No illusions please: This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents’ insurance coverage? And even if the votes were there – would President Obama sign such a repeal?Yup.
teacherken : CNN reporting that some Republican Congressmen shouted at Bart Stupak "baby-killer" #hcrEtc. Stupak ended up voting for the bill.
...
StopTheTakeover: Bart Stupak is a SPINELESS HYPOCRITE! #TCOT #IAMTHEMOB
*Insurance companies will be barred from dropping people from coverage when they get sick. Lifetime coverage limits will be eliminated and annual limits are to be restricted.posted by ennui.bz at 8:17 PM on March 21, 2010 [194 favorites]
*Insurers will be barred from excluding children for coverage because of pre-existing conditions.
*Young adults will be able to stay on their parents' health plans until the age of 26. Many health plans currently drop dependents from coverage when they turn 19 or finish college.
*Uninsured adults with a pre-existing conditions will be able to obtain health coverage through a new program that will expire once new insurance exchanges begin operating in 2014.
*A temporary reinsurance program is created to help companies maintain health coverage for early retirees between the ages of 55 and 64. This also expires in 2014.
*Medicare drug beneficiaries who fall into the "doughnut hole" coverage gap will get a $250 rebate. The bill eventually closes that gap which currently begins after $2,700 is spent on drugs. Coverage starts again after $6,154 is spent.
*A tax credit becomes available for some small businesses to help provide coverage for workers.
*A 10 percent tax on indoor tanning services that use ultraviolet lamps goes into effect on July 1.
WHAT HAPPENS IN 2011
*Medicare provides 10 percent bonus payments to primary care physicians and general surgeons.
*Medicare beneficiaries will be able to get a free annual wellness visit and personalized prevention plan service. New health plans will be required to cover preventive services with little or no cost to patients.
*A new program under the Medicaid plan for the poor goes into effect in October that allows states to offer home and community based care for the disabled that might otherwise require institutional care.
*Payments to insurers offering Medicare Advantage services are frozen at 2010 levels. These payments are to be gradually reduced to bring them more in line with traditional Medicare.
*Employers are required to disclose the value of health benefits on employees' W-2 tax forms.
*An annual fee is imposed on pharmaceutical companies according to market share. The fee does not apply to companies with sales of $5 million or less.
WHAT HAPPENS IN 2012
*Physician payment reforms are implemented in Medicare to enhance primary care services and encourage doctors to form "accountable care organizations" to improve quality and efficiency of care.
*An incentive program is established in Medicare for acute care hospitals to improve quality outcomes.
*The Centers for Medicare and Medicaid Services, which oversees the government programs, begin tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions.
WHAT HAPPENS IN 2013
*A national pilot program is established for Medicare on payment bundling to encourage doctors, hospitals and other care providers to better coordinate patient care.
*The threshold for claiming medical expenses on itemized tax returns is raised to 10 percent from 7.5 percent of income. The threshold remains at 7.5 percent for the elderly through 2016.
*The Medicare payroll tax is raised to 2.35 percent from 1.45 percent for individuals earning more than $200,000 and married couples with incomes over $250,000. The tax is imposed on some investment income for that income group.
*A 2.9 percent excise tax in imposed on the sale of medical devices. Anything generally purchased at the retail level by the public is excluded from the tax.
WHAT HAPPENS IN 2014
*State health insurance exchanges for small businesses and individuals open.
*Most people will be required to obtain health insurance coverage or pay a fine if they don't. Healthcare tax credits become available to help people with incomes up to 400 percent of poverty purchase coverage on the exchange.
*Health plans no longer can exclude people from coverage due to pre-existing conditions.
*Employers with 50 or more workers who do not offer coverage face a fine of $2,000 for each employee if any worker receives subsidized insurance on the exchange. The first 30 employees aren't counted for the fine.
*Health insurance companies begin paying a fee based on their market share.
WHAT HAPPENS IN 2015
*Medicare creates a physician payment program aimed at rewarding quality of care rather than volume of services.
WHAT HAPPENS IN 2018
*An excise tax on high cost employer-provided plans is imposed. The first $27,500 of a family plan and $10,200 for individual coverage is exempt from the tax. Higher levels are set for plans covering retirees and people in high risk professions. (Reporting by Donna Smith; Editing by David Alexander and Eric Beech)
Rove: “This thing is paid for with Bernie-Madoff-style accounting. … It’s a gigantic disaster.”Heh.
