cross-posted on Huffington Post
The final push for passage of health care legislation has brought out the worst in many Democrats. It’s been a depressing spectacle to watch, with the latest NBC News/WSJ poll a testament; especially for those who want health care reform, but find little reform in the current bill to trumpet mainly because there is no competition like a public option built into it, but also because the language against full reproductive health care makes it more difficult for women to get something that’s so important to them. Democrats seem to be lining up against women over the bill.
On Monday, Speaker Pelosi convened a small, select new media roundtable to talk about the final health care push. It wasn’t reported by the men who attended, except by one via Twitter, but there was not one single woman in attendance, which I confirmed. It was an embarrassing moment for the first female Speaker of the House who is pushing a health care bill that marginalizes women’s reproductive care.
Today, The Hill is reporting that Speaker Pelosi is convening an all female meeting of House members. The topic for discussion was reported as “to be determined.” One can only guess what this is about.
Then, MoveOn.org released an ad targeting Democrats on patriotism, shown above, channeling Liz Cheney and right-wing tactics to threaten them if they vote against the current health care bill. MoveOn’s message: Vote for this health care bill or you’re un-American!
The believe it or not aspect of all this is that Democrats are blithely willing to bargain women’s rights away by codifying the Hyde Amendment instead of challenging it or making the health care bill at least neutral in this area. Whether it’s Stupak-Pitts or the Senate Nelson language currently in the bill, the result is the same. A George Washington University Study lays it out:
One of the great challenges in insurance reform is the unintended consequences of regulation. The Stupak/Pitts Amendment is intended to reach only a specific part of the market. But the cumulative effect of the provision, in combination with existing federal laws governing Medicaid and federal employee health benefits (as well as the law of certain states) inevitably can be expected to move the entire health benefits industry away from its current inclusive coverage norms and toward a new norm of exclusion. The provisions of the legislation, as well as the technical challenges that arise in benefits administration, militate against the creation of a supplemental coverage market. Thus, if the result of national health reform is to move millions of women into a market that operates subject to the exclusion, then it is fair to predict that the entire market for coverage ultimately will be affected as a product tipping point is reached and virtually no supplemental market appears.
Shorter: As time goes by it will be too cumbersome and no longer cost effective for insurance carriers to offer full reproductive services to women, or a rider to procure what you need, which will further curtail these services. That’s the point of the Stupak-Pitts-Nelson anti women coalition. The current health care bill that Democrats are pushing actually limiting rights women have won through the courts over years.
Then came the legislative game moves of “deem and pass,” which Pelosi and Slaughter were once against but now they’re for, having lost a case on the issue, but are now considering using this tactic to get the Senate bill passed in the House. A former staff director of the House Rules Committee doesn’t think what either party does in this regard is good policy, which Karen Tumulty of Time magazine already reported on the self-executing rule, aka the “Slaughter rule.”
For political reasons, elite Democrats from Robert Reich to Donna Brazile are circling the wagons making all sorts of declarations about the current legislation, while threatening Democrats with primary challenges who are considering voting against the bill.
Taking the health care fight even further, CNN reported yesterday that Senior Obama campaign official Steve Hildebrand is considering challenging a female House member in South Dakota, Herseth Sandlin, based on her vote on the health care bill, which is expected to be a no.
There isn’t a Democrat, progressive or liberal who is against health care reform, real reform, that is, one that offers competition via a public option, but also doesn’t codify the Hyde Amendment in health care language that takes women backwards from the rights we’ve already won through the courts.
What most people I’m hearing from don’t want is the current legislation being forced through Congress. As for Pres. Obama and the current Democratic Party supporting women’s rights, well, in the current bill being considered, they go a long way to prove they do not.
It doesn’t have to be this way, as we all want real health care reform, starting with a public option, something that actually is worth all the pressure now being exerted to get passed.
The other reality we all have to face is that after remaining coy on women’s reproductive rights, Pres. Obama has now finally shown his hand. He’s willing to sell women out to get any health care bill that offers him a “win,” regardless of whether it’s actually good policy, which without a public option it is not.
