Posts Tagged ‘Debate

07
Aug
10

Weekly Address: Medicare Officially Safer After Health Reform

NEWS
Weekly Address: Medicare Officially Safer After Health Reform
President Obama Highlights Benefits to Seniors Under the Patient Protection and Affordable Care Act

Saturday, August 07, 2010

In his weekly address this week, President Obama highlighted a Medicare Trustees report noting the steps we took this year to reform the health care system have put Medicare on a sounder financial footing, which will help to preserve Medicare for generations to come. Additionally, America’s seniors are already seeing more benefits as a result of health reform, including a rebate to cover the cost of their prescriptions if they fall into the Medicare Part D drug coverage gap. In the coming years, as we continue to ramp up reform, we expect seniors to save in premiums and out of pocket costs. And the President will continue to make Medicare stronger to ensure our seniors have access to affordable and quality healthcare.

Forty-five years ago, we made a solemn compact as a nation that senior citizens would not go without the health care they need. This is the promise we made when Medicare was born. And it’s the responsibility of each generation to keep that promise.

That’s why a report issued this week by the Trustees who oversee Medicare was such good news. According to this report, the steps we took this year to reform the health care system have put Medicare on a sounder financial footing. Reform has actually added at least a dozen years to the solvency of Medicare – the single longest extension in history – while helping to preserve Medicare for generations to come.

We’ve made Medicare more solvent by going after waste, fraud, and abuse – not by changing seniors’ guaranteed benefits. In fact, seniors are starting to see that because of health reform, their benefits are getting better all the time.

Seniors who fall into the “doughnut hole” – the gap in Medicare Part D drug coverage – are eligible right now for a $250 rebate to help cover the cost of their prescriptions. Now, I know for people facing drug costs far higher than that, they need more help. That’s why we negotiated a better deal with the pharmaceutical companies for seniors. So starting next year, if you fall in the doughnut hole, you’ll get a 50-percent discount on the brand-name medicine you need. And in the coming years, this law will close the doughnut hole completely once and for all.

Already, we have put insurance companies on notice that we have the authority to review and reject unreasonable rate increases for Medicare Advantage plans. And we’ve made it clear to the insurers that we won’t hesitate to use this authority to protect seniors.

Beginning next year, preventive care – including annual physicals, wellness exams, and tests like mammograms – will be free for seniors as well. That will make it easier for folks to stay healthy. But it will also mean that doctors can catch things earlier, so treatment may be less invasive and less expensive.

And as reform ramps up in the coming years, we expect seniors to save an average of $200 per year in premiums and more than $200 each year in out of pocket costs, too.

This is possible in part through reforms that target waste and abuse and redirect those resources to where they’re supposed to go: our seniors. We’re already on track to cut improper payments in half – including money that goes to criminals who steal taxpayer dollars by setting up insurance scams and other frauds. And we won’t stop there. Because by preventing the loss of these tax dollars, we can both address the runaway costs of Medicare and improve the quality of care seniors receive – and we can crack down on those who prey on seniors and take advantage of people.

So we are no longer accepting business as usual. We’re making tough decisions to meet the challenges of our time. And as a result, Medicare is stronger and more secure. That’s important. Because Medicare isn’t just a program. It’s a commitment to America’s seniors – that after working your whole life, you’ve earned the security of quality health care you can afford. As long as I am President, that’s a commitment this country is going to keep.
Thank you.

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• Source(s): The White House
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22
Mar
10

Health Reform Now

NEWS
Health Reform Now
• This is What Change Looks Like

Monday, March 22, 2010

After a historic vote in the House to send health reform to the President, he speaks to all Americans on the change they will finally see as they are given back control over their own health care:

Good evening, everybody. Tonight, after nearly 100 years of talk and frustration, after decades of trying, and a year of sustained effort and debate, the United States Congress finally declared that America’s workers and America’s families and America’s small businesses deserve the security of knowing that here, in this country, neither illness nor accident should endanger the dreams they’ve worked a lifetime to achieve.

Tonight, at a time when the pundits said it was no longer possible, we rose above the weight of our politics. We pushed back on the undue influence of special interests. We didn’t give in to mistrust or to cynicism or to fear. Instead, we proved that we are still a people capable of doing big things and tackling our biggest challenges. We proved that this government — a government of the people and by the people — still works for the people.

I want to thank every member of Congress who stood up tonight with courage and conviction to make health care reform a reality. And I know this wasn’t an easy vote for a lot of people. But it was the right vote. I want to thank Speaker Nancy Pelosi for her extraordinary leadership, and Majority Leader Steny Hoyer and Majority Whip Jim Clyburn for their commitment to getting the job done. I want to thank my outstanding Vice President, Joe Biden, and my wonderful Secretary of Health and Human Services, Kathleen Sebelius, for their fantastic work on this issue. I want to thank the many staffers in Congress, and my own incredible staff in the White House, who have worked tirelessly over the past year with Americans of all walks of life to forge a reform package finally worthy of the people we were sent here to serve.