Plouffe: “Karl and the Republicans would be familiar with that.”
Rove: “You will bankrupt the country if this bill passes. … For God’s sake, will you stop throwing around epitaphs [sic] and deal with the facts for once, David? … We will fight the election on this,. and the Democrats will have significant losses in the House and Senate as a result of this bill.”
Plouffe: “If Karl and a lot of Republicans want to call the election already, they ought to break out that ‘Mission Accomplished’ banner.”
Rove: “That’s cheesy, David. … You should not denigrate the mission of the USS Abraham Lincoln.”
From the reuters link.... "What happens in 2014: *Health plans no longer can exclude people from coverage due to pre-existing conditions."There will be a separate government program for people who can't get regular insurance, that phases out in 2014. That goes into effect As soon as possible from what I understand.
Um, what? Why wasn't that one of the immediate things?
Actually wrong. So-called, moderate, fiscally conservative but left-leaning bluedog democrats pretty much put the nail in the coffin on this one.Well, house asside, once they decided to do this via reconciliation, they could have added the public option, or a medicare buyin to the "sidecar" but they didn't. But they can also add the public option any future legislation too.
Did they come up with this brilliant plan after Stupak has made it clear that his contempt for women’s opinions applies even to nuns? Is it possible that Nancy Pelosi called up Obama and said, “Look, I’ve been telling him and Sebelius has been telling him there’s no federal funding for abortion in this bill. He apparently needs to hear it from a man, so can you give us a hand?”posted by XQUZYPHYR at 9:43 PM on March 21, 2010 [7 favorites]
Oh for fuck's sake, I'm done here. Enjoy your celebration of the betrayal of your values.Oh please, other then a few upper middle class healthy people who don't want to buy insurance, this pretty much makes everyone better off. Could it be better? Absolutly, but it's an improvement over the current situation.
Ladies and Gentlemen, I submit to you again that it is not enough to just throw out the Democrats in favor of Republicans. We must throw out the Democrats and replace them with the right kind of Republicans — conservatives who actually are conservative. And then we must insist that these newly elected Republicans not settle for the status quo in leadership. What is now need not be left in place.
Already we have a few Republicans positioning themselves in grand theatrics to call for full repeal of Obamacare. But these same Republicans in the past have talked about the good parts of the bill and how repeal should be measured. The only way to ensure today’s rhetoric turns into future consistent actions is to surround these Republicans with true conservative warriors.
Friends, if we are going to destroy the Democrats, we must first build up an army of real conservatives in Congress. Half measures, Democrat-lite, and men who compromise in favor of more government must be unacceptable.
Let me be blunt: any Republican who says we will repeal and replace will themselves be replaced. We want repeal period.
This is not to say we will not offer up our own ideas, of which there are many. This is to say that right now there is no consensus on what to replace this monstrosity with, so instead of nuancing just promise to repeal it. We don’t need cute and clever politicians right now, we need a commitment to repeal Obamacare.
Gallup: Obama Up 3 points. Approval Now Stands at 50% [Americans That Moronic?]
March 21, 2010
Posted on Monday, March 22, 2010 1:13:00 AM by Steelfish
Gallup Daily: Obama Job Approval Obama Up 3 points. Approval Now Stands at 50% Each result is based on a three-day rolling average
Gallup tracks daily the percentage of Americans who approve or disapprove of the job Barack Obama is doing as president.
Yeah, it's going to be great when poor people have to buy insurance plans with huge deductibles that they can't afford to actually use.They do not have to purchase such plans. Knowing as many underemployed people as I do, this sounded losy to me. But, in fact:
Although most Americans who do not obtain health insurance will face a federal penalty starting in 2014, many experts question how strict the enforcement of that penalty will actually be.Meanwhile, Medicaid is available for everyone earning below 133% of the poverty line, and significant plan subsidies kick in from 133-400%, with pressure on employers to provide equivalent plans. Where's the beef?
The first year, consumers who do not have insurance will owe $95, or 1 percent of income, whichever is greater. But the penalty will subsequently rise, reaching $695, or 2 percent of income.
