The contents of these articles are based on Fact and Truth. Challenges are invited.
The day’s top political news:
Seedy Chicago Politics Passed Health Care Bill: Senator Lindsey Graham
The United States Senate reached an agreement on health care reform legislation this weekend, and they couldn’t have done it without a bit of Chicago grit. According to South Carolina Republican Lindsey Graham thinks.
Graham, says the Democrat bill, which passed the Senate late Saturday night was only reached because of “seedy Chicago politics” which have been established by the new president from Chicago. Obama and his core staffers are all denizens of the Chicago Democrat machine – the most corrupt political group in the country.
Seedy or not, now that the Senate has passed a version of its health care bill, both houses of Congress will attempt to reconcile the differences between their bills. That process should take just as much Chicago moxie to pull off. Expect bare knuckled threats, extreme arm twisting, and a great deal more bribes such as was seen in the case of Nebraska Senator Ben Nelson.
Sen. Reid’s Government-Run Health Plan STILL Requires a Monthly Abortion Fee
Senate Majority Leader Harry Reid’s (D-NV) latest health care “manager’s amendment” would STILL levy a new “abortion premium” fee on Americans under the Democrats’ health care plan. Just like the original 2,032-page, government-run health care plan from Speaker Nancy Pelosi’s (D-CA) and the last version of Senator Reid’s 2,074-page bill, this latest 383-page amendment levies an abortion premium and does not fix the problem of government funds being used to subsidize elective abortions.
Under Reid’s “manager’s amendment,” there is no prohibition on abortion coverage in federally subsidized plans participating in the Exchange. Instead the amendment includes layers of accounting gimmicks that demand that plans participating in the Exchange or the new government-run plan that will be managed by the Office of Personnel Management must establish “allocation accounts” when elective abortion is a covered benefit (p. 41). Everyone enrolled in these plans must pay a monthly abortion premium (p. 41, lines 5-8), and these funds will be used to pay for the elective abortion services.
In short, the Reid bill continues to defy the will of the American people and contradict longstanding federal policy by providing federal subsidies to private health plans that cover elective abortions. The new language does include a “state opt-out” provision if a state passes a law to prohibit insurance coverage of abortion, but it’s a sham because it does nothing to prevent one state’s tax dollars from paying for elective abortions in other states.
http://republicanleader.house.gov/blog/?p=725
Obama’s Ambitious Agenda Carries a Few Bruises for his Democrats facing the voters
On any list of tough sales jobs in American politics, tax increases, higher energy prices and foreign aid would rise to the top. Negotiations on curbing climate change involve all three It didn’t help Obama that science supporting his efforts were revealed as bogus on the even of Copenhagen.
Thousands of environmental policy makers and advocates left Copenhagen in disappointment. The agreement the United States reached lacked commitments to achieve its stated goals, was nonbinding and was not formally affirmed by participants, in any case.
Obama’s base line result from the Copenhagen climate scam, is no better than the one he was forced to accept regarding his efforts to win designation of Chicago as an Olympic site.
http://www.nytimes.com/2009/12/21/us/21caucus.html?ref=us
Opinion:
Senate Democrats are challenged to find a way to shoehorn its position into a bill the Democrat House will accept.
Keep in mind, the debate on health care schemes is strictly a Democrat matter. Democrat own whatever ends up being the “health care takeover”.
Republicans have been totally barred from any participation and Republicans have been unanimous in voting against what Harry Reid revealed this week end. Democrats will likely play a big vote penalty next November for their actions on this issue.
Doctors, who have a very direct interest in the health care issue are responding to the Democrat actions.
Investor’s Business Daily reports:
“The GOP roster for 2010 House races includes at least seven doctors. Many are military veterans as well. Rand Paul, an eye surgeon and son of Rep. Ron Paul, R-Texas, is making a Senate bid in Kentucky. Congress has 16 doctors from various fields now serving. Most are Republicans.
Polls show the public is getting increasingly anxious about a medical overhaul.”
Democrat problems reach beyond their health care conspiracies. More and more voters are recognizing the far left nature of the entire Obama program, and such perceptions do not bode well for Democrat incumbents – especially those whose election resulted from their running as “conservatives”. Of course in today’s reality NO Democrat is a conservative.
Senate passage of a health care bill will face shoe horning differing details into a final bill needing House approval. That won’t be easy given the far left demands of Democrats such as Pelosi and her people. Betting now holds the Pelosi demands will be muzzled.
