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Ben Nelson

The Senate Health Care Compromise Bill – Not Too Compromised (UPDATED)

Re:  Think Progress » The Progressive Case For Passing The Senate Health Bill , By John Podesta on Dec 16th, 2009 at 6:11 pm

Since Joe Lieberman demanded stripping the public option and Medicare buy-in provisions from the merged Senate bill, some strong progressives like Howard Dean have argued that without a public option or a Medicare buy-in provision, the bill is a giveaway to private insurers and should be killed. Other progressive leaders like Senators Jay Rockefeller, Tom Harkin and Sherrod Brown believe that the bill represents the best chance for passing health care reform in the foreseeable future. “I’m going to vote for it,” Brown told reporters. “I can’t imagine I wouldn’t. I mean there’s too much at stake.”

I am sad that Joe Lieberman and Ben Nelson are holding out for their own personal agenda. I wish we had the public option here in the US so the less fortunate can enjoy access to the same health care system. It’s a shame that we cannot provide medical treatment to those who are so poor they have to choose between buying food and paying an insurance premium.

I say lets go ahead and chunk the public option and the Medicare buy-in and then take those issues up later in a separate bill under the reconciliation process. If we pass the current bill that contains more safeguards and consumer protections than ever in the history of health insurance, then we will have accomplished at least a partial victory for the poor and working poor.

Listen to John Podesta, CEO of the Center for American Progress, and former chief of the Obama transition team:

…I come down on the side of the Senate passing the bill.

Here’s why:

The Senate health care bill is not without its problems. But if enacted, it would represent the most significant public reform of our health care system that Congress has passed in the 40 plus years I have worked in politics. The bill will give health care coverage to a record 31 million Americans who are currently uninsured, lay a foundation that will begin to lower costs for millions of families, and provide all Americans with the access to adequate and dependable coverage when they need it most.

All of us are anxious to see the final language from the Senate. And a final bill must ensure that the subsidies provided are sufficient to make insurance truly affordable for working families. But based on what we know, here are my top ten reasons for why progressives should support the Senate passing the bill:

1. Largest Expansion Of Coverage Since Medicare’s Creation: Thirty-one million previously uninsured Americans will have insurance.

2. Low/Middle Income Americans Will Not Go Without Coverage: For low-income Americans struggling near the poverty line, the bill represents the largest single expansion of Medicaid since its inception. Combined with subsidies for middle income families, the bill’s provisions will ensure that working class Americans will no longer go without basic health care coverage.

3. Insurance Companies Will Never Be Able to Drop or Deny You Coverage Because You Are Sick: Insurers can no longer deny coverage because of a pre-existing condition. They can’t rescind coverage or impose lifetime or annual limits on care. Significantly, the bill also ends insurer discrimination against women — who currently pay as much as 48% more for coverage than men — and gives them access preventive services with no cost sharing.

4. Lowers Premiums For Families: The Senate bill could lower premiums for the overall population by 8.4%. For the subsidized population, premiums would decrease even more dramatically. According to the CBO, “the amount that subsidized enrollees would pay for non-group coverage would be roughly 56 percent to 59 percent lower, on average than the nongroup premiums charged under current law.”

5. Invests in Keeping People Healthy: The bill creates a Prevention and Public Health Fund to expand and sustain funding for public prevention programs that prevent disease and promote wellness.

6. Insurers Can’t Offer Subprime Health Care: Insurers operating in the individual and small group markets will no longer sell subprime policies that deny coverage when illness strikes and you need it most. Everyone will be offered an essential benefits package of comprehensive benefits.

7. Helps Businesses Afford Coverage: Small employers can take advantage of large risk pools by purchasing coverage through the bill’s state-based exchanges. Employers with no more than 25 employees would receive a tax credit to help them provide coverage to their employees. The bill also establishes a temporary reinsurance program for employers providing coverage to retirees over the age of 55 who are not eligible for Medicare.

8. Improves Medicare: The bill eliminates the waste and fraud in the Medicare system, gets rid of the special subsidy to private insurers participating in Medicare Advantage and extends the life of the Medicare trust fund by 9 years. It also closes the doughnut hole that affected 3.4 seniors enrolled in Medicare Part D in 2008.

9. Reduces The Deficit: Not only would the bill expand coverage to 30 million Americans without adding to the nation debt, it would also reduce the deficit by up to $409 billion over 10 years.

10. Reduces National Health Spending: A CAP-Commonwealth Fund analysis concludes the bill could reduce overall spending by close to $683 billion over 10 years – with the potential to save families $2,500. Even the most conservative government estimates conclude that the bill would reduce national health care expenditures by at least 0.3% by 2019

Howard Dean wants to scrap this bill and start over. I’m not saying that Howard Dean is wrong. There are many things in this bill that are unsavory, like the mandatory purchase of insurance and the interstate rule change, but there are many things in this bill that help. There are subsidies for those who will not be able to afford premiums. The final language of the bill is still weeks away. I say cool your jets, dear progressives, and let’s work toward passing this bill.

