opposition to paying taxes for a program for which they have been lobbying for months.”

Over at the New Republic’s The Treatment, Peter Harbage argues for more funding in the Senate bill: he says states need a $1 billion fund to keep an eye on potential price gouging.  The provision currently exists only in the House version.

The New York Times’ Catherine Rampell looks at new employment numbers released today, noting, “Even as overall payrolls continue to plummet, the health care industry keeps truckin’ along.”

Politico’s Ben Smith interviews MIT economist Jonathan Gruber over controversy that Gruber had a contract with HHS during the time he made public comments supporting health overhaul plans.

And since it’s Friday, how about some multimedia on your favorite health wonks?

The talk of the beltway health policy world this week was revelations surrounding Office of Management and Budget Director Peter Orszag’s personal life. CNN’s Jeanne Moos investigates whether women of the world think nerdy is sexy:

Cato’s Michael Cannon has a podcast that focuses on if there are price controls under proposed health reform legislation.

And The Washington Post’s Ezra Klein and White House Communications officer Linda Douglass appeared on The Colbert Report to talk health care:

The Colbert Report Mon – Thurs 11:30pm / 10:30c
Drag Me to Health – Ezra Klein & Linda Douglass
www.colbertnation.com
Colbert Report Full Episodes Political Humor Economy

Friday, January 8th, 2010

On A Search Or Destroy Mission For Health Bill Votes

Bloggers are back to scrutinizing strategy memos as congressional Democrats begin final negotiations to merge the House and Senate versions of their bills.

Heritage’s Marguerite Higgins looks at reports from the New Republic and TPM that some Democratic lawmakers are eying a deal with Senate Majority Leader Harry Reid to ease restrictions for immigrants to purchase health insurance.  Higgins says the potential agreement “follows a long list of other sweetheart arrangements that Reid and other members have worked out to keep on-the-fence Democrats in-step with passing Obamacare.”

But the New Republic’s Suzy Khimm reports: “The Congressional Hispanic Caucus today denied that they had struck such a bargain with the Democratic leadership, and one leading Hispanic Representative said that he had not yet been approached about the matter.”

In other deal news, The American Spectator’s Philip Klein that in the current negotiations, the Senate health care bill “is about to get more expensive.”  His reasoning?  House Speaker Nancy Pelosi will have to find a way to ease the unhappiness in her caucus because of the loss of the government-run health plan, also called the public option. “Given that a handful of pro-life Democrats would bolt assuming the abortion language is watered down, she cannot afford any more defections among liberal members. That likely means increasing the amount of subsidies offered to individuals to purchase insurance on government exchanges, and perhaps having them start sooner — both of which would increase the cost of the legislation.”

Wonk Room’s Igor Volsky reports on one potential example of Klein’s prediction: some House Democrats are floating an idea to provide “start-up funds” to states for state-based public plans.

Meanwhile, TPM’s Evan McMorris-Santoro reports on House Minority Whip Eric Cantor’s plan to defeat the health care bill in the House.  He released a memo that targets 37 Democrats, saying, “By convincing just three House Members to switch their position and oppose this bill, we can halt this government take-over of our health care system.”

Hot Air’s Ed Morrissey thinks the strategy has merit, especially for House members uneasy about explaining votes to cut funding to Medicare Advantage programs and supporting a bill that relieves Nebraska of much of the new Medicaid funding while saddling other states with that expense: “I suspect that the elimination of the public option may be more of a hurdle with the  House progressives than these — but Cantor’s signal to the NRCC will not go unnoticed.  Any one of these Democrats voting to support a bill with these elements will have to answer these questions on the campaign trail, most likely with them being asked on TV spots flooding their districts.  If these Democrats feel comfortable about voting for them, they won’t feel comfortable facing town-hall events and answering the questions live back home.”

Wednesday, January 6th, 2010

C-SPAN’s Call For Access

Bloggers on the right are rallying behind a C-SPAN request to videotape any health bill proceedings following yesterday’s news that Democratic lawmakers may not hold formal conference committee negotiations to merge the House- and Senate-passed health overhaul measures.

C-SPAN delivered the unusual request (in letter form) to Congressional leaders on Dec. 30th, asking that meetings to combine the two versions be open and added to the “hundreds of hours of committe hearings, mark ups and floor debate … archived for future generations to study in the C-SPAN video archives.”

It looks like it could be another losing battle for Republicans, as NPR’s Scott Hensley reports, “Routine appropriations conferences have been televised, NPR’s Julie Rovner tells us, but she puts the odds of the overhaul nitty-gritty being done in public at just about zero. The work could be messy and it won’ t be orthodox. All signs point to most of the negotiations happening informally.”