Families that fall below the income-tax filing thresholds will not owe anything.posted by zvs at 11:34 PM on March 21, 2010 [2 favorites]
History is watching the Republican Party shrink in its rear-view mirror.posted by octothorpe at 6:01 AM on March 22, 2010 [4 favorites]
Based on Thursday's changes, the health legislation also:And the infamous "Cornhusker Kickback" that the Senate will strip from the bill if they don't weasel out of passing the reconciliation package is extra Federal funding for Medicaid for Nebraska.
-Retains $300 million in extra Medicaid aid for Louisiana, which had helped win support for the Senate health bill from Sen. Mary Landrieu, D-La. The state is still struggling to recover from Hurricane Katrina.
-Keeps $100 million included in the Senate bill that is expected to go for a public hospital in Connecticut sought by Dodd, who is retiring.
-Preserves language won by Baucus permitting many of the 2,900 residents of Libby, Mont., to qualify for Medicare benefits. Some of them have asbestos-related diseases from a now-shuttered mine.
-Provides an additional $8.5 billion over the next decade for 11 states and the District of Columbia to help them pay for the more generous Medicaid assistance they have been providing low-income residents. These states are Arizona, Delaware, Hawaii, Maine, Massachusetts, Minnesota, New York, Pennsylvania, Vermont, Washington and Wisconsin.
-Maintains a Senate-approved provision giving extra money for hospitals and doctors in North and South Dakota, Montana and Wyoming.
See...this is what I just don't understand about politics and political strategy. If I were a Republican strategist and really, truly, honestly wanted to kill this bill, this is the point I would have pushed constantly at the American public.The reason that the Republicans didn't do this is that it isn't true in any meaningful sense. I guess one could argue that requiring health insurance companies to spend 80 or 85 cents of every premium dollar on medical costs isn't rate regulation--after all, insurance companies could jack up premiums 50 percent by also suddenly raising the negotiated rates they pay to doctors and hospitals by 50 percent to make sure they still satisfied the minimum medical cost ratio--but in the real world, this is rate regulation. An insurance company will not be able to arbitrarily raise its premiums unless it can prove that the underlying medical costs of its members rose by an equivalent amount.
Require health plans to report the proportion of premium dollars spent on clinical services, quality, and other costs and provide rebates to consumers for the amount of the premium spent on clinical services and quality that is less than 85% for plans in the large group market and 80% for plans in the individual and small group markets. (Requirement to report medical loss ratio effective plan year 2010; requirement to provide rebates effective January 1, 2011)That probably won't have too much of an effect on the large group market, where the medical cost ratio is already pretty high (something like 93% for groups with over 1,000 employees). However, it will have a major immediate impact on the small group and individual markets, where administrative costs currently eat up about 25-30 percent of premiums.
Rep. John Boehner (R-Ohio): Health care passing 'over my dead body.' - March 17, 2010
"You know, I've been telling my staff nine months, 'They can't pass this bill.' And finally my staff wrestled me to the ground last fall and said, 'Mr. Boehner, we have to quit saying this because they're gonna pass this bill.' And I looked at my staff and I said, 'Alright, I'll try to throttle it back a little bit. But it'll be over my dead body.'"
Rep. Eric Cantor (R-Va.) - February 25, 2010
"We have to continue the fight to make sure [it is dead]," Cantor says, "but all signs indicate now they cannot pass this in the House
Fred Barnes, The Weekly Standard - January 20, 2010
"The health care bill, ObamaCare, is dead with not the slightest prospect of resurrection. Brown ran to be the 41st vote for filibuster and now he is just that. Democrats have talked up clever strategies to pass the bill in the Senate despite Brown, but they won't fly. It's one thing for ObamaCare to be rejected by the American public in poll after poll. But it becomes a matter of considerably greater political magnitude when ObamaCare causes the loss of a Senate race in the blue state of Massachusetts."
"Bin Laden Will Never Appear In An American Courtroom" -- Eric Holder
You know what would get me off?
Osama Bin Laden in chains heading to a federal courtroom. -- Ironmouth
ed: I missed your comment on preview. The affordability subsidies phase out concurrently with the introduction of exchanges where such plans can (hopefully) be purchased cheaply. -zvsThat's completely wrong. The subsides are forever.
My parents have a hard enough time keeping their fucking cars on the road. "Tax credits" is not the same thing as "The government will pay if you can't afford to buy health insurance". -- dunkaduncYes, they are. Refundable tax credits go into your pocket, no matter how much money you pay in. So if you have $500 in taxes, and $5000 in tax credits, you get a $4500 check from the government.