Today’s vote answers the dreams of so many who have fought for this reform. To every unsung American who took the time to sit down and write a letter or type out an e-mail hoping your voice would be heard — it has been heard tonight. To the untold numbers who knocked on doors and made phone calls, who organized and mobilized out of a firm conviction that change in this country comes not from the top down, but from the bottom up — let me reaffirm that conviction: This moment is possible because of you.

Most importantly, today’s vote answers the prayers of every American who has hoped deeply for something to be done about a health care system that works for insurance companies, but not for ordinary people. For most Americans, this debate has never been about abstractions, the fight between right and left, Republican and Democrat — it’s always been about something far more personal. It’s about every American who knows the shock of opening an envelope to see that their premiums just shot up again when times are already tough enough. It’s about every parent who knows the desperation of trying to cover a child with a chronic illness only to be told “no” again and again and again. It’s about every small business owner forced to choose between insuring employees and staying open for business. They are why we committed ourselves to this cause.

Tonight’s vote is not a victory for any one party — it’s a victory for them. It’s a victory for the American people. And it’s a victory for common sense.

Now, it probably goes without saying that tonight’s vote will give rise to a frenzy of instant analysis. There will be tallies of Washington winners and losers, predictions about what it means for Democrats and Republicans, for my poll numbers, for my administration. But long after the debate fades away and the prognostication fades away and the dust settles, what will remain standing is not the government-run system some feared, or the status quo that serves the interests of the insurance industry, but a health care system that incorporates ideas from both parties — a system that works better for the American people.

If you have health insurance, this reform just gave you more control by reining in the worst excesses and abuses of the insurance industry with some of the toughest consumer protections this country has ever known — so that you are actually getting what you pay for.

If you don’t have insurance, this reform gives you a chance to be a part of a big purchasing pool that will give you choice and competition and cheaper prices for insurance. And it includes the largest health care tax cut for working families and small businesses in history — so that if you lose your job and you change jobs, start that new business, you’ll finally be able to purchase quality, affordable care and the security and peace of mind that comes with it.

This reform is the right thing to do for our seniors. It makes Medicare stronger and more solvent, extending its life by almost a decade. And it’s the right thing to do for our future. It will reduce our deficit by more than $100 billion over the next decade, and more than $1 trillion in the decade after that.

So this isn’t radical reform. But it is major reform. This legislation will not fix everything that ails our health care system. But it moves us decisively in the right direction. This is what change looks like.

Now as momentous as this day is, it’s not the end of this journey. On Tuesday, the Senate will take up revisions to this legislation that the House has embraced, and these are revisions that have strengthened this law and removed provisions that had no place in it. Some have predicted another siege of parliamentary maneuvering in order to delay adoption of these improvements. I hope that’s not the case. It’s time to bring this debate to a close and begin the hard work of implementing this reform properly on behalf of the American people. This year, and in years to come, we have a solemn responsibility to do it right.

Nor does this day represent the end of the work that faces our country. The work of revitalizing our economy goes on. The work of promoting private sector job creation goes on. The work of putting American families’ dreams back within reach goes on. And we march on, with renewed confidence, energized by this victory on their behalf.

In the end, what this day represents is another stone firmly laid in the foundation of the American Dream. Tonight, we answered the call of history as so many generations of Americans have before us. When faced with crisis, we did not shrink from our challenge — we overcame it. We did not avoid our responsibility — we embraced it. We did not fear our future — we shaped it.

Thank you, God bless you, and may God bless the United States of America.

• Source(s): The White House
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22
Mar
10

Triumph: The Man Who Dared to Dream

NEWS
Triumph: The Man Who Dared to Dream

Monday, March 22, 2010

Barack Obama has hailed a historic vote on healthcare reform in the US Congress, saying the $940 billion revamp represented ”another stone firmly laid in the foundation of the American dream”.

The President, triumphant after hard-fought weeks promoting the changes, said they ensured for American families and workers that ”neither illness nor accident should endanger the dreams they’ve worked a lifetime to achieve”.

The measures, which are expected to extend health insurance to an extra 32 million people and for the first time oblige Americans to take out some cover, are the biggest makeover for the US healthcare system since the introduction in the mid-1960s of government-funded Medicare for those aged over 65.

Mr Obama saluted the House of Representatives after an exhaustive 12-hour special Sunday sitting which toiled through rancorous debate and points of order before approving the bill by 219 votes to 212. In the end, 34 Democrats voted against the bill. There were suggestions that some of them, representing conservative constituencies, had been given the OK to vote no by Democrat heavyweights confident of a majority and with one eye on November’s midterm elections.

It will now go to Mr Obama to be signed into law.

The house also passed by 220 to 211 a package of amendments in a so-called ”reconciliation” bill that will go directly to the Senate for approval.

”At a time when the pundits said it was no longer possible, we rose above the weight of our politics,” Mr Obama, side-by-side with the Vice-President, Joe Biden, said in a televised address from the White House just before midnight. ”We pushed back on the undue influence of special interests. We didn’t give in to mistrust or to cynicism or to fear. Instead, we proved that we are still a people capable of doing big things and tackling our biggest challenges.