This week end, Reid had to make major concessions – outright bribes. Nebraska Senator Ben Nelson was the last Democrat hold out, and his vote was crucial to passage. He sold out, but not without lingering demands.
Nelson, received assurances of a “limited conference” in order to secure his vote for Reid’s bill. He laid down at least two demands he says are “deal breakers”. Nelson says he can’t support: the inclusion of a government insurance plan – otherwise known as a “public option” and an income tax increase Reid’s bill would impose on wealthy individuals.
“That would break it,” Nelson said on CNN’s “State of the Union.”
There are other shaky votes – especially those of far left Congressmen (and there are many among Democrats) who are outraged Reid didn’t go as far as they wanted in imposing socialized medicine.
Democrats claim Republicans oppose health care reform. That’s a lie, of course. Republicans are in accord with a majority of Americans opposing this particular bill and the threat of socialized medicine it contains.
Normal Americans might count themselves fortunate that Reid holds the whip hand in the current progress of the radical health care bill Democrats are forcing on us all. Reid’s version has been forced to dull the cutting edge of the outrageous legislation. For Obama, victory is not as complete as he had hoped or expected. In fact, Obama and his radical crew expected to have achieved passage of their scheme last Spring.
Public opposition – demonstrated by the tea party uprising – forced major delays on that and other far left efforts. That same public opposition and unmistakable activism by millions of voters who feel strongly about threats to their government today, is needed as never before. Public opposition may be the last resort.
The overriding obligation of the moment is uprising of normal Americans everywhere. Delay, delay, delay. Obstruct, obstruct, obstruct. Hold back the far left threat to our nation and its future.
Then liberal incumbents – all those who have supported the Pelosi and Reid programs – can be held fully accountable and replaced with people who will help turn back the tide, and begin repairing the immense damage that has been done to our country.
It can be done.
Liberal insanity can be successfully confronted and defeated.
A new day on Capitol Hill can be realized.
The answer lies on the shoulders of responsible Americans everywhere.
Buddy
The day’s top blogs
1.
http://www.politico.com/news/stories/1209/30844.html
Health plans on collision course
Despite a last-minute weekend deal that put the Senate on the brink of passing health care reform this week, liberal and moderate Democrats remain on a collision course over the bill, as both sides dug in Sunday for the next phase of negotiations.
President Barack Obama’s liberal base and powerful union leaders once hoped the expected House-Senate conference would partly undo a year of retreats and compromises, with Obama weighing in to nudge the moderate Senate bill to the left.
But the titanic struggle to lock in Sen. Ben Nelson (D-Neb.) as the 60th senator for the first key test vote early Monday morning has changed all that. The need to hold Nelson and other moderates in line means major changes on the public option, abortion, taxes, Medicare and Medicaid are unlikely — and that the Senate’s vision of health reform is likely to prevail over the House’s in the final talks.
“It is very clear that the bill — the final bill — to pass in the United States Senate is going to have to be very close to the bill that has been negotiated here,” Sen. Kent Conrad (D-N.D.) said on “Fox News Sunday.” “Otherwise, you will not get 60 votes in the United States Senate.”
Nelson, who received assurances of a “limited conference” to secure his vote for the Senate bill, has already laid down at least two deal breakers in the House bill that he can’t support: the inclusion of a government insurance plan and an income tax increase on wealthy individuals.
“That would break it,” Nelson said on CNN’s “State of the Union.”
House Democrats acknowledge that they will be limited in how far they can tweak the Senate compromise. But House leadership also knows that its rank and file need to force some changes, however small, before they will accept the final package — as a face-saving measure to be able to swallow late changes to the bill in the Senate, most notably the decision to eliminate a public option.
But on the left, the sentiments of a liberal base that revolted over concessions to moderates were channeled Sunday by Howard Dean, the former Democratic National Committee chairman, who last week repeatedly called on Democrats to scrap the bill.
“This can’t be the final version of the bill,” Dean said on NBC’s “Meet the Press.” “It simply sets us on a track in this country which is expensive and where we’re going to have lots more political fights.”
In a slight shift, however, Dean tempered his words, saying the bill is better than it was earlier in the week.
“I would certainly not vote for this bill if this were the final product,” Dean said. “I would let this thing go to conference committee, and let’s see if we can fix it some more.”
