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Posts Tagged ‘abortion’

Reactions To Hectic Senate Weekend

The Senate voted early this morning to file cloture, or move forward, in the final steps toward passing its health overhaul bill.  The vote was not certain when the weekend began, and only after Sen. Ben Nelson, D-Neb., announced his support did the action proceed. Reid is now saying a final vote will take place by Christmas.

Bloggers were recovering from a busy weekend, trying to make sense of the big picture as the legislation moves forward.

Wonk Room’s Igor Volsky notes, “The Senators voted from their desks — a customary practice reserved for the most significant votes. Once the presiding president read the final tally, Democrats rushed over to congratulate Majority Leader Harry Reid (D-NV).”  He posts video of the vote, below:

The Washington Post’s Ezra Klein compares the Senate’s version with President Obama’s campaign health plan.  Klein notes that the public plan was dropped and Obama didn’t initially include an individual mandate,

But whether you love the Senate bill or loathe it, whether you’re impressed by Obama’s effort or disappointed, it is very hard to argue that the bill Congress looks likely to pass is fundamentally different from the approach Obama initially advocated. “The Obama-Biden plan both builds on and improves our current insurance system,” the campaign promised, and on that, for better or for worse, they’ve delivered.

Despite Klein’s conclusion that the plan isn’t very different from Obama’s campaign promise, Heritage’s Conn Carroll says the Senate bill’s passage “is only the beginning of a much larger health care fight.”  He continues, “This bill will only make every single problem with out health care system worse: higher spending, higher deficits, and worse care. Former-Democratic National Committee Chair Howard Dean said on Meet the Press yesterday, ‘[This bill] simply sets us on a track in this country which is expensive and where we’re going to have lots more political fights.’ Dean is dead on. President Barack Obama’s signature on this health care bill settles nothing.”

Jacob Goldstein of the Wall Street Journal’s Health Blog looks at Congressional Budget Office estimates released this weekend that found certain provisions are estimated to make little difference: “During all the last-minute action this weekend, CBO put out its estimates on the latest version of the Senate bill. As it turns out, replacing the public option with private plans overseen by a government agency — a sort of “public option lite” that was a key part of the compromise — makes almost no difference to how the bill would work in the real world, according to CBO.”

Grace-Marie Turner lists 12  “constituencies that will be gored, to which senators will have to answer next time they go before the voters.”  She includes “everyone.”

Huffington Post’s Drew Westen is disappointed with Obama’s leadership, saying his actions “soured” young people to politics:

Somehow the president has managed to turn a base of new and progressive voters he himself energized like no one else could in 2008 into the likely stay-at-home voters of 2010, souring an entire generation of young people to the political process. It isn’t hard for them to see that the winners seem to be the same no matter who the voters select (Wall Street, big oil, big Pharma, the insurance industry). In fact, the president’s leadership style, combined with the Democratic Congress’s penchant for making its sausage in public and producing new and usually more tasteless recipes every day, has had a very high toll far from the left: smack in the center of the political spectrum.

The American Spectator’s Philip Klein notes that some health insurance stocks are rising this morning.

James Capretta takes a closer look at the final version and says it’s “still a budget buster.”

And from the other perspective, Health Beat Blog’s Maggie Mahar has a series of posts looking at the details, including potential affordability challenges for older Americans, Ben Nelson’s abortion compromise and the “glass half empty/glass half full” viewpoints.

Mark Trahant reports that the Indian Health Care Improvement Act is in both the Senate and House versions.

And in the wake of the coming vote, Bob Laszewski wonders, “Is there anyone left, on either side of the political spectrum, who wants the Senate health care bill to pass?”

Monday, December 21st, 2009

Reaction to Senate Bill

The Senate finally released its merged health overhaul bill, sending the blogosphere a specific document to pour over.

The action took off when Democratic staffers announced the Congressional Budget Office’s assessment: $849 billion over ten years, a federal deficit reduction of $127 billion, and coverage for an additional 31 million Americans. Director Douglas Elmendorf offers a brief overview on his blog and is careful to note the uncertainties in some of the estimates.