”We proved that this government – a government of the people and by the people – still works for the people.”

“This isn’t radical reform, but it is major reform.”

”This is what change looks like,” he said in reference to his campaign slogan. It could also have been a rebuff to Republicans, including Sarah Palin, who goaded Democrats last month by asking, ”How’s all that hopey, changey stuff workin’ for ya?”.

Victory in the year-long push for healthcare reform was delivered finally by a bloc of about half-a-dozen anti-abortion Democrats who agreed to support the bill on receiving assurances from Mr Obama that a ban on taxpayer funds being used for abortion would stay.

The first bill – essentially, the Senate’s version of healthcare reform passed on Christmas Eve – may have allowed the channelling of some federal subsidies into abortion services. But the Michigan Democrat Bart Stupak, speaking on behalf of the bloc, said the President’s promise of an executive order reaffirming the existing ban on federal funds supporting abortions, had clinched the deal.

Republicans argued that an executive order did not carry the force of law and could be overturned. They later goaded Mr Stupak, some shouting ”baby killer” across the chamber, after he rejected eleventh-hour efforts to reopen debate on the bill.

The victory would immediately enhance Mr Obama’s presidency, commentators argued, after months of near-constant criticism that he was aloof and too cerebral for Americans, and probably overburdened by pressing issues, not least the sluggish economic recovery.

In recent weeks, however, the President has found renewed voice in his push to win backing for healthcare reform, a key plank of his election platform that promised change.

Other measures among the reforms, which preliminary analysis suggests could slice more than $143 billion off the budget deficit over 10 years, include the creation of a consumer exchange where individuals and small businesses can shop for insurance policies. It also provides for penalties if people do not buy some cover or if a business evades its responsibilities to its workers.

Introduction of the measures will be gradual, taking three to four years. Some tax imposts on wealthy Americans are not scheduled to kick in until 2018.

The House Speaker, Nancy Pelosi, marked the historic moment in Congress by describing the reform as ”an American proposal that honours the traditions of our country”.

She cited the late Edward Kennedy, as a longtime driving force, for his role in the triumph.

Shortly before his death last August, Senator Kennedy had written to Mr Obama saying that ”access to healthcare was the great unfinished business of [American] society”.

”Until today,” Mrs Pelosi added.

Lamenting what he said was a compromised bill and the fact that polls revealed a deeply divided nation over healthcare reform, the Republican leader, John Boehner, said the chamber had ”failed to listen to America, and we have failed to reflect the will of our constituents”.

”Shame on each and every one of you who substitutes your will and your desires above those of your fellow countrymen,” the House Minority Leader said.

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22
Mar
10

Barack Obama wins healthcare battle in tight vote

NEWS
Barack Obama wins healthcare battle in tight vote

Monday, March 22, 2010

The US House of Representatives has narrowly voted to pass a landmark healthcare reform bill at the heart of President Barack Obama’s agenda.

The bill was passed by 219 votes to 212, with no Republican backing, after hours of fierce argument and debate.

It extends coverage to 32 million more Americans, and marks the biggest change to the US healthcare system in decades.

“We proved that we are still a people capable of doing big things,” Mr Obama said in remarks after the vote.

“This legislation will not fix everything that ails our healthcare system, but it moves us decisively in the right direction,” he said.

Mr Obama is expected to sign the legislation into law shortly.

But a new challenge is expected in the Senate, where Democrats hope amendments to the bill will be enacted by a simple majority. Republicans say the move is unconstitutional and plan to stop it.

We will be joining those who established Social Security, Medicare and now, tonight, healthcare for all Americans.
House Speaker Nancy Pelosi

Historic vote
He has been tough and tenacious – some might say stubborn – in pushing this legislation after so much opposition and so many setbacks, our correspondent says.
This is the most significant victory for the president since he took office 14 months ago.
When the vote count hit the magic number of 216 – the minimum needed to pass the bill – Democrats hugged and cheered in celebration and chanted: “Yes we can!”

Under the legislation, health insurance will be extended to nearly all Americans, new taxes imposed on the wealthy, and restrictive insurance practices such as refusing to cover people with pre-existing medical conditions will be outlawed.

However, our correspondent says it has become a rallying point for Republicans, who are convinced the American people do not want the changes and that it will be a vote winner for them come the mid-term elections in November.

They say the measures are unaffordable and represent a government takeover of the health industry.

“We have failed to listen to America,” said Republican party leader John Boehner.

Speaking moments before the vote, House Speaker Nancy Pelosi said the health care reform honoured the nation’s traditions.

“We will be joining those who established Social Security, Medicare and now, tonight, healthcare for all Americans,” she said, referring to the government’s pension program and health insurance for the elderly established nearly 50 years ago.

Although Democrats pushed the measure through with three votes to spare, 34 members joined Republicans in voting against the bill, worried about paying a political price in November.

