Government Takeover of Health Care

House Takes Another Step on Healthcare Reform

October 29, 2009

Reuters - Democrats in the U.S. House of Representatives unveiled a sweeping healthcare overhaul on Thursday that would transform the insurance market, create a government-run insurance plan, and levy new taxes on the rich.

Weeks of closed-door negotiations to merge three House healthcare plans produced a 1,990-page bill that would cost a net $894 billion over 10 years -- just below President Barack Obama's target of $900 billion -- and reduce the deficit by $104 billion over the same period, budget analysts estimated.

The bill's release was another step forward in Obama's drive for healthcare reform that would rein in costs, reform the insurance industry and expand coverage to many of the 46 million uninsured living in the United States.

Obama has made an overhaul of the $2.5 trillion industry, which constitutes one-sixth of the economy, his top domestic priority.

The bill was met with unanimous opposition from Republicans and grumbling from some Democrats. Party liberals had sought a stronger public insurance option and party moderates want assurances that federal funds will not be used to pay for abortions under the measure.

The legislation could be debated in the House as soon as next week. The Senate is putting together its own version, and the House and Senate bills eventually must be combined before being sent to Obama for his signature.

House Dems Reach Deal on Key Health Care Elements

October 28, 2009

AP - House Democrats reached agreement Wednesday on key elements of a health care bill that would vastly alter America's medical landscape, requiring virtually universal sign-ups and establishing a new government-run insurance option for millions.

House Speaker Nancy Pelosi planned a formal announcement Thursday morning in front of the Capitol. Lawmakers said the legislation could be up for a vote on the House floor next week.

The rollout will cap months of arduous negotiations to bridge differences between liberal and moderate Democrats and blend health care overhaul bills passed by three separate committees over the summer. The developments in the House came as Senate Majority Leader Harry Reid, D-Nev., tried to round up support among moderate Democrats for his bill, which includes a modified government insurance option that states could opt out of.

Reid met Wednesday with Arkansas Sen. Blanche Lincoln, who faces a potentially tough re-election next year.

The final product in the House, reflecting many of President Barack Obama's priorities, includes new requirements for employers to offer insurance to their workers or face penalties, fines on Americans who don't purchase coverage, and subsidies to help lower-income people do so. Insurance companies would face new prohibitions against charging much more to older people or denying coverage to people with health conditions.

Pelosi has also said the bill would strip the health insurance industry of a long-standing exemption from antitrust laws covering market allocation, price fixing and bid rigging.

The price tag, topping $1 trillion over 10 years, would be paid for by taxing high-income people and cutting some $500 billion in payments to Medicare providers. The legislation would extend health coverage to around 95 percent of Americans.

Republicans criticized the bill even before it was unveiled.

"Americans' health care is too important to risk on one gigantic bill that was negotiated behind closed doors," said Rep. Dave Camp, R-Mich. "The Medicare cuts will hurt seniors, the tax increases will kill jobs and the government takeover of health care will increase premium costs."

One change expected to be revealed Thursday is that some of the provisions of the bill, which were set to take effect mostly in 2013, have been moved up so Americans would see the benefits of the legislation more quickly, according to Pelosi spokesman Nadeam Elshami.

"I'm pretty confident that we've got the right pieces in place," said Rep. George Miller, D-Calif., chairman of the Education and Labor Committee, one of the three panels involved in writing the bill. "We can quibble over parts of it, but the fact is when you're taking a 60-year-old system that grew up in a rather haphazard fashion and you're trying to bring some coherence to it, these are sort of the things you have to do at the beginning of that process."

Plenty of work remains to be done before a bill could land on Obama's desk — and there's still no guarantee that Congress can complete the legislation before year's end, as the president wants. If Obama does sign a health overhaul bill, he will have bucked decades of failed attempts by past administrations, most recently by former President Bill Clinton in the 1990s.

House leaders hope to finish the bill before Veteran's Day, Nov. 11. The Senate is aiming to start debate sometime in the next several weeks.

