From the Washington Examiner

From ChamberPost

by James Gelfand

On March 10th David Plouffe, President Obama’s former campaign manager and current White House advisor, sent out an email with a set of facts on behalf of Organizing for America about the “President’s Proposal” for health reform – which is, in actuality, a proposal for the House to pass the same bill that the Senate passed on Christmas Eve, and then for the Senate to pass a “fixer” bill using the nuclear option, budget reconciliation, with 51 votes. The email (and this page) contain a number of claims about this proposal, many of which are questionable at best. Below is our analysis:

Organizing for America Claim: “If you have health insurance through your employer and like your plan, you can keep it.”

Fact Check: False

Explanation: This was debatably true in the Senate bill, but the President’s own proposal document lays out on page 3 why this is false in the section labeled “Extend Consumer Protections against Health Insurer Practices.” The proposal would effectively end the ability to “grandfather” plans and keep them in operation after the bill is enacted, instead forcing an exhaustive and onerous list of new mandates on all plans, including employer and “grandfathered” plans. These include forcing all plans to cover “children” up to the age of 26, prohibiting rescissions (withdrawing coverage when customers mislead an insurer on their enrollment forms), mandating a new appeals process, mandatory state and federal annual rate reviews, banning annual and lifetime limits, banning all pre-existing condition exclusions, banning plan differences for highly compensated employees, and forcing all plans to cover government-designatedpreventative services with no cost-sharing. While most group health plans do not practice rescissions or have preexisting condition exclusions, the new government mandates will lead to reduced plan flexibility and higher costs. All of these policies will increase the costs of a plan, and while some of these changes may have merit, it is undeniable that forcing these changes will cause many plans to change, and some to cease operation.

Organizing for America Claim: “If you’re a small business owner, you’ll receive new tax credits that make it easier for you to provide coverage for employees if you choose to do so.”

Fact Check: False.

Explanation: Senate bill H.R. 3590 included a credit that would cover 50% of premiums for a business with 10 or fewer employees with average wages of $20,000, if that business provided highly comprehensive health benefits and if the business paid the vast majority of every employee’s premium. This credit phases out at a maximum of 25 employees and $40,000 annual compensation for employees. The credit is available for a few years, and then ends abruptly, with no transition period. This credit is highly unworkable for two reasons – first, its short and abrupt nature will dissuade employers from using it due to concern about a large spike in out-of-pocket expenses the day that the credit suddenly ends a few years later. Second is its extremely limited nature – according to the U.S. Census Bureau, the average firm with 10 or fewer employees has an average wage of $27,000, meaning the vast majority of small businesses will not even be eligible for half of the credit.

 

Organizing for America Claim: “If you have Medicare, the President’s plan guarantees that your benefits will not be cut, and the Medicare Trust Fund will be extended for more than 9 years.”

Fact Check: False.

Explanation: Both of these claims are demonstrably false. First, proponents of the bill claim that it will extend the Medicare Trust Fund – but the Congressional Budget Office (CBO) has admitted that this is highly unlikely and the discrepancy is due to a number of arcane rules CBO was forced to follow in developing the legislation’s cost estimate. This includes double-counting the $500 billion in Medicare cuts, as if the money saved by those cuts could simultaneously be reinvested in the Trust Fund and used to fund a new $500 billion entitlement for families making up to $88,000 a year. It also assumes that the Sustainable Growth Rate (SGR) formula will operate without interference, thus allowing, starting this year, an across-the-board 23% pay cut to Medicare providers. In their letter to Leader Reid on November 18th of 2009, the CBO expressed doubt that the Medicare provisions would really be enacted – especially a new global budgeting entity that would be charged with annually containing the costs of Medicare in the out years – an impossible task for a commission that cannot make systemic changes to the program, in essence forcing them to ratchet down provider reimbursement or ration care. The claim that benefits will not be cut is countered by an analysis by the Chief Actuary at the Center for Medicare and Medicaid Services, who said in an analysis released December 10, 2009, that “20 percent of Part A providers would become unprofitable” and stop seeing Medicare patients. It is semantics to pretend that losing access to 20 percent of current providers would not result in service and benefit interruptions for Medicare enrollees.