In a last-minute move designed to win the support of a bloc of anti-abortion lawmakers, Mr Obama earlier on Sunday announced plans to issue an executive order assuring that healthcare reform will not change the restrictions barring federal money for abortion.
Next steps
The bill’s final approval represented a stunning turnaround from January, when it was considered dead after Democrats lost their 60-seaty majority in the Senate, which is required to defeat a filibuster.

To avoid a second Senate vote, the House also approved on Sunday evening a package of reconciliation “fixes” – agreed beforehand between House and Senate Democrats and the White House – amending the bill that senators adopted in December.

The president is expected to sign the House-passed Senate bill as early as Tuesday, after which it will be officially enacted into law. However, it will contain some very unpopular measures that Democratic senators have agreed to amend.

The Senate will be able to make the required changes in a separate bill using a procedure known as reconciliation, which allows budget provisions to be approved with 51 votes – rather than the 60 needed to overcome blocking tactics.

The Republicans say they will seek to repeal the measure, challenge its constitutionality and co-ordinate efforts in state legislatures to block its implementation.

But the president has signalled he will fight back.

The White House plans to launch a campaign this week to persuade sceptical Americans that the reforms offer immediate benefits to them and represent the most significant effort to reduce the federal deficit since the 1990s.

According to the Congressional Budget Office, the healthcare bill will cut the federal deficit by $138bn over 10 years.

The non-partisan body said last week that the legislation would cost about $940bn over the same period.

The reforms will increase insurance coverage through tax credits for the middle class and an expansion of Medicaid for the poor.

They represent the biggest change in the US healthcare system since the creation in the 1960s of Medicare, the government-run scheme for those aged 65 or over.

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21
Mar
10

House debate on health care bill

NEWS
House debate on health care bill

Sunday, March 21, 2010

House Democrats who had withheld support of the health care legislation because of abortion concerns said Sunday afternoon that they would back the bill, all but assuring that Democrats would have the 216 votes needed for passage.

The White House and Congressional Democratic leaders announced the deal, and rank-and-file Democrats who had worried that the bill would somehow allow the use of federal money to pay for abortions or for insurance coverage of the procedure appeared at a news conference to say those concerns had been addressed.

“I am pleased to announce we have an agreement,” said Representative Bart Stupak, Democrat of Michigan and a leader of the Congressional Pro-life Caucus.

“We’re well past 216, yes.”

But a number of groups that oppose abortion rights said that an executive order was insufficient in part because of a lack of trust in the Obama administration.

Even before Mr. Stupak’s news conference ended, the House Republican Leader Representative John A. Boehner of Ohio issued a statement saying: “The law of the land trumps any Executive Order, which can be reversed or altered at the stroke of a pen by this or any subsequent President without any congressional approval or notice.”

And Mr. Boehner warned that a vote for the health care bill was a vote for taxpayer-financed abortions.

Mr. Stupak rejected that claim. Mr. Stupak also noted that the United States Conference of Catholic Bishops still wanted statutory language barring the use of federal money for abortions. “I know it’s Lent,” he said, but added that the bishops could not supply the 60 votes needed in the Senate to approve such a law.

“This has the full force of law,” he said of the executive order.

But Mr. Stupak said the order would make clear there is “no public funding for abortion” and that community health centers, which will get billions in new federal financing under the health care bill, cannot perform the procedure.

The White House, sounding a note of confidence about the health care bill, announced that after its passage, Mr. Obama will sign an executive order that will reaffirm the measure’s “consistency with longstanding restrictions on the use of federal funds for abortion.”

Kaptur, Democrat of Ohio, said, “The health care bill that will move forward today is actually a bill about life.” Also with Mr. Stupak and Ms. Kaptur at the news conference were Steve Driehaus and Kathy Dahlkemper, who noted that she considered the bill now a “full life” or “whole life piece of legislation.”

Before Mr. Stupak’s news conference, Democrats and Republicans had engaged in fierce parliamentary jousting on the House floor Sunday afternoon.

On the House floor, Republicans angrily denounced the legislation and battled furiously with Democrats over procedural issues related to the proposed rule to set terms of debate on the landmark legislation.

Representative David Dreier of California, the senior Republican on the Rules Committee, insisted that if Democrats prevailed the only certain outcome of Sunday’s votes was that the Senate-passed health care bill would be signed into law by President Obama.

Many House Democrats oppose the Senate bill because it contains a number of provisions that were aimed at winning the support of individual senators, like extra federal Medicaid money for Nebraska. House Democrats are planning to approve the Senate bill and then immediately approve a package of revisions to it included in an expedited budget reconciliation bill.

Mr. Dreier tried to make his point, saying, “We now know with absolute certainty,” only to be cut off by Representative Louise M. Slaughter of New York, the chairwoman of the Rules Committee. “No, you don’t know that,” Ms. Slaughter shouted.

But Mr. Dreier had the floor. “ I encourage everyone to read the rule,” he said, “because the only thing we are guaranteed” is that the Senate bill will become law.

Outside the Capitol, hundreds of opponents of the legislation protested, carrying signs and chanting angry slogans.