Bills passed by the House and Senate would have to be merged before a final product could be sent to Obama, and there are a number of differences between the two chambers that would have to be reconciled. Among them are the different approaches to the public plan. The House does not include the opt-out provision for states, and it has more stringent requirements for employers. The Senate would use a tax on high-value insurance plans to pay for the bill, an approach that the House version doesn't have.

In the end, Pelosi, D-Calif., and other House leaders were unable to round up the necessary votes for their preferred version of the government insurance plan — one that would base payment rates to providers on rates paid by Medicare. Instead, the Health and Human Services secretary would negotiate rates with providers, the approach preferred by moderates and the one that will be featured in the Senate's version.

That marked a defeat for liberal lawmakers, who argued for months that a public insurance plan tied to Medicare would save more money for the government, and offer cheaper rates to consumers. Moderates feared that doctors, hospitals and other providers, particularly those in rural states, would be hurt, and in the end they looked poised to prevail, despite constituting a distinct minority in the 256-member House Democratic caucus.

Some liberals were prepared to accept the negotiated rate structure. Others were still withholding support, even while pointing to Reid's inclusion of a government insurance plan in the Senate bill as a victory in itself.

"We were laughed at in August. Who would have thought that the Senate bill would have a public option?" said Rep. Lynn Woolsey, D-Calif., a co-chair of the Congressional Progressive Caucus.

Woolsey was noncommittal about whether progressives would accept the negotiated rates.

"This is not walkaway time and it is not acceptance time," Woolsey said.

Members of the progressive caucus, along with lawmakers from the black, Hispanic and Asian-Pacific American caucuses, were scheduled to meet with Obama at the White House on Thursday, she said.

The legislation would set up a new purchasing exchange where small businesses and individuals without affordable health care options could shop for and compare insurance plans. The new public plan would be one offered in the exchange, and it would be optional; an analysis by the Congressional Budget Office of early versions of the bill said that the public plan would be expected to cover 9 million to 10 million people by 2019.

The House plan also envisions a significant expansion of Medicaid, the federal-state health care program for low income people.

Democratic leaders still faced disputes over prohibiting taxpayer money for abortions and health care for illegal immigrants, issues they hoped to resolve after the bill's unveiling.

Government Insurance Plan Will Dominate Market, Senate Republicans Warn

October 27, 2009

FOXNews.com - Senate Republicans sounded the alarm over government-backed health insurance Tuesday, saying Majority Leader Harry Reid's decision to stick the public option back into his bill could create a government-dominated insurance market.

As liberal Democrats cheered Reid's decision, Republicans warned that new taxes on insurers will lead to a rise in private plan premiums that they predict will give the government plan an unfair price advantage -- potentially drawing millions into it whether the customers want it or not.

"Whether you get insurance from your employer or whether you buy it on your own, your premiums go up," Senate Minority Leader Mitch McConnell said.

Sen. Charles Grassley, R-Iowa, cited estimates from the Congressional Budget Office that under the newly created insurance exchange -- a tightly regulated marketplace for private and public plans -- the premiums associated with private plans will go up.

"Let's hope Democratic leadership and the White House aren't willing to push a bill that forces 200 million Americans to pay higher premiums unless they enroll in the new government plan. But that is certainly what is sounds like," Grassley said in a statement.

Reid's proposal would create a national insurance plan that state legislatures can vote to opt out of. The plan would be set up with government seed money and then run by a private, not-for-profit board. Though the proposal was pitched as a compromise to appease conservative Democrats, Republicans denounced it as intrusive and overbearing.

"Ultimately I think the goal is to drive private insurers out of business by undercutting them, encouraging employers to drop the employees off of the employer-provided coverage, so that ultimately you end up with a single-payer government-run health care system for all Americans. I think that is the goal," Sen. John Cornyn, R-Texas, told Fox News.