Andy Stern, president of the Service Employees International Union, identified areas beyond the public option in which Democrats in both chambers could agree, including boosting the federal insurance subsidies for middle-income Americans and strengthening insurance regulations.
“It is about progress, and we now have to fight for the changes in the conference committee and decide, when it is over,” whether to support it, Stern said on CNN’s “State of the Union.”
Senior administration officials contend the conference will not be as difficult as predicted because the differences between the two chambers have been known for months. “Once the Senate passes this bill, obviously there’s work to be done,” White House senior adviser David Axelrod said on “State of the Union.”
Two big voices in the health-reform debate came out with endorsements of the measure moving ahead in the Senate this week: the Federation of American Hospitals, which represents private community hospitals, and AARP, the nation’s largest seniors organization, which urged the Senate to move ahead with debate.
In addition, Democrats desperately tried to avoid an ugly public fight over abortion, but it looks as though the issue will haunt them right up until the end.
Abortion-rights supporters and foes alike blasted the compromise Senate Majority Leader Harry Reid (D-Nev.) cut with Nelson late Friday night. But it’s unclear whether their opposition will be enough to sink the broader bill.
“I have some deep reservations with this Nelson language on first examination,” Rep. Diana DeGette (D-Colo.), a co-chairwoman of the Congressional Pro-Choice Caucus, told POLITICO on Sunday.
Rep. Bart Stupak (D-Mich.), a leading abortion opponent, said during the weekend, “While I and many other pro-life Democratic House members wish to see health care coverage for all Americans, the proposed Senate language is unacceptable.”
The final Senate bill grants state legislatures the right to prevent insurance plans that operate in the proposed health insurance exchange from covering elective abortions. The changes also require people who seek abortion coverage through the exchange to pay two separate checks each month to their insurance company to “segregate” federal funds from private funds that pay for abortion.
Reproductive-rights advocates argue the new system would create a more onerous burden for women seeking coverage for the procedure, while abortion opponents have argued throughout the debate that segregating payments still violates the existing prohibition on federal funds being used to pay for abortion.
Douglas Johnson, the legislative director of the National Right to Life Committee, called the changes “book-keeping contortions” and said that his group plans to put pressure on any senator who votes to consider the changes Reid unveiled.
But the real fight will occur in negotiations between House and Senate leaders over a final bill.
House Speaker Nancy Pelosi of California can’t afford to lose any Democrats. And with Stupak threatening to vote against the Senate compromise, she’ll need to offset his vote with other Democrats who voted against it the first time. She might be able to pick up some moderate-to-conservative Democrats who favor the Senate approach, but many of these lawmakers will need to be OK with the final abortion restrictions.
On the other side, a bloc of abortion-rights backers, led by DeGette, has already promised to vote against any bill that includes Stupak’s amendment, which would prevent people who receive government subsidies from purchasing coverage for elective abortions through the exchange. DeGette believes many of the 41 Democrats who voted for Stupak and “yes” on the House health care bill are willing to work with party leaders to find a middle ground.
The opposing camps are similarly entrenched on the public option and the method for financing the health care expansion. The House would create a government-sponsored insurance plan, but the Senate bill is silent on this point. After several attempts at compromise, Reid nixed the public option altogether.
The taxes could prove difficult to bridge. The House relies on a so-called millionaires’ tax, and has refused to consider the tax on expensive insurance plans. The Senate has taken the exact opposite posture. But because the White House has weighed in several times in favor of the tax on “Cadillac” plans, as a key component to slow the growth rate in health care spending, the Senate is likely to win this round.
Meanwhile, Republicans increaed their attacks on the bill Sunday, criticizing a variety of deals cut to win the votes of Democratic senators, such as Nelson, who got the federal government to pick up the cost of any Medicaid expansion under the health reform bill in the state of Nebraska forever. Republicans said Democrats have refused to say which state would get about $100 million inserted into the bill on behalf of a still unidentified university hospital.
“This process is not legislation. This process is corruption,” said Sen. Tom Coburn (R-Okla.). “And it’s a shame that that’s the only way we can come to consensus in this country is to buy votes.”
But Nelson defended his efforts. “I always put Nebraska first,” he told POLITICO in an interview Saturday. “But I looked at this through the standpoint of Nebraskans and the country. ... There is a difference between holding out for something and holding up. I was holding out for something to make it better.”