Even on Sunday morning, the vote was clearly too close to call. Rep. John Larson, the chairman of the Democratic caucus, told ABC’s “This Week” program that the votes were in hand. “We have the votes now — as we speak,” he said about the 216 votes. But at the same time, Rep. Debbie Wasserman Schultz, the deputy Democratic House whip, told “Fox News Sunday” that the Democrats “don’t have a hard 216 right now.”

Shortly before midnight on Saturday, the House Rules Committee completed its work and proposed the parameters for Sunday’s floor fight, which will entail two hours of formal debate on the legislation. The committee, controlled by Democrats, also limited the ability of Republicans to disrupt the proceedings and allowed for the vote to be postponed if Democrats chose to do so.

President Obama, in an emotional address Saturday afternoon at the Capitol, exhorted rank-and-file House Democrats to approve the bill, telling them they were on the edge of making history.

“Every once in a while a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country,” he said. “This is one of those moments.”

The president declared: “We have been debating health care for decades. It has now been debated for a year. It is in your hands.”

With the ground shifting by the hour, House Democratic leaders dropped a plan to approve the Senate health bill without taking a direct vote on it. That proposed maneuver had outraged Republicans and caused consternation among some Democrats.

Thousands of opponents of the bill circled the Capitol chanting angry slogans. Some of the anger was directed at black lawmakers, including several who said that some demonstrators had hurled racial insults at them.

At the Capitol rallywith Mr. Obama, the Senate majority leader, Harry Reid of Nevada, assured House Democrats that their Senate colleagues would act quickly on the reconciliation bill, including final revisions to the health care measure. “I have the commitments of a significant majority of the United States Senate to make that good law even better,” he said.

The House Republican leader, John A. Boehner of Ohio, said the Republicans could still prevail. “The American people are making their voices heard, here on Capitol Hill and across America,” he said. “It’s time for Washington Democrats to listen.”

In his speech, Mr. Obama drew chortles from lawmakers — and laughed at himself — when he suggested that perhaps Republicans were hoping to spare Democrats political pain by blocking the bill.

“Mitch McConnell, John Boehner, Karl Rove, they are all warning you of the horrendous impact if you support this legislation,” the president said, referring to the Senate and House Republican leaders and a top adviser to former President George W. Bush.

“Now, it could be that they are suddenly having a change of heart and they are deeply concerned about their Democratic friends; they are giving you the best possible advice in order to ensure that Nancy Pelosi remains speaker and Harry Reid remains leader and all of you keep your seats,” Mr. Obama joked. “That’s a possibility.”

He continued, “But it may also be possible that they realize that after health reform passes and I sign that legislation into law, it’s going to be a little harder to mischaracterize what this legislation has been all about.”

The Congressional Budget Office on Saturday released a new cost analysis of the legislation based on a package of changes unveiled by the Democrats earlier in the day. The new assessment shows the total cost of new insurance coverage provisions in the bill to be $938 billion over 10 years, with the expense more than offset by revenues from new taxes and fees and reductions in spending on government programs including Medicare, so that the legislation would reduce future federal deficits by $143 billion. The previous budget office estimate showed a total cost of $940 billion for the coverage provisions, and $138 billion in deficit reduction.

At a news conference on Saturday, 13 House Republican freshmen assailed the measure. “Let’s kill this bill,” said Representative Cynthia M. Lummis, Republican of Wyoming.

The late-hour maneuvering on abortion mirrored a similar process in November before the House adopted its version of the health care legislation.

In November, Mr. Stupak had also succeeded in winning approval of tight limits on insurance coverage of abortions in the House bill. The current package now includes language from the bill passed in the Senate and negotiated by two Democrats, Senators Bob Casey of Pennsylvania and Ben Nelson of Nebraska, who have built up solid credentials in their political careers as abortion opponents.

Mr. Stupak and many of the lawmakers insisting on the tighter restrictions are Catholic, as is Ms. Pelosi, and all have cited their faith in justifying their position on the legislation.

In a sign of the emotion around the issue, Representative Dale E. Kildee, Democrat of Michigan, who is Catholic and opposes abortion, announced his support for the legislation in a statement pointing out that he had once studied for the priesthood. He said he had consulted his priest and concluded that the abortion restrictions in the Senate bill were sufficient.

Democratic leaders said they hoped an executive order by Mr. Obama would clarify that the legislation was not intended to change existing federal law and policy that generally bar the use of taxpayer money for abortions.

But Representative Anh Cao of Louisiana, the only Republican who voted for the bill in November, said he could not support the current measure because of its “expansion of abortion, an absolute moral evil.”

Democratic lawmakers and top aides have been working round the clock trying to address flare-ups over elements of the bill. They said they had worked out an agreement to resolve one of the last remaining issues: a dispute over geographic disparities in Medicare payments.

The agreement could lead to higher payments to doctors and hospitals in states like Iowa, Minnesota, Oregon, Washington and Wisconsin, where Medicare rates are relatively low but studies suggest that the quality of care is high.

Kathleen Sebelius, the secretary of health and human services, sent a letter to Congress saying she would commission studies by the National Academy of Sciences to investigate the issue and recommend solutions.

