The House approved the Senate version of health care reform last night, 219-212. The bill does lots of things, most notably:

  • Eliminates the ability for your insurance company to deny you coverage because you have a pre-existing condition. It creates a high risk pool from which people will be able to procure insurance with caps on out-of-pocket costs;
  • Insurance companies can no longer drop you if you become ill;
  • Eliminates annual caps on insurance;
  • Children can stay on the parents’ insurance until they’re 26;
  • Small businesses will be provided federal tax credits up to 35% of premiums to insure employees;
  • Provides incentives to states to expand health insurance for children under the Child Health Insurance Program;
  • Children can no longer be denied insurance because of a pre-existing condition;
  • Extends a tax credit to people who lose their job to maintain COBRA coverage;
  • Creates a competitive insurance market through insurance exchanges;
  • Increases Medicare reimbursements to rural health care providers; and
  • Closes the “doughnut hole” in Medicare that causes the cost of prescription drugs to increase over the long-term. In the short term people will receive a $250 rebate;
  • Taxes expensive health insurance plans known as “cadillac plans.”

It expands coverage to 31 million people, including 4 million children. One of the ways it does that by implementing an individual insurance mandate, which I discussed last night, as well as expanding Medicaid.

Regarding the mandate, it is important to note that for those individuals or families who do not receive insurance through an employer, but who make too much to qualify for Medicaid will receive a subsidy on a sliding scale. This means a family will pay somewhere between 3% and 9.5% of annual income on health care, a reduction from current limits. It, like many other provisions, begins in 2014.

The New York Times has a useful interative graphic that helps explain what the plan does, and when.

The reconciliation bill that was also approved by the House and now heads to the Senate amends the bill that President Barack Obama will sign perhaps as early as today. Here’s an explainer on what the reconciliation bill includes by issue. Majority Leader Harry Reid indicated this weekend that he had the 50 votes required to pass it as-is. The major issue is whether the tax on expensive health insurance plans impacts Social Security. Under the rules of reconciliation, Social Security cannot be altered in any way. Assuming it clears that parliamentary hurdle, 20 hours of debate begins on Tuesday and ending Thursday. Voting will commence on the bill itself immediately thereafter.

 

Lt. Gov. Bill Halter issued a statement tonight urging Sen. Blanche Lincoln to support the changes to the Senate version of the bill approved through the reconciliation process tonight. He also issued a strong statement in support of the bill itself.

Ms. Lincoln issues a statement offering her support for the Senate bill and her opposition to the changes adopted under the House reconciliation bill. She plans to vote no when the Senate takes it up next week.

Senate Majority Leader Harry Reid has indicated that 52 Democrats currently support the reconciliation bill. A simple majority is all that is required.

 

The Republican Party put the idea on the table in a counter-proposal to President Bill Clinton’s health care reform proposal in 1993. GOP Senator Lincoln Chaffee along with 19 other Republicans supported the idea, which was a contrast to Mr. Clinton’s employer mandate. Former Sen. Dave Durenberger of Minnesota was one of those co-sponsors. Asked about whether it was still the best idea, he opined:

Yes, if you are going to go to universal coverage and going to get the insurance companies, particularly the private insurance companies, to compete with each other on the basis of how much risk they’re willing to assume and to reduce and thus get their prices down. Yes, if that’s the theory of health insurance, which it should be. But you’ve got to set the rules across this country in order to make it work. That’s something that has not been related well.

Here is a comparison of the current bill, the GOP alternative and the GOP plan of 1993.

Former Senate Majority Leader Bill Frist, a Republican and a physician, advocated in favor of an individual mandate in 2009.

I believe in limited government and individual responsibility, cherish the freedom to choose, and generally oppose individual mandates—except where markets fail, individuals suffer, and society pays a hefty price. Let’s face it, in a country as productive and advanced as ours, every American deserves affordable access to healthcare delivered at the right time. And they don’t have it today.It is time for an individual health insurance mandate for a minimum level of health coverage.

Massachusetts, which passed a health care bill that included an individual mandate, saw premium costs go down.

 

Arkansas Rep. Vic Snyder will be the only Democrat from Arkansas in the House of Representatives to support health care reform tonight. Reps. Marion Berry, Mike Ross and John Boozman, a Republican, will all vote no.

Mr. Berry, who voted for the original measure when it was presented in the House, was on the fence until late this afternoon.

The New York Times has the vote at 218-209 with 4 Democrats undecided. The procedural votes have begun.

UPDATE: The House vote on its debate rule, the first crucial vote, passed comfortably, 224-206. Up next will be a vote on a GOP “motion to recommit,” which is an attempt to scuttle the whole thing. If that fails, then there will be a final vote on the bill. First Read is tracking all of it.