Sen. Olympia Snowe, R-Maine, expressed similar concerns. Democrats had hoped to have Snowe's support, since she endorsed a different version of health care reform on the Senate Finance Committee. But she said she cannot back Reid's plan. She said Reid's government plan would have an unfair advantage, even though the national program would have to negotiate rates with providers just like private insurance companies do.

"It does give the government a disproportionate advantage in the marketplace. They can set ... the prices and certainly negotiate those prices at whatever level," she told Fox News, adding that she was "surprised and disappointed" by Reid's decision.

Snowe wanted a proposal that would "trigger" a public plan down the road if the insurance companies do not meet certain benchmarks. She told Fox News that the CBO indicated her plan would yield $10-$15 billion in savings. She said the lack of GOP support "sends a terrible message that [Democrats are] no longer interested in working with Republicans"...

Sen. Bob Casey, D-Pa., told Fox News that even though he wanted a more robust version, he'll "certainly" vote for Reid's bill. He said the private insurance industry's "undue" power needs to be curtailed.

"We need competition. Insurance companies now have awesome power," Casey said.

Obama Explains How His Health Care Plan Will Eliminate Private Insurance

Obama to Sign Hate Crimes Bill Wednesday, October 28

October 26, 2009

ABC News - Eleven years after Matthew Shepard’s death, President Obama will sign the Matthew Shepard Hate Crimes bill into law during a White House signing ceremony Wednesday afternoon, White House officials confirm.

The long-sought hate crimes provision is part of the fiscal year 2010 defense authorization bill and will extend federal hate crimes law to include crimes motivated by a victim's gender, sexual orientation, gender identity or disability.

Matthew Shepard, a gay twenty-one year old college student, was brutally killed in 1998. Some of the Shepard family will be in attendance at the White House signing on Wednesday. Afterward there will be a reception with gay rights groups as well as civil rights leader to commemorate the occasion.

The main thrust of the bill is defense policy, including authorizing $130 billion for the wars in Iraq and Afghanistan. The DOD Authorization bill also strips money from the Pentagon budget for the controversial F-22 Raptor. The Pentagon and the White House wanted to stop production, but appropriators had balked at costing jobs in their states.

When Asked Where the Constitution Authorizes Congress to Order Americans To Buy Health Insurance, Pelosi Says: 'Are You Serious?'

October 23, 2009

CNSNews.com – When CNSNews.com asked House Speaker Nancy Pelosi (D-Calif.) on Thursday where the Constitution authorized Congress to order Americans to buy health insurance--a mandate included in both the House and Senate versions of the health care bill--Pelosi dismissed the question by saying:

“Are you serious? Are you serious?”

Pelosi's press secretary later responded to written follow-up questions from CNSNews.com by emailing CNSNews.com a press release on the “Constitutionality of Health Insurance Reform,” that argues that Congress derives the authority to mandate that people purchase health insurance from its constitutional power to regulate interstate commerce.



The exchange with Speaker Pelosi on Thursday occurred as follows:

CNSNews.com: “Madam Speaker, where specifically does the Constitution grant Congress the authority to enact an individual health insurance mandate?”

Pelosi: “Are you serious? Are you serious?”

CNSNews.com: “Yes, yes I am.”

Pelosi then shook her head before taking a question from another reporter. Her press spokesman, Nadeam Elshami, then told CNSNews.com that asking the speaker of the House where the Constitution authorized Congress to mandated that individual Americans buy health insurance as not a "serious question."

“You can put this on the record,” said Elshami. “That is not a serious question. That is not a serious question”...

Hoyer Says Constitution’s ‘General Welfare’ Clause Empowers Congress to Order Americans to Buy Health Insurance

October 21, 2009

CNSNews.com – House Majority Leader Steny Hoyer (D-Md.) said that the individual health insurance mandates included in every health reform bill, which require Americans to have insurance, were “like paying taxes.” He added that Congress has “broad authority” to force Americans to purchase other things as well, so long as it was trying to promote “the general welfare.”