“The current geographic variation in Medicare reimbursement rates is inequitable,” Ms. Sebelius said.

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20
Mar
10

President Obama makes final House call

NEWS
President Obama makes final House call

Saturday, March 20, 2010

President Obama delivered the final pitch Saturday to the voters who now matter most in his party’s decades-long campaign to win a major rewrite of the nation’s health care system: House Democrats.

“It is time to pass health care reform for America, and I am confident that you are going to do it tomorrow,” Obama said in an address broadcast from deep inside the underground Capitol Visitors Center. “Don’t do it for me, don’t do it for Nancy Pelosi or Harry Reid … Do it for the American people. They’re the ones looking for action right now.”

Several stories above the caucus bunker, at the southeastern edge of the Capitol grounds, several thousand protesters derisively chanted Pelosi’s first name, yelling “Nan-cy, Nan-cy, Nan-cy” in unison, as if attending a New York Mets game.

The sometimes unruly protesters notwithstanding, Obama’s Saturday afternoon pep talk came amid a bit of good news for Democratic vote-counters, who predicted they would get to the 216 needed to send the bulk of the health care overhaul to the president on Sunday.

The measure would expand access to health insurance for nearly every American and end insurers’ ability to deny coverage based on pre-existing medical conditions. Democrats, backed by a recent report from the Congressional Budget Office, say it will also produce a surplus of $138 billion over the next decade and $1.2 trillion over the following 10 years.

One outstanding issue involving disparities in Medicare reimbursement rates among states was resolved with a last-minute legislative fix and a promise from Obama and Health and Human Services Secretary Kathleen Sebelius to address the matter by conducting a study and implementing its findings.

That deal, struck with Reps. Peter DeFazio of Oregon, Ron Kind of Wisconsin, Bruce Braley of Iowa and others, brought anywhere from three to 10 votes into the Democratic fold, according to DeFazio. An even larger group had an interest in the outcome.

Earlier in the day, Democratic leaders broke off talks with Rep. Bart Stupak (D-Mich.) and a group of antiabortion lawmakers who have been demanding a guarantee for the inclusion of a stringent ban on subsidizing health insurance plans that cover abortion with federal funds.

At least one anti-abortion lawmaker, Rep. Chris Carney of Pennsylvania, announced Saturday that he would vote with Democratic leaders.

“I am voting for this legislation because all Americans should have the same insurance choices enjoyed by members of Congress and their families,” Carney said. “If it’s good enough for members of Congress, it is good enough for the people they represent.”

Though he voted for the bill on its first trip through the House last year, Carney’s commitment was viewed as a significant victory for Democratic leaders because the Senate’s milder restriction on federal funding of abortion did not stop him from vowing to vote “yes” and because he hails from a district where President Obama won just 45 percent of the vote in 2008.

The trickle of public “yes” votes continued steadily, as Reps. Jim Costa (D-Calif.) and Gerry Connolly (D-Va.) committed to vote for the bill as well.

In his eleventh-hour appeal, Obama played Democratic lawmakers’ heart strings, while emphasizing the political difficulty of Sunday’s vote.

“I am absolutely confident that it’ll end up being the smart thing to do politically – because I believe that good policy is good politics,” he said, although moments later he appeared to reverse and said:

“Now I can’t guarantee that this is good politics.”

But he asked House members to reflect on why they got into politics in the first place. This vote is one of those moments, he said, that signifies why they are serving in Congress.

“Do it for people who are really scared right now,” he said, “who’ve done the right thing, who’ve played by the rules.”

Obama’s speech was the highlight of a dramatic Saturday on Capitol Hill, where protests grew ugly at times – Reps. John Lewis and Barney Frank were both targets of shouted epithets – and tension was high among Democratic lawmakers and aides who sought to clear the path to enactment of the health care overhaul.

In that vein, House leaders on Saturday killed a controversial plan to avoid a direct up-or-down vote on the Senate version of a health care overhaul, opting instead to vote both on that bill and a package of fixes separately.

The decision to use a more standard format for considering the legislation – and abandon the GOP-dubbed “Slaughter Solution” – came just before President Obama arrived a little after 3:30 p.m. to speak to the House Democratic Caucus.

“We are going to get this done,” Obama yelled to reporters as he walked into the meeting.

House leaders did their best to project optimism, with Majority Leader Steny Hoyer (D-Md.) telling reporters, “Clearly we believe we have the votes.”

And inside the meeting, Reid said, “I’m happy to announce I have the commitment of a significant majority of the United States Senate to make that good law even better,” meaning a commitment they would accept the changes to make the bill more palatable to House Democrats reluctant to support it.

That commitment is critical because House members are being asked to send the Senate-written health care to the president for his signature in exchange for a promise that House Democrats’ fixes will be agreed to by the Senate and made into law.

But Reid declined to release a list of senators who would guarantee swift action on the House changes.

Obama and his Cabinet worked feverishly to lock down the support of recalcitrant Democrats, swaying a band of Midwestern, Pacific and Southern holdouts with legislative language that would adjust Medicare reimbursement rates for doctors and hospitals in certain states. The White House also promised to study these regional disparities before the next presidential inauguration in 2013, according to DeFazio.