Unfortunately, Democrats aren’t listening to the majority of the American people or women protesting loudly against what they’re doing. Women are once again being asked to take one for the team, but this one is for all time, reversing what we’ve already won. Democratic elites and their institutional partners who depend on big cash to survive have decided that to save Pres. Obama’s presidency and Democratic face it’s the current bill or bust.
However, come November, as polls stand today, it looks like Democrats are blindly heading toward bust. They can’t say they weren’t warned.
Even Mr. Progressive Dennis Kucinich has decided he wants to support the inadequate which appears the so called enemy of the adequate and good.
You have the power to force the real controllers of congress, namely the corporations that fund conservatives.
Go to http://www.democratz.org and send emails to demand that congress enact a strong public option.
Obama and the Dems are bad on process, policy and politics. The very early change from a “health care reform” framing to “health insurance reform” was telling, and just as bad as it looked at the time.
Meanwhile, further to the right, we hear about “government take-over” and “socialized medicine.”
I have no hope the Dems will stop their march which is, as you say Taylor, “blindly heading toward bust.”
Taylor, Excellent post.
democratz, a serious and respectful question: what do you mean by “public option”? The phrase is used by so many, so often, as if we all know what we’re talking about, and it’s the same thing.
Thanks Ramsgate.
As I told everyone earlier, Mr. Kucinich can be bought easily. All it took was a ride on Air Force One, and a little presidential stroking. Needless to say, I’m not shocked.
This bill covers millions of uninsured people, provides subsidies, and reduces the deficit.
You’re railing against it because it doesn’t cover a $500, frequently elective, procedure that women access once or twice in their lives. With families paying $1500 a month for policies with $2000 deductibles, who find they can’t even get insurance if they change jobs, this is your rallying cry.
The reasons the bill polls poorly is because a compromise makes no one happy. The teabaggers on the right are unhappy because they think it’s socialism. The teabaggers on the left are unhappy because of no public option and abortion.
Democrats are grown ups: that’s why they are unpopular with you, Taylor.
Taylor Marsh says:
17 March 2010 at 11:01 am
Its what Democrats do; they cave.
Kanzeon says:
17 March 2010 at 11:31 am
Democrats are betting on people’s ignorance, which has never proven a bad wager.
The current bill throws people into a monopolized system without competition, because it mandates people buy their product. There is also no guarantee that people can afford what Dems are making them buy.
Women’s self-determination depends on access to full reproductive health care. If you actually read the GWU study you’d see what the Nelson language will eventually do.
That said, if we were talking about a health care bill with a public option, which would offer competition, I’d sign on through an article in support of it, because that actually would be REAL REFORM.
Wait until Rep. get in and start carving away things because they’re too expensive, with the tax cuts too much.
As a political analyst, however, I understand that this is about saving Obama & Dems from humiliation. That’s the REAL reason they’re moving heaven & earth to pass it. If they do pass it my headline will read as follows: Democrats make history.
But it won’t change the facts that the bill itself stinks.
Good to see you standing up for women. It must be hard for women, particularly women with families, to take a stand on this legislation. I wonder if the provisions limiting choice are designed to bring Roe before the present Supreme Court.
Heya BG, good to see you.
Nothing gets past you, my friend. The Nelson language is doing in this bill what the right hasn’t been able to do through the courts AND IT’S BEING DONE BY DEMOCRATS.
Taylor,
The bill doesn’t stink. It just doesn’t do everything you want it to do. I could link the various detailed analyses of the bill, which generally support the conclusion that it will cover many more people at lower or at worst equal cost, but you can surely find them yourself. But you don’t care about FACTS, you care only about ranting about principle.
We ALREADY buy into the insurance system. There is no other choice. That won’t change. Poor women already have difficult access to reproductive services, whereas middle class women can get what they need by paying out of their own pockets. That won’t change.
That doesn’t change the fact that people die because they have no access to healthcare and that this bill will cover tens of millions of people who are currently uncovered.