The Congressional Budget Office, however, has stated in the past that a mandate forcing Americans to buy health insurance would be an “unprecedented form of federal action,” and that the “government has never required people to buy any good or service as a condition of lawful residence in the United States.”

Hoyer, speaking to reporters at his weekly press briefing on Tuesday, was asked by CNSNews.com where in the Constitution was Congress granted the power to mandate that a person must by a health insurance policy. Hoyer said that, in providing for the general welfare, Congress had “broad authority.”

“Well, in promoting the general welfare the Constitution obviously gives broad authority to Congress to effect that end,” Hoyer said. “The end that we’re trying to effect is to make health care affordable, so I think clearly this is within our constitutional responsibility.”

Hoyer compared a health insurance mandate to the government’s power to levy taxes, saying “we mandate other things as well, like paying taxes.”

The section of the Constitution Hoyer was referring to, Article I, Section 8, outlines the powers of Congress, including raising taxes, but not the purchasing any type of product or service. The opening paragraph of Section 8 grants Congress the power to raise taxes to, among other things, “provide for the … general welfare of the United States.”

Section 8 partly reads:

“The Congress shall have Power to lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States.”

The Constitution then details the specific powers of Congress, including raising an Army and Navy, regulating commerce between states, and to “make all laws necessary and proper” for the carrying out of these enumerated powers.

“To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof,” concludes Section 8.

CNSNews.com also asked Hoyer if there is a limit to what Congress can mandate that Americans purchase and whether there is anything that specifically could not be mandated to purchase. Hoyer said that eventually the Supreme Court would find a limit to Congress’ power, adding that mandates that unfairly favored one person or company over another would obviously be unconstitutional.

“I’m sure the [Supreme] Court will find a limit,” Hoyer said. “For instance, if we mandated that you buy General Motors’ automobiles, I believe that would be far beyond our constitutional responsibility and indeed would violate the Due Process Clause as well – in terms of equal treatment to automobile manufacturers.”

Hoyer said that the insurance mandate was constitutional because Congress is not forcing Americans to buy one particular policy, just any health insurance policy.

“We don’t mandate that they buy a particular insurance [policy] but what we do mandate is that like driving a car -- if you’re going to drive a car, to protect people on the roadway, and yourself, and the public for having to pay your expenses if you get hurt badly – that you need to have insurance,” said Hoyer.

In 1994, the Congressional Budget Office reported the following about health insurance mandates:

“A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States. An individual mandate would have two features that, in combination, would make it unique. First, it would impose a duty on individuals as members of society. Second, it would require people to purchase a specific service that would be heavily regulated by the federal government.”

Under all five of the health care bills currently being considered in Congress, every American adult would have to have a policy that conformed to government standards for coverage and premiums. Each bill creates Bronze, Silver, and Gold health insurance plans and mandates that Americans buy one of them, either through their employer or through government-run exchanges.

David B. Rivkin, a constitutional lawyer with Baker & Hostetler, told CNSNews.com that Hoyer’s argument was “silly,” adding that if the general welfare clause was that elastic, then nothing would be outside of Congress’ powers.

“Congressman Hoyer is wrong,” Rivkin said. “The notion that the general welfare language is a basis for a specific legislative exercise is all silly because if that’s true, because general welfare language is inherently limitless, then the federal government can do anything.

“The arguments are, I believe, feeble,” he said.

U.S. Senate Panel Backs Health Insurance Requirement

Editor's Note: If the government can require us to purchase health insurance, will it also require us to get microchip implants as part of our health care plans?

September 24, 2009

Reuters - A U.S. Senate panel considering a sweeping healthcare overhaul upheld a requirement on Thursday that individuals purchase health insurance and rejected a proposal that could have scuttled an $80 billion White House deal with drugmakers.

On their third day of debate, members of the Senate Finance Committee made slow progress on hundreds of amendments to the healthcare bill, the last of five measures pending in Congress on President Barack Obama's top domestic priority.

The Democratic-controlled panel defeated a Republican proposal to let individuals opt out of the bill's requirement that everyone have health insurance. The plan would offer subsidies on a sliding scale to help people buy it.