John Bresnahan contributed to this report.
2.
Republican Study Committee’s Info Alert: Summary of Major Changes to Senator Reid’s Takeover of Health Care Bill, H.R. 3590 (Patient Protection and Affordable Care Act)
Procedure:
The Senate Republicans are not giving up and will use every procedural tactic available to them in the coming days. As of now the Senate expects to have the final vote on the bill at 7:30 PM on December 24, 2009, in light of the 60-40 cloture vote on the Reid Manager's Amendment earlier this morning.
There are three possible scenarios that could play out if the Senate passes H.R. 3590 including:
Ping-Pong: The House may choose to take up the Senate bill, making necessary changes to garner enough votes, and then send it back to the Senate where once again it must achieve a 60 vote threshold. This seems the least likely scenario.
Conference Report: A robust Conference report is less likely at this point, but should that occur, final passage in the Senate will still require 60 votes for passage. Sen. Nelson, during his press conference on December 19, 2009, stated that he reserves the right to vote against the bill if major changes occur in Conference.
The House simply accepts the Senate bill through an up-or-down vote: Although Speaker Pelosi and Leader Hoyer have said they will not simply accept the Senate bill, it remains to be seen whether the progressives and pro-life Democrats will keep their promises or crumble.
Major Issues to be Resolved Between House and Senate:
Illegal immigrants’ ability to purchase coverage in the exchange
Federal funding of abortion
The government-run option vs. the federally overseen “Multi-State Plan”
Financing the expansion of coverage through a surtax on the “wealthy” and small businesses vs. a union opposed tax on “Cadillac plans” and the Medicare payroll increase for the “wealthy”
Independent Medicare Advisory Board (IMAB), also known as “MedPAC on Steroids”
Main Issues:
Costs still go up: CBO has said that the net increase in the federal budgetary commitment to health care will go up $200 billion.
o Most recently, CBO revised its long-term estimate to lower their projected savings by 0.25% of GDP or $500 billion.
Premiums still go up: CBO says the amendment would have little impact on premiums.
Hurts access and quality of care: According to CBO, if the projected $470.7 billion (up from $464.6 billion) in Medicare cuts are actually allowed to occur, they could still harm beneficiaries’ access and quality of care.
Real cost once implemented: Previous estimates place the cost of the bill once fully implemented (FY 2014-2023) at $2.5 trillion.
If you like what you, have you can’t keep it: CBO has estimated that 8-9 million people would lose employer coverage under the Reid bill.
Summary:
The nearly 400-page Manager’s Amendment (bringing the total bill to 2,733 pages) makes several substantial changes to the underlying bill, H.R. 3590. Some highlights of the changes include:
New government-run “Multi-State” plan: Although the government-run plan with a state-opt out has been removed, the Manager’s Amendment still allows for the federal government through the Office of Personnel Management (OPM), to run, oversee and “negotiate” with new “Multi-State” plans offered in State Exchanges and available nationwide.
o At least one of the plans must be non-profit and at least one plan must not offer coverage of abortions.
o Individuals who enroll in an OPM run multi-state plan will be placed in a separate risk pool from federal employees enrolled in the FEHBP.
o Qualified plans must still be licensed in each state and meet all state and federal requirements including newly established standards for medical loss ratios, profit margins, and premiums. OMP-run multi-state plans must cover all essential health benefits and meet all of the requirements of a qualified health plan, and comply with 3:1 age rating.
o CBO stated that the new plan would have little impact as insurers may not want to or be able to participate and would probably already be participating in the Exchanges.
Still allows for the funding of abortion, and is far from the Stupak language that passed the House with the support of 64 Democrats.
o Specifically Nelson’s “compromise” would mandate that every state provide an insurance plan option that does not cover abortion while giving each state the right to pass a law barring insurance coverage for abortion within state borders (which was already allowed in the underlying bill). However, the provision still allows for state taxes to go toward abortions in other states, and there is no prohibition on abortion coverage in federally-subsidized exchanges. Each state through the new government run plan (“Multi-State Plan”) overseen by the Office of Management Personnel (OMP) can provide access to two plans – only one of which must exclude abortions. Currently no plan under the Federal Employee Health Benefits Plan, overseen by OMP, provides for abortion coverage.
o Additionally, it fails to fix Sen. Mikulski’s amendment which gives the Health Resources and Services Administration (HRSA) the power to require private insurance plans include abortion coverage under the title of “preventive care.” Finally, the amendment fails to provide adequate conscience clause protection, as it does not prohibit any government entity or program from discriminating against health care providers that do not want to participate in abortions.