That brought three votes for certain and as many as 10, said DeFazio, one of a group of lawmakers who had face-to-face meetings with Sebelius. Obama backed up Sebelius’ assurances by phone, DeFazio said.

But even as votes began to flip into the “yes” column, Democratic leaders were still trying to navigate a tricky path on the issue of abortion – including the specter of a last-minute effort by Republicans to use a parliamentary tactic to get a vote on anti-abortion language favored by Stupak.

Emotions ran high, as about 100 protestors gathered outside a House meeting room Saturday, and one shouted “Baby killer!” at Rep. Lewis, a veteran of the civil rights movement, after he told them he planned to vote for the bill.

One possible last-minute compromise – getting Obama to sign an executive order enshrining the Stupak language in law – drew serious consideration and seemed to offer a possible way out of the impasse. But such a move would be sure to draw withering fire from the Democrats’ supporters among pro-abortion-rights activists, including groups like NARAL, which has already called the Stupak language a “non-starter.”

Following by reporters as she rushed from the House chamber to a private meeting in a nearby office, Pelosi could be heard to say: “An executive order is a different thing. That might be a possibility.”

Hoyer confirmed that negotiations were ongoing about an executive order, but said, “I don’t know where they stand.”

House Majority Whip James Clyburn said he was “hopeful” that an executive order that he is said is being drafted could help pick up votes.

“I understand the language is being read by various people,” he said, adding that “we’re going to be taking a measure of that within the next couple of hours to make sure.”

A White House spokesman declined to comment on the possibility of an executive order.

It is also possible that Republicans could attempt to use a “motion to recommit” to add Stupak’s language to the House bill designed to make fixes to the Senate bill under reconciliation. Democrats have options at hand to prevent such a move from succeeding – including asking rank-and-file members who supported Stupak in November to switch their vote – but, if agreed to, it could throw a procedural wrench into the reconciliation bill.

That’s because the abortion-related language would almost certainly be subject to a procedural challenge in the Senate, increasing the possibility that the two chambers would have to play ping-pong with the reconciliation bill. Minority party leaders keep their plans on motions to recommit close to their vests, so it was unclear whether an abortion-related motion to recommit would actually be offered.

“The talks have collapsed, but I believe in the resurrection,” said Michigan Rep. Dale Kildee, an anti-abortion Democrat who announced he would support the bill last week.

House leaders hoped they cleared one major procedural problem out of the way by abandoning the “deem and pass” idea, which Republicans have called the Slaughter Solution in reference to Rules Committee Chair Louise Slaughter (D-N.Y.). The provision – which would allow the House to “deem” the Senate bill passed without a separate vote – drew increasing criticism, and some Democrats feared that it looked like another sneaky legislative two-step, reminiscent of the Cornhusker Kickback and other special deals.

Democratic lawmakers and aides say they will get the votes they need even if they don’t win the support of Stupak and some of his anti-abortion allies, but reaching 216 is significantly more difficult without them.

Rep. Dan Lipinski (D-Ill.), though, said Stupak’s group is holding firm.

He said that to support the legislation he needs an ironclad guarantee that Stupak’s language will be resurrected and enforced whether the vehicle is legislation or executive action.

“There’s still time and they still need votes,” he said Saturday morning.

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20
Mar
10

House Plans Direct Vote on Senate Health Care Bill

NEWS
House Plans Direct Vote on Senate Health Care Bill

Saturday, March 20, 2010

Democrats edged closer to finding 216 lawmakers to back a landmark health-care bill Saturday, as party leaders and White House officials were working on an executive order that they hope will win over a substantial number of antiabortion Democrats.

The House Rules Committee continued its session on the third floor of the Capitol, where the panel is tasked with setting the terms of Sunday’s floor debate. House leaders have decided to take a separate vote on the Senate version of the health-care bill, rejecting an earlier, much-criticized strategy that would have permitted them to “deem” the measure passed without an explicit vote.

Rep. Chris Van Hollen (D-Md.) said the House will take three votes on Sunday: first, on a resolution that will set the terms of debate; second, on a package of amendments to the Senate bill that have been demanded by House members; and third, on the Senate bill itself.

Van Hollen, who has been working on the issue with House Speaker Nancy Pelosi (D-Calif.), said House leaders concluded that that order — approving the amendments before approving the Senate bill — makes clear that the House intends to modify the Senate bill and not approve the Senate bill itself.

“We believe this is a better process,” House Majority Leader Steny Hoyer (D-Md.) said of the vote strategy. “We determined we could do this. . . . We believe we have the votes.”

At the Rules Committee hearing, lawmakers from both parties welcomed the news that the chamber would take a separate vote on the Senate health bill.

“I think we’ve had sanity prevail here, and we’re very pleased about that,” said Rep. Dennis Cardoza (D-Calif.), adding that it was proper for Congress to take such an important vote “in the light of day.”