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UPDATE: I jsut read a great article slamming Howard Dean and his call to kill the health reform bill. It is linked from the Huffington Post to the Washington Post. The article is short, but full of facts. By Ezra Klein:

…This morning, Howard Dean vowed to oppose the bill unless the state-based exchanges “act as prudent purchasers and select only the most efficient insurers.” (If that was included, he said, a “stripped-down” version of the bill would be acceptable, though it’s not clear what that means.)

What’s so strange about Dean’s objection is that the exchanges in the Senate bill (pdf) do act as “prudent purchasers,” that is to say, they set limits on the plans that can enter in the exchange to ensure that people are getting good choices. The relevant section begins on page 131 of the Senate bill. “The Secretary shall, by regulation, establish criteria for the certification of health plans as qualified health plans.” A couple of pages of relevant criteria follow, including marketing requirements (plans can be disqualified for focusing their marketing in outlets that would bring them uncommonly healthy enrollees), broad provider networks, coverage of options used by low-income folks (community health centers, say), quality measures, quality improvement strategies, consumer ratings, standardized benefit packages, etc.

And then, a couple of pages later, the language gets stronger. On page 143, the exchanges are given power to certify insurance plans based on whether “the Exchange determines that making available such health plan through such Exchange is in the interests of qualified individuals and qualified employers in the State.” On 144, premiums, and premium increases, enter explicitly into the discussion. Any insurance plan that wants to increase premiums has to submit a written justification for their decision. It will have to post that information on its Web site. And if the exchange is not convinced, it can decertify the plan.

Sounds pretty good to me!

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A Second Look | Executive and Legislative Ambulance Chasing

Does slowing down the legislative process equate to “killing” health care? If so, how?

via Citing CBO-Director’s Statements, Senate Centrists Urge Slower Pace For Health Care Reform | TPMDC.

Six key Senate Centrists–Ben Nelson (D-NE), Joe Lieberman (I-CT), Mary Landrieu (D-LA), Olympia Snowe (R-ME), Susan Collins (R-ME), and Ron Wyden (D-OR)–are asking Democratic and Republican leaders to slow down the pace of health care reform efforts.

“[I]n the view of [CBO Director Doug Elmendorf's] statement, there is much heavy lifting ahead,” reads a letter the group signed today. “We look forward to working with you to develop legislation that is vital to the well-being of the American people and urge you to resist timelines which prevent us from achieving the best results.”

According to Huffington Post’s Ryan Grim, who first obtained the letter, “The organized effort to slow down the process is a blow to the reform effort.” And, indeed, there [sic] letter exemplifies a growing sense among centrists and health reform skeptics that the pace of reform should be slowed down. But it’s also a restatement of very publicly held views. Earlier today, Nelson himself appeared on CNN and suggested congressional health care leaders should not to move too quickly.

The President wants the Senate bill yesterday, and conventional wisdom says that if this process drags on past the August recess then there will be the possibility that it won’t pass this year. So? I would much rather see the right bill get passed at a later date than have the wrong bill passed immediately. The “Gang of Six” have asked for a little more time, not a hatchet.

President Obama gave his weekly address this morning on this subject. I read the transcript and there is no solid reason or justification that would back up the idea that this legislation has to be out of committee before the August recess. The video:

Here is the only part of the President’s address that speaks to the urgency of the bill:

(snip) This is the status quo. This is the system we have today. This is what the debate in Congress is all about: Whether we’ll keep talking and tinkering and letting this problem fester as more families and businesses go under, and more Americans lose their coverage. Or whether we’ll seize this opportunity – one we might not have again for generations – and finally pass health insurance reform this year, in 2009.

I agree. Health care reform must pass this year – and it must contain a public plan. But, in all honesty, will giving it a couple more weeks do irreparable harm?

In yet another attack on the liberal agenda, the ultra left-wing economist Paul Krugman penned an op-ed today harshly criticizing any notion of delay in the process of passing the health care reform bill. The op-ed is entitled, The Six Deadly Hypocrites.

Will the destructive center kill health care reform? It looks all too possible.

What’s especially galling is the hypocrisy of their claimed reason for delaying progress — concern about the fiscal burden. After all, in the past most of them have shown no concern at all for the nation’s long-term fiscal outlook.

Case in point: the Medicare Modernization Act of 2003, which denied Medicare the right to bargain for lower drug prices, locked in overpayments to private insurance companies, and did nothing, nothing at all, to pay for its proposed outlays. How many of these six self-proclaimed defenders of solvency voted no on the crucial procedural vote? One. (Joe Lieberman, to my surprise.)

Well, Paul, the Bush administration never paid for any legislation at all, especially the most expensive – the  Bush tax cuts of 2003 that cost over a trillion dollars. And you are right, there was no concern for fiscal responsibility at that time from these six Senators. But times have changed. Obama has taken full responsibility for today’s economy. He has opened his arms and has embraced this mess as if it were his own. President Obama is the one who has demanded fiscal responsibility, and yet he wants to hurry the process of health care reform without giving these conservative Democrats a chance to catch their breaths and consider the impact of the costs. It’s okay nowadays to talk about saving money in the long run.