Increase in individual mandate penalty: The penalty is now tied to the higher of a flat dollar (up to $750) amount or 2% of taxable income up to the national average of the “Bronze” (lowest value) plan premium, bringing in $15 billion - $7 billion more than the underlying bill.
Tighter insurance restrictions on Medical Loss Ratio (MLR): It requires insurers both before and after the establishment of the Exchanges to have a MLR of 80% in the small group and individual market and 85% in the large group market, forcing insurers to cut down on administrative costs such as Health IT, fraud detection, care management, etc. Plans that exceed this must give a rebate to consumers, and states can determine a higher MLR rate in any market. This is a new federal intrusion into private companies as it dictates how companies can allocate their resources. According to CBO, if the government dictates MLR up to 90% (combined with the bills other regulations) it would essentially make private insurance a government program, dramatically adding to the cost of the bill.
Removes the temporary “Doc Fix”(SGR): The underlying bill provided for an 0.5% increase in Medicare reimbursements to physicians for 2010. The Manager’s Amendment removes this doc fix without addressing the problem. The temporary payment freeze passed in the DOD bill to avoid the 21.2% cut effective January 1, 2010 will expire March 1, 2010 and thus the Senate must enact a separate SGR fix. Some members may be concerned that such an important health priority is omitted from a “health care reform” bill and that this change is simply a budget gimmick to eliminate the $11.3 billion cost of the patch.
Still expands Medicaid with new carve outs: The bill still contains unfunded mandates to states through the expansion of Medicaid, but this time with new special treatment for the states of Nebraska, Vermont, and Massachusetts (tailored to get the votes from Sens. Nelson and Sanders).
These states will receive FMAP bonuses such that:
o Nebraska will receive 100% FMAP for newly eligibles indefinitely.
o Vermont will receive a 2.2% FMAP increase for 6 years for their entire program.
o Massachusetts will receive a 0.5% FMAP increase for three years for the entire program.
o According to CBO “there would be roughly 15 million more enrollees in Medicaid and CHIP than is projected under current law,” bringing the total in 2019 to 50 million people or 1 in 6 (50 million out of 282 million).
Coverage: Increase coverage by 1 million people – now leaving 23 million vs. 24 million uninsured under the bill.
Taxes: The bill increases taxes by $518.5 billion – up $25 billion from the underlying bill and still raises taxes on middle class families, breaking President Obama’s pledge not to tax Americans earning less than $250,000. The major changes to the tax provisions include:
o $86.8 billion tax increase: Raises the Medicare payroll tax by 0.9% (an additional 0.4% increase from the underlying bill which raised it by 0.5%) on individuals making $200,000 and families making $250,000 (thus maintaining the marriage penalty).
o $2.7 billion tax increase: Replaces the “botax” or excise tax on elective cosmetic surgery with a new excise tax (10% of the amount paid for the service by the customer) on indoor tanning services.
o $19.2 billion tax increase: Moves the annual tax on medical devices back one year from 2010 to 2011 and increases it to $3 billion up from the previous $2 billion beginning in 2018.
o $13.3 billion tax increase: Indexes Flexible Spending Accounts (FSAs) to CPI-U after 2011
o $59.6 billion tax increase: Moves the tax on health insurers back one year (from 2010 to 2011) and changes it from a flat tax of $6.7 billion a year to a phased in tax starting at $2 billion in 2011, $4 billion in 2012, $7 billion in 2013, $9 billion in 2014 - 2016, and $10 billion in 2017 and thereafter.
o $2.6 billion tax increase: Places a “fee” on insurance policies to fund the Patient-Centered Outcomes Research Trust Fund. The amendment provides a new exemption from the health insurer fee for nonprofit insurers that meet certain requirements (only two insurers in the States of Nebraska and Michigan qualify), including a high MLR.
o $148.9 billion tax increase: Includes additional carve outs for several types of insurance that would be subject to the tax on “Cadillac” or high-cost health care plans such as workers compensation, automobile medical payment insurance, coverage for on-site medical clinics, supplemental liability insurance.