We all have our philosophical objections, but the leaders of the Democratic party are grown ups who live in the real world. Opposing this bill is juvenile and mean-spirited. That goes for those who are fighting on the “principle” of opposing socialism and those who are fighting over the principle of the public option.
Without competition, the bill stinks.
We ALREADY buy into the insurance system.
There is choice now, not a penalty if you don’t have the money. Some people likely will pay the penalty if it’s cheaper than insurance.
Additionally, right now women don’t have to write 2 checks to get the coverage they need. State Medicaid helping poor women, because Hyde deals with federal HHS money. Once the exchanges get absorbed that won’t be the case. The goal to make abortion more and more difficult to get, with all sorts of ramifications.
Hyde currently has to be served up in every budget; assuming the current bill passes, it will now be further codified into health care law.
It stinks.
Opposing this bill is juvenile and mean-spirited.
The analysis I’ve given on the current bill is correct.
Taylor,
I think you just don’t understand what is necessary to expand coverage. EVERYBODY has to be in the system: the young and healthy don’t get to gamble. This is the case with a government run system – everyone pays into it in the form of taxes, and everyone takes out of it. If we don’t force the young and healthy to participate, then only the older and the sick are in the system, and the costs are unsustainable. There MUST be mandates. Unless we were eliminating the entire private insurance system, those mandates would compel people to pay for private insurance. The public option, as presented, as never intended to dominate the market, but only to provide a measure of competition.
This has been the case from day one. Now, if someone chooses to pay the fine rather than have insurance, that probably is an unwise choice. I would think that person would NEVER purchase insurance in the current system, but might if part of the cost were unavoidable. But the fine will pay for other more responsible people to get subsidies and will pay to cover costs in the system when the person who chooses the fine over the insurance has to go to the emergency room.
This is basic. Complaining about the mandate is senseless.
Oh brother, now you’re going to lecture me on mandates? Hilarious.
Complaining about the mandate is senseless.
Forcing people into a monopolized system without competition is what’s not only un-democratic, but makes the current bill bad.
Taylor,
You have absolutely no credibility on this issue. You don’t even attempt to defend your position. Explain to the board how you can have a system that reaches near universal coverage without mandates, or how the reality that mandates would not be paid to private insurers was ever on the table.
On the GWU study, I’ve read it and I see nothing but unfounded speculation. Stupack “may” have “spillover” effects based on largely unsupported assumptions about how the insurance industry will react. I’m not an expert on the report (only read it once), but it doesn’t make a great deal of sense to me. For example, the amendement is quoted, on page 2 of the report, as not prohibiting funds being spent where a woman requires an abortion because of a physical illness, including an illness arising from pregnancy. On page 12, it claims that this may result in broad exclusions of care – but only if the entire industry moves to the “life-threatening” standard.” But the amendement doesn’t SET a “life-threatening” standard – only one that references physical illness, specifically including life-threatening conditions.
I certainly see the ambiguity involved in the language, and that, in the absence of futher guidance, insurers might be expected to play safe. But the reality is that the amendment isn’t the last word. As soon as the amendment is passed, the administrative rule making apparatus goes into effect. Those rules will provide safe harbors, which may be narrow or broad, depending on who the president appoints to make the rules. I think the reality is that nobody knows the reach and effect of Stupack, but that the effect is partly in the discretion of the executive.
The link:
http://www.gwumc.edu/sphhs/departments/healthpolicy/dhp_publications/pub_uploads/dhpPublication_FED314C4-5056-9D20-3DBE77EF6ABF0FED.pdf
Kanzeon, your analysis is absolutely spot-on. You’re dropping knowledge. And you get extra credit for expressing yourself so well. Keep it up.
Taylor,
Perhaps you can help me with my basic problem with the study.
First, if you look at the terms of the amendment, on page 2 and 3, it appears the Stupack amendment is targeted at elective abortions, not those that are medically indicated, and it does not seek to limit the ability of states to cover abortion services.
The report states that upwards of 80% of plans cover medically indicated abortions, but isn’t clear on how many cover elective abortions.