Organizing for America Claim: “If you’re uninsured, you could receive a tax credit to help pay for coverage if needed—part of the largest middle class tax cut for health care in history.”

Fact Check: False.

Explanation: While the uninsured may be eligible for subsidies under the plan, this is in no way a tax cut. In all, the bill contains about $500,000,000,000.00 in new taxes. Money will be taxed from some people, and then given to others, or given back to the taxpayer. In fact, those same Americans will be facing one of the largest tax increases in history. According to Doug Elmendorf, Director of the CBO, in his testimony before a Senate committee, taxes on health insurance policies, prescription drugs, and medical devices, will all be passed on directly to consumers. Taxes on “Cadillac” high-value health insurance plans will result in benefit cuts or reduced wages. Small business owners who file taxes as individuals will pay massive new “Medicare” payroll and investment surtaxes.Worse, these taxes will rapidly expand like the Alternative Minimum Tax, because they are not properly indexed to inflation – the surtaxes are not indexed whatsoever. Small businesses will be burdened with a new paperwork tax. In addition, consumers will pay higher health care costs because of reduced government payments to providers – a practice called “cost-shifting” where, without overtly raising taxes, the government transfers costs to the private sector. All of this will result in a large series of “hidden taxes” that may not be direct income taxes, but will all result in higher costs – and less money in the pockets – of small businesses and middle class Americans. Calling this bill a tax cut is highly misleading.

Organizing for America Claim: “Even if you currently have health insurance, there will be new protections from insurance company abuses, and tax credits will make coverage more affordable.”

Fact Check: False.

Explanation: While for a small minority of people, who buy insurance individually, there may be some benefits from insurance market reforms, the vast majority of Americans receive health benefits through their employers, and the majority of them are beneficiaries of self-insured ERISA plans. These people will see no change in the new so-called “protections” other than higher costs resulting from a loss of plan flexibility and onerous new requirements and mandates on health insurance providers. Further, the President and White House staff have independently admitted that for many Americans, health insurance will become more expensive, but claimed that this is acceptable because Americans would be required to purchase more comprehensive plans. While the merit of forcing more comprehensive plans can be debated (the U.S. Chamber of Commerce supports allowing individuals to purchase high-deductible and more basic, affordable plans), the Administration has already conceded that health insurance will be more expensive for many Americans.

Organizing for America Claim: “You will never again be hit with arbitrary health insurance premium hikes.”

Fact Check: False.

Explanation: Proponents continue to vilify health insurance providers in an effort to distract from the public’s concerns about the proposal. While the health insurance industry has made an easy target, the allegation that they arbitrarily raise rates has been thoroughly discredited. In fact, the health insurance industry makes only a 2.2 percent profit, compared to 19.4 for the internet services industry and 20.4 percent for the communications equipment industry, among others. Overall, the primary drivers of health insurance cost increases are increases in the costs of health care services, products, and pharmaceuticals. The Administration chooses to overlook the fact that many insurers are currently being forced to increase their rates to build up cash reserves in anticipation of heavy losses if the President’s proposal is enacted. By enacting guaranteed issue and community rating, with an ineffective individual mandate, the plan will cause a death-spiral for health insurance pools when healthy people opt out and sick people opt in.

Organizing for America Claim: “If We Do Not Pass [the Senate Bill]… Up to 17 million more people will be uninsured by 2019.”

Fact Check: Misleading.

Explanation: The Senate bill and President’s proposal delay the enactment of their primary coverage provisions for four years – this was done in an effort to lower the visible costs of the legislation by gaming the CBO score with budget gimmicks and moving four years of spending beyond the 10-year budget window the CBO uses to estimate scores. Now, the Administration has also continued to claim that every day we do not act, 14,000 people lose their health insurance. In other words, the Senate bill’s budget gimmicks will cause 14,000 people, times 365 days, times 4 years, so 20,440,000 people to lose their health insurance. Further, in a letter from the CBO to Senator Reid on November 30th, 2009, they found that even after enactment of the Senate bill and spending almost $1 trillion over ten years, 24 million people would still be uninsured in 2019. The Chamber’s calculations, based on Census Bureau data, found that of the 46 million people the Administration claimed were uninsured last year, more than 10 mill ion were undocumented or illegal, 11 million were already eligible for free or subsidized health insurance, 15 million were in income brackets such that they could likely afford reform, and only around 10 million were chronically uninsured not necessarily by choice. All of this adds up to point to a very confusing picture of tens of millions with no coverage without the bill, yet tens of millions with no coverage if the bill is enacted. Claiming that the bill will somehow save 17 million people from being uninsured in 2019 is misleading at best.