Here’s what various folks are saying:

Hot Air’s Allah Pundit is very unimpressed, and argues that a CBO score matters only “when it’s bad:”

Another week, another “scoring” of a bill that (a) looks nothing like what it’ll look like in its final form and (b) almost certainly has been crafted to hide certain key costs (a la “doctor fix” in the House bill) to improve its “score.” Realistically, the only time a CBO score matters is when it’s bad: Were this to come in at over $900 billion or be judged a deficit-buster over the long term, it would be rejected for failing to meet the White House’s baseline demands. But this one just makes the cut, so look for the obligatory back-pat in this weekend’s presidential message about it being a “fine starting point” or an “encouraging beginning” or whatever. Reid managed to come up with a bill that isn’t too expensive … for Barack Obama. Congratulations.

The New Republic’s Jonathan Cohn compares the Senate’s offering with the House-passed bill.  Cohn seems cautiously optimistic, although he admits it’s “worse than the House:”

But, again, the Senate was never going to pass the House bill. Realistically, the question going forward was whether Majority Leader Harry Reid was going to be able to improve what came out of the Senate Finance Committee–and move it closer to what the Senate Health, Educaiton, Labor, and Pensions Committee produced. And there it seems pretty clear that he did, mostly. The early consensus among experts (and, again, this is pending further analysis) is that the new Senate bill boosts financial support for people purchasing health insurance. And, of course, it has a public insurance plan.

It’s not huge progress. But given the political pull to the right from conservative Democrats and independent Joe Lieberman, any progress is an accomplishment. And Reid clearly deserves credit for that.

The Washington Monthly’s Steve Benen thinks some Democratic holdouts should be satisfied: “it’s worth taking a moment to remember that center-right Democrats, who’ve been complaining about this initiative all year, have very little to complain about right now. Indeed, they should be thrilled — Senate Majority Leader Harry Reid (D-Nev.) has put together a reform package custom made to give the so-called “moderates” just about everything they said they wanted.”

Jacob Goldstein of the WSJ’s Health Blog lists the key tax provisions in the Senate bill, which include a tax on high-end health insurance plans and an increase in the payroll tax for high-income earners.

Insure Blog’s Henry Stern is nonplussed with the bill’s estimated savings: “That bears repeating: if (and that’s a big if) it really meets expectations, Sen Reid’s baby will cut, over 10 years, the equivalent of one month’s deficit. Color me underwhelmed.” (Italics/bold Stern’s).

The Washington Post’s Ezra Klein disagrees, looking at the bill’s cost provisions in the three decades following its passage.  “In the second decade, however, …savings from Medicare and Medicaid, paired with the excise tax (which CBO says “is effectively a reduction in the existing tax expenditure for health insurance premiums”) and a handful of other changes, leaves the government spending no more on health care than it otherwise planned to. That’s impressive stuff. And it implies, of course, that in the third decade, the federal commitment actually goes down relative to expectation. The curve, as they say, is bent.”  Klein goes on to argue that getting these cost controls in the bill was part of a “grand bargain” that would not have passed without coverage expansions.

Critical Condition’s Kathryn Jean Lopez posts a message from the National Right to Life Committee on the bill’s abortion provisions.  The anti abortion group says: “Regrettably but predictably, Reid rejected the bipartisan Stupak-Pitts language.  Instead, Reid has sought to please the militant minority that demands funding of abortion through federal programs, even though substantial majorities of Americans believe that abortion should be excluded from government-funded and government-sponsored health programs.”

Amy Allina of Raising Women’s Voices takes a look at the abortion provisions from the other side of the issue:

Senator Reid rejected the calls of antichoice activists to add the House-passed ban on abortion coverage in the exchange.  For the most part, the Senate bill confirms current law on access to abortion, as the Senate Finance bill did.  To respond to the concerns of antichoice Democrats, Reid’s bill spells out more specific accounting guidelines for the segregation of public and private funds to ensure that no federal money would be used to pay for abortion care.  It would allow insurers to offer abortion coverage to women in the exchange, including women who choose the public option if the Secretary of HHS ensures that federal money is not being used to pay for the services.  It also confirms that states would be allowed to pay for abortion services on their own, if the federal government decided not to include them in the public option.