The rest of the report goes on to speculate why the amendment will not have the effect of simply applying to elective abortions and not affecting those covered by the state. The report claims that spillover effects will prevent states from offering services, and that medically indicated abortions, and even related services, will no longer be covered. This is an extraordinary conclusion: that the amendment will NOT mean what it says, and it offers no solution. Apparently there is no way to reference abortion in any way without having these dramatic effects.
My view is that, if Stupack works as it is plainly written, it is perhaps undesirable, not not a reason to oppose the bill. The catastrophic predictions are based on the words not meaning, in the end, what they plainly say. And the only evidence is “trust us, we know how insurers will react” without any consideration of rule making authority. I have trouble with that. Perhaps you can clear it up.
No, the Democrats are NOT preying on my ignorance.
If/when women’s health is sacrificed at the altar of BO’s ego and the medical industry’s profits, Secretary of State Clinton must cease and desist insisting that other countries provide adequate health care for their female population.
How much more of our hypocrisy can the rest of the world take?
Kanzeon says:
17 March 2010 at 1:48 pm
Look, Kanzeon, the bill is not a good bill. I understand why Democrats are circling the wagons, but I’m not coming at this as a movement progressive. That’s not my gig. I’m also not going to argue with you about Mr. Stupak, as we’re talking about Nelson language in the current bill, because Stupak was taken apart in the Senate bill, because it was just that bad. That does not, however, nullify the onerous language in the health care bill, the ramifications of which are real to those who study the purpose of legislation.
That this bill puts people in a system that has no competition is not a positive outcome. Rationalizing otherwise doesn’t make it so.
When the bill passes, which people are starting to think it will, Dems will have an historic victory. It doesn’t make it a good bill. These two things are separate.
Thanks for stopping by, Kanzeon.
Taylor,
Basically, you’re just not interested in defending your position. If you want to rely on the study, for instance, I think it’s important to understand it. Reason isn’t “rationalization” just because you disagree, for reasons you cannot or choose not to defend.
I find it offensive that you would reduce this to pure politics. It isn’t. It is about giving millions of people access to healthcare and increasing security for millions more, and reducing costs. Lives are at stake. Not just politics. Your choice is to screw everyone for another eight years or more, becuase your philosophical agenda wasn’t satisfied. THAT’S politics.
I have really had it that idiots like Kanzeon keep saying this bill “covers millions of uninsured people.” I might punch whoever this is right in the damn face if I heard this in person.
The bill does nothing of the kind. It MANDATES the purchase of insurance from the enemy and does nothing to reduce costs. It doesn’t GIVE “millions of people access to healthcare.” It makes criminals out of those who can’t or choose not to buy health insurance.
This is worse than a bad bill. It’s a HORRIBLE bill that kills any future hope of real reform.
TaosJohn,
I can’t help you with your anger issues, but the FACT is that the bill gives access to millions of people.
It also MANDATES purchases from companies we are already forced to buy from anyway. Apparently this just can’t be in your world – something could actually have a good and bad side, all at once.
If you want to disagree with the CBO report, Krugman, Klein and dozens of other people who have looked at the issues in depth, fine. But you haven’t presented anything in response that makes them “idiots.”
Want to get ideas for how you can take charge of your own health care costs? Check out Whatstherealcost.org
TaosJohn says:
17 March 2010 at 5:04 pm
People buy into the talking points all the time, TJ, especially when they’re repeated by favorite Dem insiders.
It’s St. Patrick’s Day, have a pint!
Can someone explain to me how the bill gives access to health insurance to millions of people? Is it because of subsidies offered to the poor that enable them to purchase insurance? Or is it because of the pre-existing condition clause. I understand all will have a mandate to buy… but I don’t understand how this mandate translates into insurance suddenly becoming accessible. If these millions that previously could not access HC due to pre-existing conditions, suddenly do have access, it still doesn’t mean it is affordable… unless there are massive subsidies offered to ALL.