And what is “especially galling” to me sometimes is how Krugman, Ryan Grim, and others can begin pouting and stomping their feet whenever some  new event happens that upsets the progressive left’s apple cart. If we can make it through eight years of the most spendy administration ever, we can surely do  the next few months without a major mishap. We’ll get the apple vendor safely to the hospital, so stop fretting.

UPDATE ,07/19/09:
via Orszag: Republicans Trying To Kill Health Care Reform Through Delay

President Obama’s Director of the Office of Management and Budget, Peter Orszag, accused Senate Republicans on Sunday of trying to kill health care reform by dragging out the legislative process.

Appearing on CNN’s State of the Union, Orszag labeled the attempts to push back the health care reform timeline as a “typical Washington bureaucratic game of if you don’t have a better alternative just delay in hopes that that kills something.”

“We want to get this done by August and we think we can,” he added. “There are those that are advocating delay just as a desperation move to try and kill this.”

Orszag stressed that not everyone calling for delay had sinister motives. The moderate Democrats in the Senate and Blue Dog Democrats in the House, he said, were “actively participating in the debate and that is great.” This past week, Sens. Ben Nelson (D-Neb.) Mary Landrieu (La.) and Ron Wyden (Ore.), along with Independent Sen. Joe Lieberman (Conn.) and Maine Republican Sens. Olympia Snowe and Susan Collins signed a letter asking to slow down the health care reform debate.

See? Not everyone calling for delay has sinister motives. Besides, Orszag accuses Republicans of trying to kill health care reform by slowing it down without ever offering any conclusive evidence that they are, in fact, doing that.

And, he doesn’t tell us how slowing down the process will kill the bill. His explanation sounds a bit hokey. He speaks of Republican attempts to ask for more time as a, “typical Washington bureaucratic game of if you don’t have a better alternative just delay in hopes that that kills something.”

Weak.

Listen. If we are steadfast and continue to call, sign petitions, and generally push from our end then health care reform, with a public option, will pass Congress. If it is not done by the August recess, then it will be soon after. Obama told us during the campaign that change is up to us, not him, so keep up the pressure.

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A Second Look | Unfair to Private Insurance Plans. Huh?

via Ben Nelson Plans To Oppose Public Health Plan.

Sen. Ben Nelson (D-Neb.) said Friday that he will oppose legislation that would give people the option of a public health insurance plan. The move put

Sen. Ben Nelson (D-Neb.)

s him on the opposite side of two-thirds of Americans.

A poll released this week by Consumer Reports National Research Center showed that 66 percent of Americans back the creation of a public health plan that would compete with private plans. Nelson, in comments made to CQ, joins the 16 percent of poll respondents who said they oppose the plan.

Nelson also said that not only does he oppose a public health system, but he intends to go out and recruit other Democratic Senators to stand with him against the will of the majority.

Nelson’s problem, he told CQ, is that the public plan would be too attractive and would hurt the private insurance plans. “At the end of the day, the publ

ic plan wins the game,” Nelson said. Including a public option in a health plan, he said, was a “deal breaker.”

He said that it would be too attractive. That it would “hurt the private insurance plans”. There are 40 million uninsured, and at least 30 million more under-insured that right now do not give a damn about hurting the private insurance plans.These are not individuals that are uninsured, but entire families. Families that could not get check-ups for their kids without SCHIP.

Nelson’s protection of the right-wing corporatist’s interests is the same kind of thinking that won over the Supreme Court in Bush v. Gore - and look where that got us.

Nelson is forcing Obama’s hand. Obama will have no choice

but to use the reconciliation process in negotiating the health care reform bill since Nelson will filibuster the vote himself. The way I understand it, the reconciliation process may be used to bypass the filibuster and go straight to cloture. It is used only for budgetary matters. Nelson must gain enough votes for a simple majority to kill public health, and looking around, he may not have such a hard time doing that. Including himself he only needs nine more, counting Al Frankin.

Lets see. Which conservative Democratic Senators might vote with him?

Mary Landrieu (LA), Mark Pryor (AR),  Bill Nelson (FL),  Blanch Lincoln (AR), Joe Lieberman (I-CT), Arlan Spector (PA), Tom Carper (DE), Kirsten Gillibrand (NY), Evan Bayh (IN), Michael Bennet (CO), Mark Begich (AK), Kay Hagan (NC), Herb Kohl (WI), Claire McCaskill (MO), Jeanne Shaheen (NH), Mark Udall (CO), and Mark Warner (VA)

That’s 17 Senators that might jump on the bandwagon with Ben Nelson. Blatantly backing the insurance industry and stating that any private insurance plan would hurt them is an attempt to limit the debate and is an outrage to the millions of Americans unable to obtain even simple preventive care.

Folks, we need to get ahead of this issue and fast.  A public health system will not only raise up the poor, but it will add jobs and help revive our economy. Please write or call your Senators to persuade them that we absolutely need a public health system now.

Contact information for all U.S. Senators can be found at U.S. Senate: Senate Home.

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