Wonk Room’s Igor Volsky made a table comparing the House and Senate bills, saying, “The merged Senate legislation has lower affordability standards, covers less people, invests less in prevention, does not require all large employers to provide health insurance, and includes a weaker public option. But the bill goes further in controlling health care spending and reducing the deficit.”

And you can always follow the action on Twitter.  A selection of this morning’s many thousands of tweets below.

tweets

Thursday, November 19th, 2009

Taxing and Saving?

Yesterday we looked at Ezra Klein’s list of ways Democrats could avoid a filibuster, and today abortion rights supporters might see a benefit to using a different way of bypassing the Senate tradition: Politico’s Jonathan Allen reports that “Democrats will almost certainly kill the anti-abortion Stupak amendment in the process if they go to Plan B on passing health care — using a filibuster-proof reconciliation bill — budget experts say.”

There’s been another theme emerging during this recess week besides more back-and-forth over the Stupak amendment: controlling costs and raising taxes. 

Hot Air’s Ed Morrissey is unhappy with a proposal to increase the capital gains tax, saying, “The Pelosi Plan would strangle the economy.”

Wonk Room’s Igor Volsky makes a table that compares increasing the Medicare payroll tax (currently being floated in the Senate) versus the House’s surtax on high income earners.

Robert Laszewski expands on his nod toward an independent commission to look at health care costs. He thinks the fate of a bill “might just hinge more not on how ‘robust’ the public option would be but on how ‘robust’ an entitlement commission would be.”

Perhaps there’s another reason for a commission: Heritage’s Ed Haislmaier is unconvinced that Congress will make the future cuts to Medicare that it is proposing: “Enacting H.R. 3961 would mean that Congress has thrown in the towel on its previous attempt to control Medicare spending. It will also mean that no rational person can believe that Congress will actually enforce any new Medicare spending cuts included in pending health care legislation. That, in turn, would mean that new health care legislation would actually result in further, massive increases in either Federal borrowing or taxes.”

Lastly, a key architect of Massachusetts’ reform plan and an economic adviser to many Dems, MIT’s Jonathan Gruber, offers his thoughts on the amount of cost control in the bills. It’s not necessarily a ringing endorsement (via an interview with Ezra Klein):

Here’s how I think about this: Do you know Pascal’s wager? Why not believe in God? I think of health-care reform similarly. We don’t know if we’ll really bend the cost curve. But if we do this and we don’t do anything, we still go bankrupt in 100 years. We don’t lose much. But if we do it and it works, then it’s a savior.

It also moves the conversation on cost control in a way that’s impossible without this bill. It does real things on cost control, and then it does real things to make cost control more politically viable. It lays the groundwork for doing more. To kill this bill for not doing enough on cost control would be like criticizing the Yankees for not winning the Super Bowl. They won the World Series! They did what they could do!

Friday, November 13th, 2009

Division Continues Over Stupak Abortion Amendment

Bloggers continue to mull over the abortion amendment to the House bill – which the The Daily Beast’s Dana Goldstein calls “the wedge dividing Obama’s health coalition.” 

politifactPolitiFact.com rates Rep. Nita Lowey’s statement that the Stupak amendment “puts new restrictions on women’s access to abortion coverage in the private health insurance market even when they would pay premiums with their own money,”  calling it “false.” According to PolitiFact, “There’s plenty of room for debate about how the Stupak-Pitts amendment will eventually shape the availability of abortion coverage. But Lowey is wrong on two points.”

Cato’s Michael Cannon says government subsides of health care cause the underlying dilemma:

Either those taxpayer dollars will fund abortions, or the restrictions necessary to prevent taxpayer funding will curtail access to private abortion coverage. There is no middle ground.

Thus both sides’ fears are justified. Both sides of the abortion debate are learning why government should not subsidize health care. Tip of the hat to President Obama for creating this teachable moment.

The American Spectator’s Philip Klein agrees: “The only reason the Stupak-Pitts amendment would apply restrictions to the private market is that the government would be drastically expanding its role in the private market as a result of the health care legislation.”