Organizing for America Claim: “If We Do Not Pass [The Senate Bill]… The average family’s health care costs will nearly double by 2020, from $13,000 to $24,000.”

Fact Check: False.

Explanation: In the November 30th, 2009 analysis of the Senate bill, the CBO wrote that: “Average premiums per policy in the nongroup market in 2016 would be roughly $5,800 for single policies and $15,200 for family policies under the proposal, compared with roughly $5,500 for single policies and $13,100 for family policies under current law… [an increase] of 10 percent to 13 percent in the average premium per person.” In other words, health insurance will cost more if the President’s proposal (the Senate bill) is enacted, not less.

In the Weekly Republican Address, newly-elected Sen. Scott Brown of Massachusetts explains that the Democrats running Washington have their priorities all wrong. Sen. Brown says Americans “told me that they want their President and Congress to focus on creating jobs and reviving Americas economy. Instead, for more than a year now, we have seen a bitter, destructive, and endless drive to completely transform Americas health care system.”

“Somehow,” Sen. Brown notes, “the greater the public opposition to the health care bill, the more determined they seem to force it on us anyway. Their attitude shows Washington at its very worst the presumption that they know best, and theyre going to get their way whether the American people like it or not.”

Sen. Brown says, “I havent been here very long, but, I can tell you this much already: Nothing has distracted the attention and energy of the nations capital more than this disastrous detour. And, the surest way to return to the peoples business is to listen to the people themselves: We need to drop this whole scheme of federally controlled health care, start over, and work together on real reforms at the state level that will contain costs and wont leave America trillions of dollars deeper in debt.”

From National Review Online

“Game on,” says Rep. Paul Ryan (R., Wis.), the ranking member of the House Budget Committee, to National Review Online. “The Democrats are moving on reconciliation. They are revving up their machine, even though they don’t yet have the votes to pass the Senate bill in the House. This is their do-or-die moment. They know can’t let their members go home for Easter with this hanging out there.”

Ryan says that, come Monday, Democrats “will bring a shell piece of reconciliation legislation” to the budget committee. “The reconciliation process has to begin there,” he says. “Here’s what they’ll do: They will take the House health-care bill and mark it up so that it can become a reconciliation vehicle. Republicans will make runs at this via motions to instruct, but since we’re outnumbered, their package will get through the committee. Then they’ll send that shell of a bill to the House Rules Committee. The rules committee will then gut the budget committee’s reconciliation bill and drop in all of the deals that Speaker Pelosi arranges with members who vote for the Senate health-care bill in the House.” Those deals, he adds, “will be hard to scrutinize, and we may never know their full extent, since many of them will be orchestrated outside of health-care legislation.”

Regardless of how bad a reconciliation package looks, Ryan says it is the passage of the Senate bill in the House that troubles him the most. “The Senate parliamentarian made it clear today,” he says. “The Senate bill has to become law before reconciliation can be taken up in the Senate. Knowing this, the Democrats are doing whatever they can to convince House members to walk the plank. But let’s be very clear: If the Senate bill passes in the House, it’s not just some setup for reconciliation — it’s a huge, new federal entitlement that’ll be signed into law.”

“To get that, they need to make promises to members about what’ll come next, so look for them to thread the needle on policy changes and abortion in the budget and rules committees,” Ryan says. “Reconciliation is a distraction for the Democratic leadership — something to talk about with members while keeping their eye on the main prize, which is passing the Senate bill.”

From National Review Online

Sitting in an airport, on his way home to Michigan, Rep. Bart Stupak, a pro-life Democrat, is chagrined. “They’re ignoring me,” he says, in a phone interview with National Review Online. “That’s their strategy now. The House Democratic leaders think they have the votes to pass the Senate’s health-care bill without us. At this point, there is no doubt that they’ve been able to peel off one or two of my twelve. And even if they don’t have the votes, it’s been made clear to us that they won’t insert our language on the abortion issue.”