Specifically exempts Longshore (Union) workers from the tax on “Cadillac” plans by qualifying them as “high-risk workers”.
CLASS Act: It still contains the new unsustainable long-term care entitlement program – the CLASS Act, which faced major opposition from Senate Democrats, including Senator Conrad, the Chairman of the Budget Committee, who called it a “Ponzi Scheme”. The CLASS Act, would create a government-sponsored long term care insurance program that would automatically enroll individuals unless they actively opt-out. This amounts to a federal take-over of the private long-term health insurance system.
o Individuals would pay premium levels set by the federal government (estimated to be $123/month on average) in exchange for a $50-a-day benefits to cover the cost of care. However, an individual must first pay into the program through premiums for 5 years before they can receive any benefits - meaning that the program would not pay anything out until 2016. Furthermore, the $50-a-day allocation for long-term care insurance is only a portion of the actual cost of long-term care for seniors. The CLASS Act would only add confusion about Medicare coverage of long-term care without covering the true cost of care. This may cause seniors to drop their current coverage.
o The CLASS Act is another unsustainable program being used to disguise the short-term costs of the broader bill through a budget gimmick. According to the CBO, the CLASS Act would raise $72 billion over the first ten years in the Senate bill (while paying out $0 in benefits for half of that time), but will begin to increase the deficit following FY2029. A group of seven Democrat Senators stated in a letter to Senate Majority Leader Reid, “We have grave concerns that the real effect of the provisions would be to create a new federal entitlement program with large, long-term spending increases that far exceed revenues. This is especially the case if savings from the first decade of the program are spent on other health reform priorities.”
o Numerous organizations have raised concerns with the CLASS Act, including CBO, the Concord Coalition, as well as the American Academy of Actuaries, who found that due to its program design, the program would require massive premium increases and benefit decreases by 2019 to remain solvent. Some conservatives may be concerned that this is another unsustainable program being used to disguise the short-term costs of the broader bill through a budget gimmick.
Comparative Effectiveness Research: The bill still establishes the Patient Centered Outcomes Research Institute (PCORI), a nonprofit corporation, to conduct comparative effectiveness research (CER). PCORI will replace the Federal Coordinating Council created in the American Recovery and Reinvestment Act of 2009. Despite repeated attempts by Republicans to prohibit the government from using CER to make coverage decisions, such amendments failed along party lines. There is concern that this unelected, bureaucrat-appointed board will lead to rationing and make one-size-fits-all judgments prohibiting treatment options on the basis of cost.
o The bill allows the Secretary of HHS to use CER findings to make a determination regarding coverage as long as it is done through an open and transparent process.
o To pay for these activities, the bill would impose a new “fair share” tax on insurance policies.
Still contains the Independent Medicare Advisory Board (IMAB), or “MedPAC on Steroids,” made up of non-elected government bureaucrats that are empowered to make arbitrary cuts to Medicare providers that will limit access to care for seniors. Congress would be required to consider legislation implementing the proposal or alternative proposals with the same budgetary impact on a fast track basis. The recommendations of the board would go into effect automatically unless blocked by subsequent legislative action.
o IMAB’s recommendations would be required if the Chief Actuary for the Medicare program projected that the program’s spending per beneficiary would grow faster than the average of the growth rates of the consumer price index for medical services and the overall index for all urban consumers fiscal years 2015 through 2019
o After 2019, the threshold would be increased and IMAB’s recommendations would be required if Medicare spending growth rose faster than gross domestic product (GDP) per capita plus 1 percentage point.
o CBO revised its long-term estimate to take into account this change in 2019, such that it lowered the projected savings by 0.25% of GDP or $500 billion.
Adds State demonstration programs for Medical Liability Reform: The amendment allows for grants to States to test alternatives to civil tort litigation, which would be evaluated by the Secretary of HHS who would then determine their effectiveness. These demonstration projects would only allow models that emphasize patient safety, disclosure of health care errors, and the early resolution of disputes with the ability for patients to opt-out at any time. The bill contains no actual medical liability reform.
“Free-Choice vouchers”: The amendment requires employers to provide their share of premiums through a tax-exempt voucher to be used in the Exchange if coverage they offer is unaffordable for employees. Eligible employees are individuals below 400% of the Federal Poverty Level (FPL) whose premiums exceed 8% of income (but not above 9.8%) and are not enrolled in employer coverage. CBO estimates that about 100,000 workers would utilize this option.