Peter Suderman of the libertarian Reason agrees with Rovner that such a broadcast is unlikley, but says its “pretty disappointing” because “we’ll miss out on the historical record, which is both useful (in terms of understanding the legislative process) and interesting (as political narrative). That’s important for any bill, and it’s especially a bill of this size, with this sort of transformational impact. When future generations — or, hell, current generations — ask how we got the system we have, we’ll be able to tell part of the story, but when it comes to the end, we’ll simply have to speculate, or shrug our shoulders in confusion, as crucial details from the final days of negotiating will be missing.”

Right-leaning bloggers immediately jumped on the news, with support for C-SPAN’S request registered from Heritage’s Mike Brownfield and The Weekly Standard’s Mary Katharine Ham. 

Hot Air’s Ed Morrissey quips, “This, then, is transparency as defined by Democrats: votes in the dead of night, committee processes that produce strawman bills, and Senators scurrying from camera lenses to dole out favors and cash to one another.” 

Meanwhile, Jeff Davis in The New Republic identifies another reason Democrats may want to avoid conference: a rule in the 2007 ethics bill that dictates what can be added (or subtracted) in a conference committee. Davis says, “Don’t expect to see any more conference committees on controversial party-line bills. Ever.”

And Austin Frakt offers a list of items to watch during the negotiations, like the penalty on employers for not providing health insurance and whether the Medicare “doughnut hole” in the prescription drug benefit will be closed.

Tuesday, January 5th, 2010

Lawmakers Likely To Hold Unofficial Conference, Circumventing Republican Objections To Health Bill

Blog-generated health policy news returns with bang after a quiet holiday intermission.  Reports first circulated late last night from The New Republic’s Jonathan Cohn that Senate and House Democrats are “almost certain” to hold informal negotiations when merging the chambers’ health overhaul bills:

According to a pair of senior Capitol Hill staffers, one from each chamber, House and Senate Democrats are “almost certain” to negotiate informally rather than convene a formal conference committee. Doing so would allow Democrats to avoid a series of procedural steps–not least among them, a series of special motions in the Senate, each requiring a vote with full debate–that Republicans could use to stall deliberations, just as they did in November and December.

The Huffington Post’s Sam Stein followed Cohn’s reports Monday afternoon, writing: “In what one health care reform activist calls a ‘quasi ping-pong’ strategy, House and Senate leaders will each have a set of negotiators bounce variations of health care legislation back and forth until the disagreements between the two chambers are hammered out.”

The National Review Online’s Kathryn Jean Lopez concludes from a conversation with a source on the Hill, “Will the Left make it more Left? This vet [her source] doubts it: ‘The bill will have to align fairly closely to the Senate bill; don’t believe all the hype about liberals demanding changes — they’ll cave as always.’”

Hot Air’s Ed Morrissey seems unsurprised that Dems are avoiding a conference, saying, “Given the bill’s increasing unpopularity, it doesn’t surprise that Democrats want to hide themselves while trying to get it out of Congress.  However, that kind of approach will not build support for ObamaCare.  It will undermine whatever support it has left except as a purely partisan exercise — which explains why its support among likely voters closely mirrors the percentage of Democrats among that sample.”

The Washington Post’s Ezra Klein thinks its not Democrats hiding, it’s Republicans obstructing:

But like the budget reconciliation process or the entitlements commission, this is another example of polarization and obstruction forcing the majority party to take the scenic route when the highway would be better. The product of a Congress that doesn’t work isn’t simply that things don’t get done, but that many of the things that do get done are passed through strange processes that lead to worse legislation.

Elsewhere:

  • Matthew Holt, founder of The Health Care Blog, lists five items “to pay attention to” this year, including more on a health overhaul: “The finish is the start: It looks like some version of the Senate bill will be a done deal by sometime late January. That means that there’s about two years of health care industry players figuring out what it all means;”
  • Bruce Barlett asks if Republicans should have compromised to begin with on a health bill;
  • Maggie Mahar “fact checks” what effects, exactly, a “Cadillac tax” would have on the health insurance market;
  • Andrew Gelman plots health spending versus life expectancy in a handful of nations;
  • James Capretta and Yuval Levin in the Weekly Standard call the Senate health bill “an appalling disaster in the making, for its own sponsors no less than for the rest of the country;”
  • And the New Yorker’s Hendrik Hertzberg says “it is nonsense” for liberals “to attribute the less than fully satisfactory” health overhaul bill “to the alleged perfidy of the President or ‘the Democrats.’”

Monday, January 4th, 2010