According to Stupak, that group of twelve pro-life House Democrats — the “Stupak dozen” — has privately agreed for months to vote ‘no’ on the Senate’s health-care bill if federal funding for abortion is included in the final legislative language. Now, in the debate’s final hours, Stupak says the other eleven are coming under “enormous” political pressure from both the White House and House Speaker Nancy Pelosi (D., Calif.). “I am a definite ‘no’ vote,” he says. “I didn’t cave. The others are having both of their arms twisted, and we’re all getting pounded by our traditional Democratic supporters, like unions.”

Stupak says he also doesn’t trust the “Slaughter solution,” a legislative maneuver being bandied about on Capitol Hill as a way to pass the Senate bill in the House without actually voting on it. “Fool me once, shame on you. Fool me twice, shame on me,” he says. “I don’t have a warm-and-fuzzy feeling about what I’m hearing.”

Stupak notes that his negotiations with House Democratic leaders in recent days have been revealing. “I really believe that the Democratic leadership is simply unwilling to change its stance,” he says. “Their position says that women, especially those without means available, should have their abortions covered.” The arguments they have made to him in recent deliberations, he adds, “are a pretty sad commentary on the state of the Democratic party.”

Read the rest of the column.

From Gary Bauer’s End of Day Report

There’s an old saying that if you’re arguing process, you’ve lost the debate. In this age of Twitter and 30-second sound bites, it is generally true, and I try not to delve too deeply into the weeds of process and procedure in this daily report. But you need to know what’s going on in Congress right now.

Last week President Obama insisted that healthcare reform was so important that it deserved an up or down vote by any means necessary. Obama demanded Democrats get it done before the end of March, before members of Congress have to face their constituents back home. He also ordered Democrats to go “nuclear” by resorting to complicated and controversial budget reconciliation rules, which he and other Democrats once vehemently opposed.

For days, Nancy Pelosi and Harry Reid have struggled to figure how they can “reform” 20% of our economy under strict rules only intended to guarantee the passage of a budget. Reconciliation rules require that the House pass the Senate’s healthcare bill first, then pass a “bill of fixes” or a separate reconciliation bill, which then has to be approved by the Senate.

The problem for House Democrats is that the Senate bill includes several provisions considered onerous to many House members for a variety of reasons – from abortion funding to immigration issues, kickbacks and tax hikes. Many House Democrats do not want to vote for the Senate bill, which is reportedly “dead on arrival.” But Speaker Pelosi and other House leaders thought they had a way around it.

Speaker Nancy Pelosi reportedly cancelled all House committee hearings today so she could corral members of her caucus and present details of their “end game.” One plan under consideration would invoke another parliamentary maneuver referred to as the “Slaughter rule,” after Rep. Louise Slaughter (D-NY), chairwoman of the House Rules Committee. The Slaughter rule allows the House to vote on only the reconciliation “bill of fixes,” and in doing so consider the Senate bill as passed by the House without an actual up or down vote on the Senate’s bill.

I realize this is a lot of “inside baseball,” but it is important. Nothing could more clearly demonstrate the consequences of elections and why it is so critical that we take back Congress in 236 days. The fact that Democrats are going through such contortions to pass a bill the public opposes is an insult to the central principle of our republic: The Consent of the Governed.

The author of the reconciliation process, Sen. Robert Bryd (D-WV,) understood this. Here’s a stirring video of Byrd explaining why he refused to allow Bill Clinton to pass HillaryCare through reconciliation. All those arguments are valid today. The difference is that there’s a new gang in town, and it plays by whatever rules it must in order to win.

But there is good news breaking now! According to Roll Call, “The Senate parliamentarian has ruled that President Barack Obama must sign Congress’ original health care reform bill before the Senate can act on a companion reconciliation package.” In other words, the House must pass the Senate bill, with all its objectionable provisions, before the reconciliation bill can proceed. This is a major blow to ObamaCare because, as I noted, there is little support for the Senate bill in the House today. Stay tuned!

From The Galen Institute

President Obama will be visiting the St. Louis area Wednesday to garner support for his health reform plan.  As Washington prepares for a final bare-knuckled battle this month, the stakes could not be higher.  With Republicans united in opposition, Democratic leaders are planning to enact a sweeping health overhaul that the American people continue to say in the every way possible that they don’t want.