New carve outs for some physician-owned hospitals: The amendment pushes back the date from February 1, 2010 to August 1, 2010 by which a physician-owned hospital must have a provider agreement to participate in Medicare. Of the 125 projects projected estimated to be eliminated through the prohibition on physician owned hospitals, 55 are expected to be saved by this carve out (including projects in Nebraska).
Other Provisions:
Extends CHIP program: Continues the current reauthorization period of CHIP for two years, through September 30, 2015.
Adds a Second Amendment protection clause: Clarifies that the Secretary of HHS cannot collect, maintain or use information on the possession or use of firearms. The amendment also prohibits the Secretary from implementing any sort of incentive program (including wellness programs), that could change rates on insurance, simply due to an individual owning, possessing or using a firearm.
Expands basic health program eligibility to immigrants: Allows legal immigrants with incomes less than 133% FPL, who are not eligible for Medicaid due to the five-year waiting period, to be eligible for the new state-run, federally-funded, basic health program that states can establish for “low-income” individuals above 133% FPL.
Expansion of the Center for Medicare and Medicaid Innovation: Adds payment reform models to the list of items the Center may consider and instructs the Secretary of HHS to focus on models expected to reduce program costs while preserving or enhancing quality of care.
Health professionals State loan repayment tax relief: Excludes from gross income for tax purposes, payments for participants in the National Health Service Corps, as well as State loan repayment or loan forgiveness programs, to provide for the increased availability of health care services in underserved or health professional shortage areas.
Expands adoption tax credit: Makes the adoption tax credit refundable, increases it from $10,000 to $13,170 and allows for the tax exclusion for employer-provided adoption assistance benefits to be increased by the same amount.
Adds the Indian Health Services reauthorization, the Indian Health Care Improvement Act.
2.
From: Bluegrass Institute for Public Policy Solutions
Government and the gallows: History repeats itself, again
Jim Waters
In the biblical account of Queen Esther, the evil Haman, one of her nation’s highest government officials became so consumed with envy and control that he eventually hung on the gallows he built for Mordecai, his righteous nemesis.
Haman used legislative maneuvers to trick the king into signing an edict to destroy the Jewish people, including Esther, a leader in the nation, and her Uncle Mordecai.
In the current battle over the future of our nation, the people – just like the ancient king – got tricked into believing more government would mean a better life for them and a more hopeful future for their children.
But then they started discovering the truth:
The nation’s “Esthers” discovered that the current health care bill would result in middle class Kentucky families paying 19 percent of their pre-tax income on insurance premiums, copays and deductibles.
Elderly “Mordecais” found out about $500 billion in proposed Medicare funding cuts. The people learned that women younger than age 50 and older than age 74 face pressure to forego mammograms, while those older than age 50 are ordered to get them only every two years.
The health care proposal represents a trillion-dollar gallows built to kill our freedom. But it remains to be seen who hangs. With chances of a “government option” fading, it appears the unraveling is under way.
Meanwhile, environmental wackos built gallows, too – from recycled arguments, of course. Like Haman, they count on folks not finding out that they have based their tax-raising, government-growing and business-destroying plans on a fraud.
The king in that ancient Persian tale started reading old news when he couldn’t sleep one night. He discovered that his life had once been saved by none other than Mordecai – the man Haman was trying to destroy. So now we read old e-mails acquired by a hacker that reveal manipulation of data to hide the fact that the earth may actually be cooling.
Gov. Steve Beshear, state Democrats and the horse-racing industry set fundraising records in the Dec. 8 special state Senate election. They spent more than $1 million to build political gallows for Senate Republicans and their candidate, Jimmy Higdon.
But it backfired. Higdon of Lebanon routed Jodie Haydon from Bardstown and further diminished chances of lawmakers approving expanded casino gambling.
Instead of popping champagne, Beshear & Co. find themselves with the proverbial noose around their political necks on their own very costly gallows. Kentuckians found out that gambling won’t repair our fading economy or crumbling schools. It only serves politicians and shady gambling interests.
Higdon ran against a national Democratic Party radical agenda, and the 2010 midterm elections could see quite a few political “hangings” of the gallows builders.
Envy and a desire to control the flow of information also play a part in this modern-day Queen Esther story.