Senate Majority Leader Harry Reid (D-Nev.), meanwhile, delivered good news to House Democrats worried that the Senate might not follow suit by passing a package of “fixes” to the Senate bill.

“I am happy to announce I have the commitment of a majority of the United States Senate to make a good law even better,” Reid said, prompting loud applause at the Capital Visitors Center, where President Obama showed up to rally Democrats ahead of Sunday’s vote.

The real developments Saturday were taking place behind closed doors, as Pelosi and other House Democratic leaders tried a new tack in their effort to secure the votes of Democrats who fear that the Senate health bill will allow federal funding of abortions. The details of the proposed executive order remain unclear, but leaders and senior party aides confirmed that it was now the most viable solution to breaking the impasse over abortion funding.

The turn in the negotiations came after Pelosi rejected a proposal from Rep. Bart Stupak (Mich.), the leader of the antiabortion bloc among House Democrats, to change the health measure’s abortion language via a separate vote.

Pelosi told reporters there would be no such separate vote, “not on abortion, not on public option, not on single payer, not on anything,” she said, later adding: “The bill is the bill.”

Stupak’s office said the lawmaker “remains open” to reaching an agreement with Democratic leaders. Key members of the House’s abortion rights coalition also suggested Saturday they were amenable to the possibility of an executive order on abortion.

The Rules panel, meanwhile, continued its contentious session Saturday afternoon after breaking for House votes.

The committee hearing comes after Democratic leaders persuaded four more House members Friday to support a landmark health-care bill after initially opposing it. More than 200 House members have announced that they will vote Sunday against the Senate’s health-care bill. That leaves Democrats little margin for error as they attempt to gather the 216 votes needed for passage among the few dozen lawmakers who remain publicly undeclared.

Those holdout lawmakers, most of whom hail from the Midwest and are Catholic, generally support the $940 billion package and its aim of providing coverage for 32 million more Americans. But they have voiced objections to how the Senate bill would handle insurance coverage of abortions.

Heading into a meeting of the Democratic whip team Saturday, Rep. Xavier Becerra (D-Calif.) said the bill remained on track despite the abortion disagreement.

“I continue to believe . . . we’ll have the votes,” Becerra said. “We are moving closer to 216.”

A few other Democrats voiced concern Friday about another issue, the bill’s Medicare funding formulas for doctors and hospitals. Liberals such as Reps. Peter A. DeFazio (Ore.) and Michael E. Capuano (Mass.) said they would withhold their support unless the formulas were rewritten.

The House is expected to vote Sunday on a health-care bill that the Senate approved on Christmas Eve, along with a separate package of amendments.

All 178 Republicans are expected to oppose the bill, so they need to peel off 38 Democrats to defeat the measure, almost the exact number that opposed the first version of the legislation in November. “I just think it is clearly false momentum,” said House Minority Whip Eric Cantor (R-Va.). “The votes still aren’t there.”

The White House said that, just this week, the president has spoken 64 times to wavering lawmakers, often in one-on-one meetings in the Oval Office. That work paid off Friday when Reps. John Boccieri (Ohio), Allen Boyd (Fla.), Suzanne Kosmas (Fla.) and Scott Murphy (N.Y.) announced their new support, bringing to seven the number of Democratic converts this week. Boccieri, Kosmas and Murphy are freshmen whom Republicans have targeted in the November midterm elections.

If the bill is approved, Obama would sign the Senate version into law. The amendments to that law would be sent across the Capitol, where the Senate would try to approve them next week.

The House has already confronted the hurdle of abortion once in this year-long health-care debate.

In November, antiabortion Democrats led by Stupak successfully pushed an amendment that would bar people who receive federal subsidies for insurance from using that money to buy policies covering abortions. The House then passed its health-care bill.

The Senate’s version included slightly less stringent restrictions. State-run insurance exchanges created under the legislation would be permitted to bar abortion coverage in the policies they offer, but recipients of federal tax credits for insurance would be permitted to buy policies with abortion coverage if it were available. Their tax credit would finance the bulk of their policy, but they would have to write a separate check, with their own money, to pay for the part of the policy that covers elective abortions.

“They’ll send you two bills and you’ll write two checks,” said Timothy Jost, a legal and health policy expert at the Washington and Lee School of Law who has studied the legislation. Jost, who appeared Friday at a news conference organized by antiabortion groups who support the Senate language, said he expects that few people will buy the extra coverage, particularly if they get insurance through an employer.

The Senate bill includes a number of often-overlooked provisions designed to reduce the number of abortions. They include a $250 million grant program for young, pregnant women who need help with child care or college tuition, additional tax credits for adoptive parents, and $11 million for community health centers, which serve many poor women and are barred by federal law from offering abortion services. Health and Human Services Secretary Kathleen Sebelius affirmed Friday the administration’s commitment to that ban.

Despite claiming unity, the antiabortion bloc of Democrats has fissures within its ranks. Stupak is the staunchest critic of the Senate language, believing it would breach the 32-year-old Hyde Amendment prohibiting federal funding for abortion except in cases of rape, incest or to save the life of the woman.

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