While the president can make a compelling case for action, his assertions about his plan are not backed by facts.  Based upon his most recent health reform statements, the president will continue to make arguments refuted by the facts and independent analyses when he visits Wednesday.  Here are just a few examples:

President Obama said at the White House on March 3 that his plan will “bring down the cost of health care for millions – families, businesses, and the federal government.”

But the non-partisan Congressional Budget Office (CBO) says health insurance premiums will continue their steady upward climb under the Senate bill.  Families purchasing insurance in the individual market would see an increase of $2,100 in the year 2016, over and above increases they already will be facing.  That means those families would be paying $15,200 in 2016 for health insurance if the Senate bill passes, and $13,100 if it doesn’t.

His legislation will do nothing to slow the steady climb of health costs.  Families who get health insurance through small businesses will be paying $19,200 in six years, and those working for large firms, $20,100, according to CBO.

And the Obama administration’s own Chief Medicare Actuary estimates that, under the Senate bill, “Federal expenditures would increase by a net total of $279 billion” between 2010 and 2019.

So it would cost families, businesses, and taxpayers more, not less, if his plan passes.

President Obama: “If you like your plan, you can keep your plan.”

He claims no one will have to change plans, but at the health reform summit, the president acknowledged that the Senate bill could take away the current health insurance coverage for eight to nine million Americans.

The steep cuts in Medicare Advantage that President Obama supports would mean at least one-third of seniors in Missouri, Illinois and 45 other states likely could lose their comprehensive Medicare Advantage coverage as their plans are forced to withdraw from the program, cut their benefits, or raise premiums (three states received sweetheart deals to protect their seniors from the cuts).  In addition, about 10 million people with employer-sponsored insurance could lose their current coverage, according to the CBO.

President Obama says his plan “brings down our deficit.”

No one believes this to be true and for good reason.  The president and congressional leaders employed trillion-dollar budget gimmicks to make this assertion.  CBO, the budget scorekeeper, was cynically given a bill with ten years of tax hikes and Medicare cuts to pay for only six years of new entitlement subsidies.  The IRS would throw ordinary Americans in jail if they used this type of accounting.

In reality, the ten-year cost of the Senate bill is estimated at $2.4 trillion.  The Senate legislation would significantly expand, not shrink, the deficit.

So just on these three examples – keeping your current coverage, lowering costs, and reducing the deficit – the president’s assertions are wrong.  One hopes his St. Louis speech will not employ what we’ve seen from President Obama throughout this debate: using the same arguments that have been proven as inaccurate by independent studies and analyses, and hoping that maybe, just maybe, this time the speech will work.

By Hugh Hewitt Friday, February 26, 2010

It seems very likely that if Obamacare is going to be stopped, it will have to happen in the House. And that means turning some of supporters the deeply unpopular bill into opponents with at least enough spine to tell Nancy Pelosi and the president “No.”

Thus the two lists below. The first list is of all the so-called “Blue Dogs,” the alleged “moderate Democrats” in the House. Many refused to vote for Obamacare the first time around, and they need to be bucked up and made to understand that their hopes of re-election depend upon continuing to stand against the government takeover of American health care and the massive cuts to Medicare on which the takeover is premised.

The second list are the Democrats who voted for the bill in the fall but who hail from swing districts. These are the House members identified by the National Republican Congressional Committee’s ReverseTheVote.org effort. The last thing they want are phone calls and e-mails from voters pledging to throw time and money at their opponents if Obamacare passes.

The Congressional switchboard works for them all – 202-225-3121, but direct calls to their offices and especially their district offices are even more effective. E-mails work as well, but many of their number won’t accept e-mails unless a district zip code is used, which means a little work for the dedicated anti-Obamacare activist. (Just use the zip code of their district office address if you want to communicate despite their filter.)

What matters is a wall of calls between now and the last-ditch effort to push the bill through. Some of the pro-life Demcrats led by Bart Stupak will stay strong and refuse to support the Senate bill with its public funding of abortion, but some will fold. Perhaps a Member or two will vote no as well because there is no “public option” by that name and they realize if they don’t get it now they’ll never get it.

But it will be a very close thing either way. Never have your calls and e-mails mattered more.