You know, it's illegal to drive a car in the UK without car insurance (I'm guessing it's the same in the US). You can get fined and/or your car taken away if you do. Yet, somehow, insurance companies fight to provide the cheapest insurance quotes to attract drivers rather than jacking up the prices because you have to have insurance. -- EndsOfInventionThat's true in the U.S. but unlike Car insurance where you have tons of providers, most people get health insurance through their employer, so they don't get to pick. And in many states, there is only one insurance company that provides almost all of the insurance products. If people try to buy on their own, they really get screwed because there's no collective bargaining.
For some reason, engineering of all sorts is and always has been very popular with far-right conservatives and very religious Christians.Others have mentioned the "overestimation of their own skills/intelligence" issue, which is a good one. With right-wingers in particular, I think part of the reason there's a correspondence between engineering and political conservatism is that engineering for many is an "aspirational" profession: for a lot of people, a degree in engineering is seen as a path to making money and professional success, without having to "waste" all that time with stuff like medical school or law school. So you get a lot of people who see themselves at the top of the economic/class heap or believe that they deserve to be, or believe that one day they will be, and they vote accordingly, in part in the hopes of being seen as "one of the rich" by other people who are genuinely wealthy: which means they have to be even more doctrinaire conservatives to prove their bona fides, because their actual economic class lies more between the middle and upper middle classes.
Perhaps it's something about the nature of engineering as a mental discipline: the rigour of absolutes (figures, rules, no room for subjective nuance as in the humanities) combined with directly dealing with the concrete world (as opposed to theory, as physicists and mathematicians, for example, have the luxury of)?
This bill will immediately begin to lower health care costs for American families and small businesses.posted by saulgoodman at 10:37 AM on March 22, 2010 [5 favorites]
o In 2010, small businesses that choose to offer coverage will begin to receive tax credits of up to 35 percent of premiums to help make employee coverage more affordable.
o In 2010, adults who are uninsured because of pre-existing conditions will have access to affordable insurance through a temporary high-risk pool.
o This bill starts to close the Medicare Part D doughnut hole in 2010 by providing a $250 rebate to Medicare beneficiaries who hit the gap in prescription drug coverage. And beginning in 2011, the bill institutes a 50 percent discount on prescription drugs in the doughnut hole.
o Starting this year, new private plans will be required to provide free preventive care: no co-payments and no deductibles for preventive services. And beginning Jan. 1, 2011, Medicare will do the same.
o In 2010, this bill will provide help for early retirees by creating a temporary re-insurance program to help offset the costs of expensive premiums for employers and for retirees ages 55-64.
Under health reform, Americans will see an immediate expansion of coverage.
o This year, children with pre-existing conditions can no longer be denied health insurance coverage. The bill outlaws that practice for new health plans as well as grandfathered group plans. Moving forward, no insurance company can deny a child coverage based on his or her health.
o This year, new health care plans and select grandfathered plans will allow young people to remain on their parents’ insurance policy until their 26th birthday.
o This year, insurance companies will be banned from dropping people from coverage when they get sick, and they will be banned from implementing lifetime caps on coverage. This year, restrictive annual limits on coverage will be banned for new plans and grandfathered group health plans. Under health reform, Americans will be ensured access to the care they need.
o The bill increases funding for community health centers so that nearly twice the number of patients can be treated in their community health centers over the next five years. The funding begins in the next fiscal year.
o The health reform bill will increase the number of primary care doctors, nurses, nurse practitioners and physician assistants through new investments. This funding takes effect in the next fiscal year.
Health reform will immediately curb some of the worst insurance industry practices and strengthen consumer protections.
o Beginning this year, this bill creates a new, independent appeals process that ensures consumers in new private plans have access to an effective process to appeal decisions made by their insurer.
o Starting Jan. 1, 2011, insurers in the individual and small group market will be required to spend 80 percent of their premium dollars on medical services. Insurers in the large group market will be required to spend 85 percent of their premium dollars on medical services. Any insurers that don’t meet those thresholds will be required to provide rebates to their policyholders.
o This year, discrimination based on salary will be outlawed. New group health plans will be prohibited from establishing any eligibility rules for health care coverage that discriminate in favor of higher-wage employees.
o This bill holds insurance companies accountable for unreasonable rate hikes. Starting in 2011, it helps states require insurance companies to submit justification for all requested premium increases. Any company with excessive or unjustified premium increases may not be able to participate in the new health insurance exchanges.
o Beginning this fiscal year, this bill provides funding to states to help establish offices of health insurance consumer assistance in order to help individuals in the process of filing complaints or appeals against insurance co
A majority of Americans oppose the health bill passed by Congress but still trust Democrats and President Obama more than Republicans when it comes to healthcare reform, a new CNN poll finds.