The Plum Line’s Greg Sargent reports that Rep. Jan Schakowsky is the first lawmaker to publicly state she’ll vote “no” against a final health overhaul bill containing Stupak’s abortion language.

Schakowsky isn’t the only one that is withdrawing support. The Washington Post’s Ezra Klein responds to the New England Journal of Medicine’s Marcia Angell who calls the House bill “worse than nothing.”  Klein strongly disagrees: “Failure does not breed success. Obama’s defeat will not mean that more ambitious reforms have ‘a better chance of trying again.’ It will mean that less ambitious reformers have a better chance of trying next time.”

The New Republic’s Jonathan Cohn counters Angell as well as statements from other fellow liberals, saying:

As I’ve argued repeatedly, the House bill is not close to perfect. Neither is its Senate counterpart. But we don’t pass perfect laws in the U.S. We pass imperfect ones and then do our very best to improve them over time.

It happened that way with Social Security and Medicare. It can happen that way with comprehensive health care reform, too. But only if we do something, rather than nothing.

Tuesday, November 10th, 2009

Outrage Erupts Over Stupak Amendment

Bloggers have erupted in response to Democratic Rep. Bart Stupak’s amendment that bans the use of federal funds for abortion to a significantly broader extent than ever before. It also prohibits plans offered on the exchange that receive subsidies from covering abortion services.

It’s just another twist in the already contentious debate that’s left many liberals wondering how much more they can stomach and a White House trying to stay above the fray.

Time’s Amy Sullivan examines some of the events that led to Speaker Pelosi’s acceptance of the Stupak amendment:

[It] also seems clear that the Democratic leadership and White House dropped the ball on finding a compromise with pro-life Democrats. The deal reached late last night/early this morning in the Speaker’s office is not a compromise; it is in fact more than the Catholic bishops and Stupak himself asked for as late as mid-summer. The Speaker didn’t get rolled by crafty or stubborn members of her party, though. This was a predictable consequence of a high-handed approach to dealing with pro-life members of the Democratic caucus.

The American Prospect’s Ann Friedman reacts:

This also sets apart women’s rights from the Democratic/progressive/whatever agenda. As something expendable. But fundamental rights for women are not peripheral. They are core. And not just because of so-called progressive values. In a political sense, too: Seeing as how the Democratic Party relies on women voters to win elections, you would think they would have come around to this no-brainer by now.

It’s pretty cramped underneath this bus, what with 50 percent of Americans down here.

Huffington Post’s Sam Stein reports that President Obama’s press secretary refused to take a position on the amendent during today’s briefing: “Despite pledging during the presidential campaign to protect a woman’s right to choose, the Obama White House is refusing to weigh in on an amendment that represents perhaps the most restrictive anti-abortion measure introduced in a generation.”

The New Republic’s Jonathan Cohn says, “Opponents of abortion rights won a significant political victory last night, making it more likely that millions of American women will no longer be able to purchase insurance that covers abortion services.”

Jessica Aarons guest-blogs on Wonk Room, calling the amendment “A Monumental Setback For Abortion Access.” She argues, “Eighty-seven percent of employer plans offer abortion coverage. None of that will matter if the Senate takes its cues from the House. In every other way, this bill will expand access to health care. But for millions of women, they are about to lose coverage they currently have and often need.”

However, some republican and conservatives think the Stupak amendmenet may spell the end for reform.  The Weekly Standard’s John McCormack examines Republican strategy on the amendment:

Substantively, the Stupak amendment was a “tremendous victory for pro-lifers, and the size of the vote actually should occasion some comment about the audacity of the Democratic leadership to try to block the overwhelming will of the House,” says National Review’s Ramesh Ponnuru, author of The Party of Death. “I think we have really pushed far into the future any chance that they’re going to make a run at the Hyde amendment.”

Strategically, the Stupak amendment has divided the Democrats. Pelosi’s decision to allow a vote on it elicited “tears from some veteran [Democratic] female lawmakers.” … Democrats are left playing a game of chicken.