Contact The Blue Dogs:

Alabama

Rep. Bobby Bright  2nd District
DC Phone: (202) 225-2901
District Phone: Dothan (334) 794-9680; Montgomery (334) 277-9113; Opp (334) 493-9253
Link to E-mail

Rep. Parker Griffith  5th District
DC Phone: (202) 225-4801
District Phone: Huntsville (256) 551-0190; Decatur (256) 355-9400; Shoals (256) 381-3450
Link to E-mail

Arkansas

Rep. Marion Berry  1st District
DC Phone: (202) 225-4076
District Phone: Jonesboro (870) 972-4600; Cabot (501) 843-4955; Mountain Home (870) 425-3510
Link to E-Mail

Rep. Mike Ross  4th District
DC Phone: 1-800-223-2220
District Phone: El Dorado (870) 881-0681; Hot Springs (501) 520-5892; Pine Bluff (870) 536-3376; Prescott (870) 887-6787
Link to E-mail

Read the rest of this entry »

From One News Now

A conservative congresswoman is calling for an independent investigation to determine whether President Obama is attempting to trade a federal judgeship for a vote in favor of his healthcare reform plan.

President Obama hosted a closed reception at the White House Wednesday that included ten House Democrats who voted “no” on the healthcare reform bill. One of the ten was Congressman John Matheson (D-Utah), whose brother Scott Matheson, Jr., was nominated Wednesday by President Obama to serve on the U.S. Court of Appeals for the Tenth Circuit.

Representative Matheson contends that the president did not nominate his brother in exchange for a “yes” vote on healthcare reform. But some Republicans are not buying that claim. Congresswoman Michele Bachmann (R-Minnesota) told CNN’s Larry King that there needs to be an independent investigation into the Matheson matter.
 
“We’ve seen the Cornhusker kickback, the Louisiana Purchase, the union loophole, and now the big question is: Is the White House trading healthcare votes for judgeships?” she argued. “This is a pretty serious issue, Larry.”
 
White House officials label as “absurd” the notion that the Matheson judgeship would be tied to a healthcare vote.

From the Boston Herald

So this is what it looks like when a mild-mannered, liberal community activist goes “nuclear.”

President Barack Obama didn’t use the “n” word – or even the “r” word, “reconciliation.” But he made it clear he’s ready to go to Democrat DefCon4, give the partisan launch codes and inflict Obamacare on the American people at any political cost.

In defending his decision to go nuclear, Obama talked about insurance company “abuses.” He talked about premium hikes in California. He talked about a sick mom in Wisconsin. He even talked (in extremely modest ways) about Republican ideas like tort reform and fighting Medicare fraud.

What Obama didn’t mention was Massachusetts.

In fact, despite having given (based on my calculations) some 57,432 speeches, press conferences, pep talks, pillow talks and interpretive dances on health care in the past 12 months, Obama somehow manages to leave us out of nearly every conversation.

This is telling, because we’re the one state already glowing in the radioactive haze of Romneycare, aka “ObamaCare: The Beta Version.”

Shouldn’t Obama have been bragging yesterday about bringing the benefits of Bay State reform to all of America?

As we prepare to wander into this coming nuclear winter of hyper-partisan politics – one in which we’re almost certain to see widespread political fatalities among congressional Democrats – I have to ask: If bringing Massachusetts-style “universal coverage” to America is worth this terrible price, why doesn’t Obama at least mention us once in awhile?

Maybe he thinks of us as the Manhattan Project of medical insurance reform. Too top secret to discuss. More likely, it has something to do with the nightmare results of this government-run debacle. Here are a few “highlights” of the current status of the Obamacare experiment in Massachusetts:

• It’s exploding the budget: Our “universal” health insurance scheme is already $47 million over budget for 2010. Romneycare will cost taxpayers more than $900 million next year alone.
• It’s killing us on costs: Average Massachusetts premiums are the highest in the nation and rising. We also spend 27 percent more on health care services, per capita, than the national average. Those costs, contrary to what we were promised, have been going up faster here than nearly everywhere else.
• It’s creating bizarre marketplace mutations: In Massachusetts, ObamaCare 1.0 is such a mess our governor is talking about imposing draconian price controls. He’s even suggested going to “capitation,” a system where doctors get a fixed amount of money per patient – and then that’s it. Which means it would become in your doctor’s financial interest never to see you again.