Republicans said the issue was a matter of personal freedom and questioned the constitutionality of forcing people to purchase insurance.

"The individual mandate in this bill is un-American. It may even be unconstitutional," said Republican Senator Jim Bunning, the amendment's sponsor.

Democrats said the requirement was vital to the success of the overhaul, which aims for a dramatic reduction in the number of uninsured people living in the United States.

"The system won't work if this passes," Baucus said of the amendment.

The panel's bill, which committee staff said would cost about $900 billion over 10 years, mirrors Obama's proposals to rein in costs, increase insurance competition and regulation and expand coverage to the uninsured.

Another GOP Senator Open to Health Care Overhaul

October 14, 2009

AP - A second Republican senator signaled Wednesday she's open to voting for sweeping health care legislation this year, putting President Barack Obama closer to a historic achievement that has eluded generations of Democratic leaders.

But Sen. Susan Collins, R-Maine, told The Associated Press that the bill approved Tuesday by the Finance Committee needs substantial improvements to make coverage more affordable, contain costs, and protect Medicare. Nevertheless, she joined her Maine GOP colleague Sen. Olympia Snowe in endorsing the goal of far-reaching changes.

"My hope is we that can fix the flaws in the bill and come together with a truly bipartisan bill that could garner widespread support," Collins said in an interview. "I think this bill is far superior to the ones passed by the Senate (health) committee and the three House committees, but it needs substantial additional work."

The 10-year, $829 billion Finance bill was approved by the committee Tuesday on a 14-9 vote, after Snowe broke ranks with her Republican colleagues to support Chairman Max Baucus' middle-of-the-road plan.

Wednesday, Snowe tackled the most divisive issue still on the table: creation of a government insurance plan that would compete with private ones.

While emphasizing that she still opposes the so-called public option, Snowe said in a nationally broadcast interview that she could foresee a government-run plan that would "kick in" if private insurers failed to live up to expectations that they keep premiums in check.

"I think the government would have a disproportionate advantage" in the event of a government-run option, Snowe acknowledged. At the same time, she added, "I want to make sure the insurance industry performs, and that's why we eliminate many egregious practices."

If the industry didn't follow through on congressionally-mandated changes aimed at making health care more affordable, she said, "then you could have the public option kick in immediately."

Snowe previously had proposed using the public option as an incentive, or a threat, to private insurers. This "trigger" option, or some version of it, has survived the bitter debate and scrutiny to remain a viable option for compromise.

Such a statement from a Republican can be very influential in an environment in which GOP lawmakers almost universally have opposed any kind of government-run health care option to compete with private insurers. It represents a break in party solidarity, even if finite. Health care proposals advanced in the House include such a government option.

Snowe broached her standby notion again as talks among lawmakers on health care were going back behind closed doors; Senate leaders are trying to merge two very different bills into a new version that can get the 60 votes needed to guarantee passage...

House Majority Leader Steny Hoyer, D-Md., told reporters that it was unlikely that the House would vote before the first week of November. He said he expected a vote by Christmas but was making no guarantees.

Senate Majority Leader Harry Reid, D-Nev., has said he wants move quickly to merge the Finance bill with a version passed earlier by the Senate health committee. His goal is to get health care overhaul legislation onto the floor the week after next...

In general, bills moving toward floor votes in both houses would require most Americans to purchase insurance, provide federal subsidies to help those of lower incomes afford coverage, and give small businesses help in defraying the cost of coverage for their workers.

The measures would, among other things, bar insurance companies from denying coverage on the basis of pre-existing medical conditions and for the first time limit their ability to charge higher premiums on the basis of age or family size. Expanded coverage would be paid for by cutting hundreds of billions of dollars from future Medicare payments to health care providers. Each house also envisions higher taxes — an income tax surcharge on million-dollar wage-earners in the case of the House, and a new excise levy on insurance companies selling high-cost policies in the Senate Finance Committee bill.