When Mordecai informed King Xerxes about the attempt on his life, his stature among the people rose – putting Haman’s downfall in motion.
When Fox News began exposing the truth about the radical agenda the big-government types in Washington have planned for hard working taxpayers – including, as President Barack Obama said during the campaign, taking from those who work hard to earn and giving it to bailout-minded moochers – White House staff built gallows: They shut out Fox reporters from the president’s network interviews.
It gives me hope that the administration’s numbers began to tank while Fox’s ratings went stratospheric.
Is that the gallows I hear creaking?
— Jim Waters is director of policy and communications for the Bluegrass Institute, Kentucky’s free-market think tank. You can reach him at jwaters@freedomkentucky.com. Previously published columns can be read at www.bipps.org
3.
Who's responsible for the Senate's middle-of-the-night vote?
Byron York
Chief Political Correspondent
Why did the Senate gather at 1 a.m. Monday for a vote to move ahead on the Reid Amendment to the Democrats' national health care bill? Democrats blame Republicans. "Everyone knows we're here at one in the morning because of my friends on the other side of the aisle," Senate Majority Leader Harry Reid said moments before the vote. On CBS Sunday, Democratic Sen. Mary Landrieu said, "We don't have to vote in the middle of the night, but [Republican Sen. Tom Coburn] is the one making us do it -- not Harry Reid, not the Democrats. It is a Republican obstructionist that is making us vote in the middle of the night."
Coburn has no doubt slowed debate on the bill. But the fact is, there is no reason the Reid Amendment vote could not have been held at a more reasonable hour. One a.m. Monday was the earliest moment that Senate rules allowed a vote, but there is no rule keeping the Senate from voting at some time after 1 a.m. If Reid had scheduled the vote for, say, 11 a.m. Monday, that would have been fine. If he scheduled it for 4 p.m. Monday, or 10 a.m. Tuesday, that would have been fine, too.
But Reid is determined to pass the national health care bill by Christmas, and to do so he has to get the cloture vote on his amendment done at the earliest moment. The timeline is Reid's and Reid's alone. "The bottom line is, Sen. Reid schedules the floor," says one well-connected GOP aide. "He is the only one who can schedule the floor." If Reid had scheduled the vote during business hours on, say, Tuesday, a final vote would not have taken place until the day after Christmas -- an outcome Reid apparently found unacceptable.
This is how it works. Reid introduced his amendment Saturday morning. (It's the one that has the Sen. Ben Nelson Medicaid buy-off and other curious features.) Senate rules say there has to be an intervening day between the introduction of the amendment and a vote on limiting debate on the amendment. That intervening day was Sunday. That meant the cloture vote could be held Monday, or any time thereafter. The rules also say that the vote has to be held at least one hour after that next day has begun. So the Senate's Monday business began at 12:01 a.m., and the Reid Amendment vote could be held at 1:01 a.m. (As it happened, Reid himself spoke last, and his remarks went over the mark by six minutes.)
After the middle-of-the-night vote, there will be a maximum of 30 hours debate on the amendment. Then there will be a 30-hour period for a Republican substitute bill, followed by a 30-hour period on the final bill. Reid's schedule calls for a final, final vote on the health care measure to take place at about 7 p.m. on Christmas Eve. Voila! The bill will be passed by Christmas. That couldn't be done unless the Reid Amendment cloture vote were held in the earliest hours of Monday morning, setting off the final chain of votes and waiting periods. "This is purely to satisfy a self-imposed, arbitrary deadline," says the GOP aide.
By the way, when the 1 a.m. vote took place, the Reid Amendment had been public for about 36 hours, and the public had not had a single business day to examine it. "Make no mistake," said Minority Leader Mitch McConnell a few minutes before the vote. "If the people who wrote this bill were proud of it, they wouldn't be forcing this vote in the dead of night." Referring to the Nelson buy-off and other special arrangements in the bill, McConnell said few people would have imagined that the health care debate would have ended "with a couple of cheap deals and a rushed vote at one o'clock in the morning."
But that's what happened. In the end, to no one's surprise, the Reid Amendment moved ahead, 60-40, on a straight party-line vote. Democrats can blame Sen. Coburn and Republicans all they like, but the fact is, there is no reason, beyond the Christmas deadline, that the vote had to take place at 1 a.m.
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Posted by: Alena | December 21, 2009 at 11:51 PM