All this damage to the taxpayers, the insured and the responsible business owners . . . and for what?

The percentage of uninsured Bay State residents has gone from around 6 percent to around 3 percent.

In other words, it’s a dud.

Read the rest of the column.

From the Washington Examiner

President Obama declared the health care debate over on Wednesday and urged congressional Democrats to take the politically risky step of pushing his newly written compromise reform bill through using a controversial tactic to circumvent a Republican filibuster.

Calling for an “up-or-down” vote, Mr. Obama offered to add a few Republican ideas to the $1 trillion bill, but made clear that the time for talk was over.

“Every idea has been put on the table; every argument has been made,” Mr. Obama said in a speech before an audience of health care professionals in the East Room of the White House. “So now is the time to make a decision about how to finally reform health care so that it works, not just for the insurance companies, but for America’s families and businesses.”

Republicans scoffed at Mr. Obama’s tough talk, vowing to fight the effort at every turn and to tap the American public’s distaste for the measure in the midterm elections.

“They’re making a vigorous effort to try to jam this down the throats of the American people, who don’t want it,” said Senate Minority Leader Mitch McConnell, Kentucky Republican.

“We think that’s a policy mistake, and we think resorting to these kinds of tactics, to thumb your nose at the American people, is something that ought to be resisted,” Mr. McConnell added.

At stake is the biggest policy initiative of the year-old Obama presidency, a rewrite of the nation’s health care system that would trim hundreds of billions of dollars from Medicare, expand Medicaid, mandate that every American join a plan and rewrite rules telling insurance companies how they can operate.

The House and Senate have passed their own versions of bills, but the debate has been stalled for nearly two months after Democrats lost their filibuster-proof majority in the Senate in January.

Now, Democrats are looking to turn to a complex budget procedure known as “reconciliation,” under which legislation can pass the Senate with 51 votes rather than 60.

Read the rest of the column.

From the Wall Street Journal

By Mitch Daniels

As Washington prepares to revisit the subject of health-care reform, perhaps some fresh experience from Middle America would be of value.

When I was elected governor of Indiana five years ago, I asked that a consumer-directed health insurance option, or Health Savings Account (HSA), be added to the conventional plans then available to state employees. I thought this additional choice might work well for at least a few of my co-workers, and in the first year some 4% of us signed up for it.

In Indiana’s HSA, the state deposits $2,750 per year into an account controlled by the employee, out of which he pays all his health bills. Indiana covers the premium for the plan. The intent is that participants will become more cost-conscious and careful about overpayment or overutilization.

Unused funds in the account—to date some $30 million or about $2,000 per employee and growing fast—are the worker’s permanent property. For the very small number of employees (about 6% last year) who use their entire account balance, the state shares further health costs up to an out-of-pocket maximum of $8,000, after which the employee is completely protected.

The HSA option has proven highly popular. This year, over 70% of our 30,000 Indiana state workers chose it, by far the highest in public-sector America. Due to the rejection of these plans by government unions, the average use of HSAs in the public sector across the country is just 2%.

What we, and independent health-care experts at Mercer Consulting, have found is that individually owned and directed health-care coverage has a startlingly positive effect on costs for both employees and the state. What follows is a summary of our experience:

State employees enrolled in the consumer-driven plan will save more than $8 million in 2010 compared to their coworkers in the old-fashioned preferred provider organization (PPO) alternative. In the second straight year in which we’ve been forced to skip salary increases, workers switching to the HSA are adding thousands of dollars to their take-home pay. (Even if an employee had health issues and incurred the maximum out-of-pocket expenses, he would still be hundreds of dollars ahead.) HSA customers seem highly satisfied; only 3% have opted to switch back to the PPO.

Read the rest of the column

From the Washington Examiner

By Hugh Hewitt

President Obama, House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid are embarked on a radical plan to fundamentally change American health care.

The operative term is “radical,” and the media should use that term in order to accurately convey the nature not just of the scope of the changes being pushed, or of the level of Medicare cuts on which those changes are premised, but also to accurately describe the process by which the radical Democrats propose to impose their vision.