 

Rep. Dick Armey circa 1993:

The impact on job creation is going to be devastating, and the American young people in particular will suffer a fairly substantial deferment of their lives because there simply won’t be jobs for the next two to three years to go around to our young graduates across the country.

Rep. John Kasich:

Come next year… we’re going to find out whether we have higher deficits, we’re going to find out whether we have a slower economy, we’re going to find out what’s going to happen to interest rates, and it’s our bet that this is a job killer.

More from Congress Matters. Much of the same rhetoric is being used by the GOP during the health care reform debate. Like #hcr, no one from the GOP supported the Clinton plan.

Here’s the economic record under the Clinton administration. Needless to say these guys were wrong.

 
  • The New York Times has the vote count at 211 – 208. 12 Democrats remain undecided. Talking Points Memo has a running tally as preference is declared. Arkansas Rep. Marion Berry remains the only incumbent not running for re-election who is undecided.
  • There was lots of attention paid to rumors that Rep. Bart Stupak was going to support #hcr. He’s still a “no” vote according to his spokesperson.
  • The vote has been pushed to somewhere around midnight tonight. Settle in. We’re a ways away.

 
  • The House convenes at noon today for two hours of debate before the vote.

 

Jonathan Alter of Newsweek sums it up:

The remaining stumbling block is the Stupak faction, which wants Obama to sign an executive order making the Senate bill more like the original House bill that contained the Stupak amendment. It’s not clear how far the White House is prepared to go in the executive order, but Rep. Diana DeGette and the pro-choice faction, while furious after meeting with Nancy Pelosi Friday, have nowhere to go.

House Democrats are fine with the end of the “deem and pass” gimmick; its abandonment this morning cost them no votes. But there’s still a lot of anger that they are voting based on Harry Reid’s word and that he won’t release the letter he says he has with the signatures of 51 Senators committing to  the House reconciliation amendments. The problem for Reid is that he only has a general commitment from those 51 because they couldn’t yet commit to something the House hadn’t yet agreed upon.

The bottom line is that with the vote tomorrow on the Senate bill, the measure, if approved, will be available for the president’s signature immediately. The demise of “deem and pass” makes this clearer. At that point all of the haggling in the Senate over reconciliation will be anti-climactic. The end of discrimination against people with pre-existing conditions and the other central elements of the bill will be law.

 

Fire the A**holes

From The Washington Post:

Black lawmakers said Saturday that “tea party” protesters outside the Capitol hurled racial epithets at Rep. John Lewis (D-Ga.), a former civil rights leader who was nearly beaten to death during a 1965 march, as he headed out of the building on his way to President Obama’s final health-care rally.

Rep. Andre Carson (D-Ind.), walking next to Lewis after the Obama speech, told reporters that protesters yelled “kill the bill,” then used a racial epithet to describe Carson and Lewis, who is a revered figure on both sides of the aisle. By the time the president spoke, thousands of protesters had gathered south of the Capitol.

“They were shouting the N-word,” Carson told reporters from Roll Call and other media outlets. “It was like a page out of a time machine.”

 

Rep. Mike Ross, who has been opposed to health care reform from the very beginning, issued a statement today praising the Democratic leadership for not using the “deem and pass” rule for health care reform.

I’m trying to figure out why he cares. He’s a firm NO vote.

Here’s what Max Brantley of the Arkansas Times had to say:

Solid nominee for dick of the day: U.S. Rep. Mike Ross, who sanctimoniously issues a news release praising Democrats for having an up-or-down vote on which he’ll vote NO.

As for #hcr, The New York Times has to vote at 209-206 with 19 Democrats undecided. 216 is the magic number for passage.

 

Obama, Health Care and History

From Ron Brownstein in The National Journal:

Win or lose, Obama has pursued health care reform as tenaciously as any president has pursued any domestic initiative in decades. Health care has now been his presidency’s central domestic focus for a full year. That’s about as long as it took to pass the Civil Rights Act of 1964, originally introduced by John F. Kennedy and driven home by Lyndon Johnson. Rarely since World War II has a president devoted so much time, at so much political cost, to shouldering a single priority through Congress

 

Remembering Medicare Part D

Joe Klein of TIME reminds readers about Medicare Part D, an enormous entitlement program, that passed under President George W. Bush.

It should be noted that the Medicare Part D legislation was an unpaid for entitlement that will cost taxpayers an estimated $7 Trillion this century. But when Rove, and other Republicans, send up the sort of smokescreen about the legislative process being manipulated by Democrats, it is good to remember that one noted political genius described the process as “the kind of horse-trading that has always been part of politics”…and this time, according to the Congressional Budget Office, the new entitlement will be paid for.