Hot Air’s Ed Morrissey looks at reports that several Republican lawmakers were considering voting “present” instead of approving the amendment.  Morrissey believes the Republicans did “the right thing” voting yes:

Republicans can make that argument only because they supported the Stupak amendment, even against what appeared to be their longer-term interests at that moment.  They acted on principle and can now argue that the Stupak coalition must respond in kind or be exposed as the worst kind of hypocrites in election challenges next year — challenges which that Stupak town-hall meeting shows will resonate.  Had they tried playing the legislative game with the Stupak amendment, this rift among Democrats shown by Sargent would never have appeared, and they would have lost the ability to highlight a backroom effort to rid the bill of an amendment that received more votes than the bill itself.

As the debate continues, there’s more buzz in reference to this post from The Plum Line’s Greg Sargent, who reports that several lawmakers are pledging to strip the Stupak amendment from the bill.  He posts video of Rep. Debbie Wasserman-Schultz, who says she has the votes to overturn the amendment. However, according to Sargent, the politics going forward get much more complex:

It will be much tougher for pro-choice Dems to cave and support the bill with Stupak than it was for House progressives to cave and back the bill despite its lack of a robust public option.

Here’s why: Because the public option had initially been written off for dead, the version liberals did secure allowed them to claim they had won something. By contrast, Stupak is a significant step backward for advocates of abortion rights and women’s health issues. So it will be much tougher for pro-choice House Dems to back a final bill with Stupak in the end. This will intensify.

Monday, November 9th, 2009

House Calls?

Bloggers are rushing to put in their two cents before the House’s scheduled vote on a landmark health overhaul bill late  Saturday afternoon.  But questions remain on whether leaders have  enough votes, and Majority Whip Steny Hoyer admitted to reporters that a delay was possible.

Hot Air’s Ed Morrissey calls the scheduling of the vote a “Hail Nancy play.  She couldn’t afford to wait too long for the vote after dropping 2,000 pages on members last week, and having them see the results of the elections this week.  Pelosi and Hoyer thought that rushing a vote would allow them to bully recalcitrant moderates into support.”

Wonk Room’s Igor Volksy compiled a table comparing amendments on two key issues holding up votes: abortion and immigration.

Cato’s Michael Cannon in the National Review Online calls the bill a “$1.5 trillion fraud,” zeroing in on the off-budget costs of an individual mandate.

The Washington Post’s Ezra Klein says House leadership is “mired in negotiations with three different types of Democrats who are proving restive at the eleventh hour.”  According the Klein, those groups are the “controversialists” (lawmakers concerned with “electric” issues like abortion and immigration), “centrist skeptics” (general concerns about ideas like taxes or a public option) and lawmakers “worried about the process” (they don’t want to vote for a more liberal bill then the Senate.)

And Erin Kanoy of the Heritage Foundation looks at what might be happening in the Rules Commiteee: who set the guidelines for tomorrow’s debate: “The rule being debated today will not only cover HR 3962 but will also apply to HR 3961, the Medicare Physician Payment Reform Act, also known as the Doc Fix. This is a procedural gimmick that allows the costly Doc Fix bill to be combined with H.R. 3962 after the bill passes the House. This allows Congressional Leaders to avoid a stand alone vote on Doc Fix in the Senate.”

Stay tuned to KHN  this weekend for more coverage of the House vote.

Saturday, November 7th, 2009

More to life than the public plan

Today bloggers are turning to amendments offered to the Senate Finance Commitee other than Tuesday’s failed public option submissions.

Paul Testa of the New Health Dialogue pulled key words from the Democratic and Republican senators’ opening statements made during last week’s markup hearings. According to the word clouds, “health” and “insurance” were the most common ones used by both parties. Those spectators of those opening festivities often noted the differing tone between the parties, which is not borne out by this comparison.
Dems:

Reps:

But onto the amendments.

Time’s Karen Tumulty reports that Olympia Snowe may decide to withdraw her much-anticipated amendment to create a “trigger” for a public option, and instead “offer it when the bill reaches the Senate floor.”

Critical Condition’s John Hood, referring to the defeat of a public plan option in the Senate Finance bill, says, “winning that one battle won’t win the war.”  He continues:

It is critically important that we all understand what will happen if a Baucus-type bill passes even without a government-run plan or government-sponsored cooperatives. Once the federal government enacts a mandate that businesses or individuals purchase government-approved health insurance — along with new regulations that essentially abolish real insurance in favor of mandatory, prepaid health care for all comers — the resulting political dynamic will lead inevitably to the unraveling of the private market and a government takeover in the future.