I’m not that well-informed on the issue and really would like some answers.
whitepaw says:
17 March 2010 at 6:31 pm
You ask some good questions. There will be more subsidies to purchase health insurance and Medicaid will be expanded, from what I understand. Also, there will be more community health centers across the country, something that Senator Bernie Sanders from Vermont got into the bill. There is a formula that basically figures out who will get what, as far as the subsidies are concerned. It lines up with percentages above the poverty level for family income. Subsidies are phased out for families earning more than 60 or 80,000 dollars or something to that effect. I think the pre-existing conditions issue extends to children first, then adults, but don’t quote me on that. Again, premiums and deductibles are very big issues. Lawrence O’Donnell was on Morning Joe this past week and said (I think jokingly) you might get a good pre-existing conditions policy for $75,000. Who knows, really?
This health care issue has been a war in the party as well as the country. This spring, summer and fall is going to get interesting to say the least. I am not happy at all at my party as well as this healthcare bill. I am glad that more americans will be covered but if this healthcare bill does not go to plan, the democratic party will be in hugh trouble. Either way, the democrats are going to have to fight hard to keep there seats. Yes this will be historic if the healthcare bill passes, but its going to come at a hugh cost for the democrats.
Thanks Lynnette — very much.
What is very frightening to me is, as you point out, the cost that those with pre-existing conditions will have to pay and will be mandated to do so..
With exhorbitant costs, people will opt to pay the fine instead. Little will change as taxpayers will still end up footing the high medical costs for these individuals when they go to the ER.
Medicaid is the current govt. program for low income families? As opposed to Medicare for seniors? Finally, how is it possible that there can be subsidies and expanded Medicaid… without increases in taxes… unless they are still proposing to tax Cadillac plans and those earning $250K plus?
So far — I agree with Taylor… It is a bad bill.
whitepaw:
I think Ezra Klein is one of the best writers on this topic. I suppose Taylor will say it’s just because he’s a “Dem insider,” but what he writes makes sense to me, and I haven’t seen anyone refute it.
Five cost controls in the Senate bill:
http://voices.washingtonpost.com/ezra-klein/2009/12/five_cost_controls_in_the_sena.html
Klein on the CBO report:
http://voices.washingtonpost.com/ezra-klein/2009/12/to_repeat_the_cbo_found_that_p.html
Here’s a chart of CBO findings:
http://wonkroom.thinkprogress.org/2009/11/30/cbo-premiums/
The last has a link to the CBO report.
The bottom line seems to be that the cost cutting measures are judged likely to be effective by many, if not most, experts in the field who have worked with the numbers.
whitepaw says:
17 March 2010 at 8:07 pm Medicaid is the current govt. program for low income families?
“Yes. It will be expanded to include more people.”
Finally, how is it possible that there can be subsidies and expanded Medicaid… without increases in taxes… unless they are still proposing to tax Cadillac plans and those earning $250K plus?
Well, the Cadillac plans are going to be taxed, but Mr. Richard Trumka, head of the AFL-CIO, negotiated a deal a few weeks back to put off the excise tax until 2018 or something like that. But I read today where he was called back to the White House to renegotiate the details because the CBO is having a hard time coming in at the 900 billion dollar limit the President wants on the health insurance reform cost. He wants to show it will lower the deficit. http://www.politico.com/blogs/bensmith/0310/Excise_tax_questions_reemerging.html
My “anger issue” on this mandate topic is understandable, if regrettable in a public forum.
A few years ago I cancelled our high-deductible Blue Cross plan for my wife and myself. With hardly any money coming in, the premiums were just too much, and as we often noted, the plan didn’t pay for preventive care–the only kind we needed–and if we could just stay healthy until we qualified for Medicare, we’d be okay. It’s no fun being in your 60s and uninsured, but like I said, even if we’d kept the policy and had an accident or gotten sick, the benefits would have been quite minimal and still left us with huge out of pocket debts.
After two year of no insurance, I had to have a hernia operation, and this is where it gets interesting: I had to pay cash, of course, mostly borrowed. But when I added up what the preceding two years of premiums WOULD have cost, calculated benefits, copays, and out of pocket expenses based on the old policy I no longer had, it turned out that my operation was 50% CHEAPER due to NOT having had insurance! Let me run that by you again: two years of premiums + surgery expenses minus benefits would have been DOUBLE what I actually ended up paying! I was better off *without* insurance, at least in this instance.