Mr. Rove wrote this about the Medicare Part D process in his book, “Courage and Consequence”:

The House finally voted between 3 am and 5:55 am on the morning of November 22 [2003]. The tally at first stalled out at 216 to 218 against us. House leaders kept the vote open and , using the kind of horse-trading that has always been part of politics, flipped enough members to arrive at 220 to 215 for the Medicare overhaul.

Rep. John Boozman and Sen. Blanche Lincoln were the only Arkansawyers to vote in favor of the bill. Mr. Boozman stands opposed to the current health care reform bill. And Ms. Lincoln has expressed concerns about the legislative process.

 

Lt. Gov. Bill Halter lobbed the accusation that Sen. Blanche Lincoln was ducking a debate. Today, the Lincoln campaign responded:

The campaign has received a handful of inquiries from media outlets about the Senator’s willingness to attend debates, and each time we have indicated that she is eager to debate the issues with her opponents,” Charlie Gocio, Deputy Communications Director for Lincoln for Senate. “However, those inquiries haven’t included specific dates yet. The only dated request that we have received came from a group in Conway named the Conservative Forum which is sponsoring a debate on the UCA campus on April 7. Unfortunately, the Senator already has a scheduling conflict. In the coming weeks, the Senator has already committed to appear at several candidate forums sponsored by the Arkansas Farm Bureau and other groups, and she looks forward to other debate opportunities in the future.

 

All signs point to a vote for health care reform Sunday in the U.S. House of Representatives. As that floor fight prepares, The New York Times has an interactive graphic so you can chart those that remain undecided. They have vote count at 203-204 with 24 votes in play. 216 is the magic number.

13 votes shy, the Democrats are making even more concessions to conservative Democrats like Rep. Marion Berry on abortion. There are 12 votes to be had on this issue alone.

Some progressives are sounding a defeatist tone. No public option, after all.

Democrats are in “fierce” negotiations for votes.

President Barack Obama meets with the House Democratic caucuse today at 2:00 p.m. CST.

The House will convene at noon (CST) tomorrow to consider the bill.

 

Here are my thoughts on labor’s role in the Democratic primary for US Senate.

 

Today, Sen. Blanche Lincoln will be in Forrest City, Arkansas to host a Child Nutrition Town Hall at 2:00 p.m.. Yesterday, she unveiled The Healthy, Hunger-Free Kids Act.

Lt. Governor Bill Halter will hold a press conference at his campaign headquarters at 11:00 a.m. to comment on the pending health care reform vote in the House of Representatives this week. Any idea what the message will be? Here’s my guess: Pass the damn bill. It’s covers 95% of Americans. It prohibits insurance companies from denying you because you have a pre-existing condition. It reduces the federal deficit. Procure is a red herring. A vote for any of it – including procedural issues – is a vote for health care reform. And it’s okay – in fact, very smart – to vote in favor of this bill. As mentioned, it’s going to do lots of good things, especially for the 400,000 Arkansans without health insurance.

I can’t make either. Please pass along what you hear.

UPDATE: I was wrong. Mr. Halter merely said that he supported the student loan reform bill. Not surprising. It provides more money for Pell grants. Sen. Blanche Lincoln’s been on the fence. It gives Mr. Halter more ammunition on education.

 

From MoveOn.org:

I’ve never understood fully why Sen. Blanche Lincoln was concerned (I’d say opposed, but he campaign insists that is inaccurate) about President Barack Obama’s student loan reform bill. Here’s what she said in a news release:

As Congress has moved forward on student loan reform, I have expressed my concerns – outlined in a letter with Senator Pryor to Senate Health, Education, Labor and Pensions Committee Chairman, Tom Harkin – that non-profit state agencies such as the ASLA and SLGFA be allowed to remain productive partners in the lending and servicing of student loans. And after hearing from several Arkansas colleges and universities, I have also asked that our schools be provided with an adequate amount of time and assistance to make the changes that will be required to change loan programs so that services for Arkansas students and families are not disrupted.

The New York Times outlines the legislation, which includes $36 billion in new financing for Pell grants over the next 10 years. The maximum annual Pell grant would increase by $625 by 2017, to $5,975. It should be noted that this Pell initiative also covers a shortfall $13.5 due to a large increase in students attending college.

But as the Times also notes,

The Obama administration’s effort to end the subsidies and federal guarantees for student loans, known as the Federal Family Education Loan program, and redirect billions of dollars to students, has been strongly opposed by bankers, Republicans and some Democrats from areas with strong student-loan businesses.