Anthony Wright of the Health Access Blog examines what he calls “the other big debate in the Senate Finance Committee.” This battle was focused on amendments regarding whether a minimum actuarial value standard should be set for plans offered through the health insurance exchange.

The Washington Post’s Ezra Klein reports that an amendment from Orrin Hatch that would require women to purchase separate insurance to cover abortions was rejected.

Philip Klein of the American Spectator blog says commitee members voted down an amendment from John Ensign that would have exempted middle-class families from paying a penalty for not purchasing health insurance.

Wonk Room’s Igor Volksy relays debate between Chuck Grassley and Jeff Bingaman over whether to require people applying for Medicaid to show a photo ID.

To round out your afternoon, a group called PSAmockery spoofed a video that’s been making the rounds that featured celebrities mocking insurance company executives.  The new “spoof of a spoof”  is matched almost shot-by-shot to the former video, but the message has changed: “Something terrible is happening… Overpaid celebrities don’t have a big enough voice when it comes to health care reform.” (Via Hot Air)

Thursday, October 1st, 2009

Bloggers looking beyond a public plan option

There’s a shift of attention in the blogosphere today as health policy commentators begin to puzzle over reform items other than the public plan (we’ll see how long it lasts…)

The first: long-term care. Many Americans mistakenly believe long-term care is provided by Medicare. As the baby boom generation begins to realize it isn’t–and to contemplate its future–the long-term care issue is gaining attention among health policy types, many of whom are themselves boomers.

CBO Director Douglas Elmendorf talks long-term care, summarizing the agency’s scoring of a new federal long-term care insurance program. Called the the Community Living Assistance Services and Supports (CLASS) Act, the provisions are a part of the Senate Health, Education, Labor and Pensions bill and would require premium contributions starting at $65 per month. CBO found the program would result in a net decrease of $58 billion in the federal budget deficit in the 10 years of 2010-2019. But then, he says:

Beyond the 10-year budget window, the effects of the program could be quite different, and CBO expects that the HHS Secretary would need to reduce benefit payments and increase premiums to maintain the program’s solvency … Overall, CBO estimates, if the Secretary did not modify the program to ensure its actuarial soundness, the program would add to future federal budget deficits in a large and growing fashion beginning a few years beyond the 10-year budget window.

Next up: Family planning benefits and health reform. The American Prospect’s Dana Goldstein worries about the impact of a minimum benefit standard under a national health insurance exchange. Some lawmakers want to exclude certain family planning services, including abortion.  Goldstein reports:

It looks as though both the Senate and House leadership are willing to hand the Health and Human Services secretary — currently the pro-choice Kathleen Sebelius — ultimate discretion over these questions of what will and won’t be covered by plans that participate in the health exchanges.

Another major unknown looming over a health overhaul bill is the status of antitrust laws.  Currently doctors, hospitals and drug makers can be prosecuted by the federal government for collusion if they make a deal to reduce costs or set standard prices.  The issue is very much at stake as hospital associations and PhRMA come to agreements to find savings for health reform.  The Incidental Economist looks at one idea involving collaboration to save costs, Accountable Care Organziations, and concludes:

I worry that some issues will be settled and constraints imposed via antitrust lawsuits before the economics community can makes sense of things. Consumers will likely be harmed if courts do not have the tools necessary to make rational judgments.

Lastly, Chris Collins, director of amfAR, examines the strategy for a national HIV/AIDS strategy on the Altarum Institute’s blog.

Elsewhere:

On the Wall Street Journal’s Washington Wire Alicia Mundy goes through all the qualifications listed sited in an FDA ‘want ad’ for director of the agency’s new tobacco center.

Michael Millenson says a standup comedy routine’s success could spell trouble for President Obama’s proposal to reform health care.

Action for Better Health Care is starting a five-part interview series with hospital CEOs about their views on health reform. The first, with Don Ammon of Adventist Health, is below.

Tuesday, July 7th, 2009