But the real point is this: my decision to kill the policy was a personal family matter motivated by what was best for our survival. For our SURVIVAL!!! When someone steps between my family and what I know I have to do to take care of us, it arouses a furious primal defensive reaction.
Take note of “furious.” That’s what’s going to happen. You can’t just rationally argue that la-dee-dah, we all just have to take our medicine, because this is a direct attack on a fundamental human right. Being required to purchase junk insurance from a crooked, for-profit private company will enrage people, many of whom have made the scary decision to go without insurance based on their own judgement of what is best for them and their families. The mandate, if it passes, will be a catalyst for the whirlwind the Democrats are going to reap.
That they don’t see this is mind-boggling beyond description and wholly infuriating. Pass this bill at. your. peril. This will not stand.
TaosJohn:
I appreciate you sharing your story. I understand that people need to make tough choices. I don’t follow one thing, though: your concern that the insurance was more expensive than a hernia operation.
No matter what the system – whether it is publicly funded or private – people need to pay in at least what they get out. I have paid much more for car insurance that I will probably ever take out in claims. Programs like social security depend for their long term stability on people paying in what they get out, but people who die young don’t receive the benefit, and pay much more than they get out. That’s a feature of any healthcare system, or any system that shares costs.
I realize that people who go without health insurance are not on the upper levels of income. The question there is whether the subsidies are sufficient. But that, again, is a problem that is present in any system, publicly run or not.
My reading indicates that the program is likely to reduce premimums, and it does provide subsidies. This is improvement over what many people in situations similar to yours are facing or may otherwise face in the future.
Hey TJ, thanks for sharing your story.
lynnette says:
17 March 2010 at 8:32 pm
Yep, as Lawrence O’Donnell has said, here comes the big tax hike. It’s the only way to pay for it.
I was waiting for the idiocy of the car insurance comparison. There are a multitude of car insurance companies, with real competition in that market. Obama & Dems are throwing Americans into a monopolized system, WITHOUT ANY COMPETITION WHATSOEVER; while also giving the insurance companies guinea pigs, because they are being forced into it.
Can’t wait for the enforcement stories re: people who won’t buy insurance.
Additionally, it’s really remarkable that I have to even write this, but if you don’t want to drive you don’t have to get car insurance. Public transportation solves that in a heart beat. This car ins. v. health ins. fable died months ago, as it should.
Whitepaw, it is a bad bill.
Taylor,
“I was waiting for the idiocy of the car insurance comparison.”
What an odd thing to say. Taosjohn complained that his insurance premiums would have cost more than the operation he paid for out of his own pocket. I noted that this is how insurance, or any shared set of expenses, like social security, works. You end up paying what you are expected to get out. These things provide security – they don’t save you money.
But this is “idiocy” because car insurance doesn’t have an antitrust exemption.
I don’t know what to say. I can’t tell if you’re just not very smart, or if you’re just dishonest. I assume you are just dishonest, because I specifically gave the second example of social security.
What is it, Taylor, that makes you want to push your agenda dishonestly?
Honey, my “agenda” is telling it like I see it.
You’re trying to prop up incompetent Democrats and the president. When compared to policy, I don’t care about either.
Read up:
http://law.jrank.org/pages/8497/McCarran-Ferguson-Act-1945.html
Kanzeon says:
18 March 2010 at 3:54 pm
—
Nasty and rude response…
whitepaw:
I provided links to back up my points, and logical arguments. Did you happen to take a look at those Klein articles?
Ms Marsh provides nothing. Zero. Zip. If you appear on her board, and disagree with her, you are called an idiot, and have people say they want to punch you in the face.
She uses arguments she doesn’t bother to logically defend to bash the Democratic party. She either isn’t too bright, or exceedingly dishonest, or a little of both.
Nasty? Rude? I think that if someone is actively enabling the conservative takeover of Congress, they either should BE a conservative, or have the decency to logically defend their destructive course.