Enter Ms. Lincoln. Still, with education being one of the hottest – if not the hottest – issue in Arkansas right now, I’m curious as to the political advantages of standing in the way of more money for Pell grants. That’s the headline; that’s the issue people care about.

After all, Ms. Lincoln doesn’t appear to be opposed on fiscal grounds (an initial CBO study suggested that it would save $20 billion less than originally expected).

 

The Arkansas Election Line rates the 4th Congressional District: Safe Ross

The Arkansas Election Line rates the Republican Primary: Toss up

Rep. Mike Ross does not have an opponent in the Democratic Primary.

Blake’s Think Tank Analysis:

Unlike Attorney General Dustin McDaniel, the other Democrat positioning himself for a bid for governor in 2014, Rep. Mike Ross, will face an opponent this November. The question is who that opponent will be. Beth Anne Rankin, a former staffer to Gov. Mike Huckabee, faces off against Tea Party activist Glenn Gallas. If anything, this race will illustrate whether the Tea Party has any strength in Arkansas. We don’t know much about these two candidates beyond their backgrounds, so we’re going to wait until the first round of fundraising is reported. At this point, this primary is a toss up.

Mr. Ross has no opponent in the Democratic Primary, and although he’ll have an opponent in November, his voting record has positioned him well to run in what may otherwise be a difficult year for incumbents, particularly Democrats. Barring an epic collapse, this seat will stay with the Democrats.

Read more from The Arkansas Election Line partners Talk Business and The Tolbert Report.

 

Light Blogging

Blogging will be light the next two days. I’d love to say it’s because I’m in _____ cheering on the Arkansas Razorbacks in the first round of the men’s NCAA tournament, but they didn’t make it. Alas, I’m in Tunica talking to a group of insurance execs about how social media can help them grow their business. Hoping to make it by Morgan Freeman’s club in Clarksdale before I leave the area.  Before I check out today, here are a couple of things worth noting:

  • Max Brantley talks to Rep. Marion Berry about his upcoming “no” vote on health care reform because the bill doesn’t include the Stupack amendment on abortion. It doesn’t need it of course; the Senate bill contains much stronger protections as it’s written. I’ve beaten this horse dead, I feel.
  • John Brummett says we need a debate between Sen. Blanche Lincoln and Lt. Gov Bill Halter. Duh.
  • My good buddy Justin Allen, the chief deputy attorney general of Arkansas, is leaving his government gig and heading back Wright, Lindsey & Jennings. JTA and I worked together for several years at that law firm before he left for the AG’s office and I moved on to SW. The folks at WLJ are getting even a more seasoned pro than they had before.
  • The CBO has scored the health care bill coming up for a vote this weekend in the U.S. House. It reduces the deficit by more than $1 trillion over the next 20 years. A vote is headed for Sunday, 72 hours after the CBO score as the House leadership promised.
  • Despite “awful” provisions on abortion, health care reform will help women. Michelle Goldberg explains.
  • The NCAA men’s tournament tips off at11:20 a.m. today. Here’s a look at my bracket. Kansas, Syracuse, Kentucky and Baylor make my Final Four.

 

The Arkansas Election Line rates the 3rd Congressional district: Safe GOP

The Arkansas Election Line rates the GOP primate: Toss-up

The Arkansas Election Line rates the Democratic primary: Safe Whitaker

Blake’s Think Tank Analysis:

In the most heavily Republican congressional district in Arkansas 8 candidates are vying for the party’s nomination. State Sen. Cecile Bledsoe and Rogers Mayor Steve Womack have generated the most early headlines. Gunner DeLay, a former candidate for Attorney General, is on the ballot. These three candidates stand out among a field that also includes Boone Co. Judge Mike Moore, Kurt Maddox, Steve Lowry, Doug Mattayo and Bernie Skoch. With this many candidates in the field, a strong constituency is likely to secure a place in the run-off. Ms. Beldsoe and Mr. Rogers both come from the same city. Mr. DeLay stands out as the only candidate from the other side of the US 540 corridor, Ft. Smith. It’s a toss-up right now. We’ll be monitoring it closely to see if any candidates is able to break away from the pack.

On the Democratic side David Whitaker’s thrown his hat into the ring. He joins a long line of candidates who hope to pull of a political upset. His campaign is aggressive and is working hard. This district has changes so much since Bill Clinton nearly beat Rep. John Paul Hammerschmidt way back when. And that change has benefited every GOP candidate since.

Please check out Arkansas Election Line partners Talk Business and The Tolbert Report for more analysis.