Fifty-nine percent of respondents say they oppose the bill passed by Congress. (The poll was conducted before last night's passage). Thirty-nine percent favor the bill.
It should be noted, however, that of the 59% who oppose the bill, 13% do so because it's "not liberal enough." So a majority of respondents (52%) either support the bill or want Democrats to do more.
President Obama still holds an advantage over Republicans. Just about half of respondents--51%--say they trust the president on healthcare, compared to 39% who say the same of the GOP. Congressional Democrats also lead Republicans on the issue, by a margin of 45% to 29%.
and for those who said that Dem left opposition to this measure didn't help the GOP, take a look at this poll cited by the Hill:That's a very reductivist approach: Everything that doesn't help democrats helps republicans, Even if republicans and democrats team up for some 'ole fashion "bipartisanship" I suppose.
When the GOP commits to all out 'bar the door of the University of Alabama' style-resistance, then a very reductivist approach is appropriate.Yeah, but it didn't. Recrimination in loss is pretty common, but you have to be pretty bitter to recriminate in a success. Reminds me of when Carville started attacking Howard Dean after the dems took the congress in '06. More interested in settling scores with other liberal factions then enjoying success.
Avoiding dealing with the enemy in your plans is a fatal error. It almost cost us this bill.
And in that sense, what the GOP did was tactically right. They stopped the public option with the wall of resistance. The minute they decided they were going to be 100% against the legislation, the public option was dead. But it is going to cost them electorally now.That's actually pretty insane. Republican votes would have made the public option even less likely. In fact, their resistance to any deal made the plan much more liberal: Yglesias:
But David Frum is largely on board with my interpretation, though I think he in many ways goes too far. Frum’s point is that if conservatives had been willing to engage constructively in the negotiations on the big enchilada, they could have gotten a more conservative version of universal health care. After all, Max Baucus wanted conservatives to engage constructively in the negotiations and all signs are that he wanted a more conservative bill.Of course, it's all subjective. But I find your subjective analysis to be pretty whack in general.
My point is even more basic—at a couple of moments along this race the conservatives won the argument and Democrats were ready to buckle. Credit for not buckling goes to Nancy Pelosi and other gutsy leaders. But it also goes to the GOP. They wouldn’t take “yes” for an answer when lots of people wanted to surrender and settle for something much smaller. Instead, whipped up into a frenzy of ideological fanaticism and overconfidence, they decided to take no prisoners. So nobody surrendered! And that’s how Mitch McConnell brought universal health care to America. And the thing of it is that most conservatives are so shallow, and so driven by hippie-hatred rather than any real views, that if they get to use this as an “issue” to win seats in the midterms and it never gets repealed, they’ll consider themselves vindicated.
It was the minute the GOP's scorched earth tactics came on board. It is like a war. You have to react to your enemy.The GOP decided to make themselves irrelevant and they succeeded. As I said, the bill is more liberal then it would have been if the republicans had been willing to negotiate. The idea that the GOP killed the Public Option is ridiculous. As far as I can tell, the public option died because unknown democratic senators or congress people told leadership they wouldn't vote for it if it was in there, after being lobbied hard by the insurance industry.
Indoor tanning is now an illegal lifestyle choice.Well, those people should really switch to sunless tanners. All that UV really fucks up your skin IMO.
For the record, @GOPBoehner is a joke account.For the record, it's my joke account... :)
I'm gussing this will be blamed on:Scrolling down and scanning as i go, I read this:
1) Tort claims; and
2) Illegal aliens "burdening" the system.
How do I know? I'm frickin' Nostradamus.
posted by Pollomacho at 11:09 AM on March 22 [5 favorites +] [!]
posted by angrycat at 7:57 PM on March 21, 2010 [29 favorites]