The plan is to push Obamacare through the House on the promise of a subsequent “fix” that will use an arcane Senate procedure known as “reconciliation” to modify the health care legislation in order to bypass the Senate’s 60-vote requirement for substantive legislation.

No matter what rhetoric the Democrats employ, this is indeed a radical — there’s that word again — maneuver, one that will demolish forever the Senate’s long-standing tradition of requiring a supermajority to enact sweeping legislation that fundamentally alters an area of complex law. Reconciliation has indeed been used for tax rate changes, which go up and down, and on two occasions for very focused initiatives on welfare reform and continuance of health care coverage.

But reconciliation is a recent and rare exception to the rule of supermajority, and its use here will forever spell the end of the 60-vote requirement for major legislation. If the vast changes contemplated by Obamacare can be pushed through reconciliation, then there is no limiting principle for the future.

Expect both conservatives and liberals to insist that, if the process could be made to fit for Obamacare in 2010, then it surely must be able to accommodate any other fervently hoped for piece of legislation.

Thus in the space of 10 years the Senate Democrats will have re-engineered the supermajority tradition of the “Greatest Deliberative Body in the World” into one that is routinely applied to judicial nominees but waived for the most sweeping, most partisan legislative jam-downs.

With the exception of the bipartisan filibuster of President Johnson’s ethically compromised pick of Abe Fortas as chief justice of the Supreme Court in 1968, judicial filibusters were unheard of before 2003.

Though “blue slips” and “holds” did hobble many nominees in committee or on the floor, these procedures are distinct from the requirement of 60-plus votes to pass new laws. As rare as a judicial filibuster was in the last century, so, too, was the use of reconciliation to avoid the requirement of supermajority in law-making. Senate Democrats have trashed both traditions, and both were done in the service of ideology over basic traditions of governance.

Pelosi’s tired talking point about “majority rule” asks the public to dismiss as irrelevant the jettisoning of a long-standing approach to governance that limited the speed with which Congress could act.

This has been a virtue of the American republic since “The Federalist Papers” defended the Constitution’s original design as one intended to keep factions from moving too quickly to dominate politics for short times of abrupt change.

We are not a majority rule system, and never have been. Government’s ability to move quickly was cabined from the start and for the very good reason that sudden swings in law are not often to the advantage of freedom.

If Obamacare does indeed make it into law, the damage it will do to health care will be immense. But just as great a cost will be the injury done to the Senate and to the measured approach to legislation that has marked America as a deliberate and deliberating republic.

From the Wall Street Journal

Natural experiments are rare in politics, but few are as instructive as the prototype for ObamaCare that Massachusetts set in motion in 2006. The bills for “universal coverage” are now coming due, and it appears the state political class is prepared to do lasting damage to one of America’s top-flight health-care systems.

Last month, Democratic Governor Deval Patrick landed a neutron bomb, proposing hard price controls across almost all Massachusetts health care. State regulators already have the power to cap insurance premiums, which Mr. Patrick is activating. He also filed a bill that would give state regulators the power to review the rates of hospitals, physician groups and some specialty providers. Those that are deemed too high “shall be presumptively disapproved.”

Mr. Patrick ad-libbed that he had “a whole bunch of pals here who are in the health-care field, and I saw the color drain out of their faces.” Little wonder. The administered prices of Medicare and Medicaid already shift costs to private patients while below-cost reimbursement creates balance-sheet havoc among providers. Now the governor wants to import these distortions to save the state’s heavily subsidized insurance program as costs explode.

It doesn’t even count as an irony that former Governor Mitt Romney (like President Obama) sold this plan as a way to control spending. As with all new entitlements, the rolling cost crisis began almost immediately. For fiscal 2010 taxpayer costs are $47 million over budget, in part due to the recession, and while the $913 million Mr. Patrick requested for 2011 is a 5% increase over 2010, spending has grown on average 6.7% per year.

Meanwhile, average Massachusetts insurance premiums are now the highest in the nation. Since 2006, they’ve climbed at an annual rate of 30% in the individual market. Small business costs have increased by 5.8%. Per capita health spending in Massachusetts is now 27% higher than the national average, and 15% higher even after adjusting for local wages and academic research grants. The growth rate is faster too.

Read the rest of the column