Category: Health care

Christmas miracle – do the right thing for 9/11 responders

Christmas miracle – do the right thing for 9/11 responders

Posted on by Jack

It has been called a Christmas miracle. But it is not quite there yet. Let’s hope the Senate can do the right thing.

The James Zadroga 9/11 Health and Compensation Act of 2010 has been passed by the House but is now being filibustered in the Senate. The bill (HR 847) was passed by the House on September 29, 2010 and passed on to the Senate. Well it seems the Senate was rather busy and managed to read it twice by the middle of November and put it on the calendar and finally considered it on December 6. Then it was filibustered and on December 9 they voted to end the filibuster but that voted failed.

This is the recent legislative history accord to Thomas, Library of Congress

9/29/2010:
Received in the Senate. Read the first time. Placed on Senate Legislative Calendar under Read the First Time.
11/15/2010:
Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 641.
12/6/2010:
Motion to proceed to consideration of measure made in Senate. (consideration: CR S8552)
12/6/2010:
Cloture motion on the motion to proceed to the bill presented in Senate. (consideration: CR S8552; text: CR S8552)
12/9/2010:
Cloture on the motion to proceed to the bill not invoked in Senate by Yea-Nay Vote. 57 – 42. Record Vote Number: 269. (consideration: CR S8668-8669; text: CR S8669)
12/9/2010:
Motion by Senator Reid to reconsider the vote by which cloture was not invoked on the motion to proceed to the bill (Roll Call Vote No. 269) made in Senate. (consideration: CR S8669)

These are the votes (Roll Call Vote No. 269 to invoke cloture) according to Thomas

Grouped By Vote Position
YEAs —57
Akaka (D-HI)
Baucus (D-MT)
Bayh (D-IN)
Begich (D-AK)
Bennet (D-CO)
Bingaman (D-NM)
Boxer (D-CA)
Brown (D-OH)
Cantwell (D-WA)
Cardin (D-MD)
Carper (D-DE)
Casey (D-PA)
Conrad (D-ND)
Coons (D-DE)
Dodd (D-CT)
Dorgan (D-ND)
Durbin (D-IL)
Feingold (D-WI)
Feinstein (D-CA)
Franken (D-MN)
Gillibrand (D-NY)
Hagan (D-NC)
Harkin (D-IA)
Inouye (D-HI)
Johnson (D-SD)
Kerry (D-MA)
Klobuchar (D-MN)
Kohl (D-WI)
Landrieu (D-LA)
Lautenberg (D-NJ)
Leahy (D-VT)
Levin (D-MI)
Lieberman (ID-CT)
Lincoln (D-AR)
Manchin (D-WV)
McCaskill (D-MO)
Menendez (D-NJ)
Merkley (D-OR)
Mikulski (D-MD)
Murray (D-WA)
Nelson (D-FL)
Nelson (D-NE)
Pryor (D-AR)
Reed (D-RI)
Rockefeller (D-WV)
Sanders (I-VT)
Schumer (D-NY)
Shaheen (D-NH)
Specter (D-PA)
Stabenow (D-MI)
Tester (D-MT)
Udall (D-CO)
Udall (D-NM)
Warner (D-VA)
Webb (D-VA)
Whitehouse (D-RI)
Wyden (D-OR)

NAYs —42
Alexander (R-TN)
Barrasso (R-WY)
Bennett (R-UT)
Bond (R-MO)
Brown (R-MA)
Bunning (R-KY)
Burr (R-NC)
Chambliss (R-GA)
Coburn (R-OK)
Cochran (R-MS)
Collins (R-ME)
Corker (R-TN)
Cornyn (R-TX)
Crapo (R-ID)
DeMint (R-SC)
Ensign (R-NV)
Enzi (R-WY)
Graham (R-SC)
Grassley (R-IA)
Gregg (R-NH)
Hatch (R-UT)
Hutchison (R-TX)
Inhofe (R-OK)
Isakson (R-GA)
Johanns (R-NE)
Kirk (R-IL)
Kyl (R-AZ)
LeMieux (R-FL)
Lugar (R-IN)
McCain (R-AZ)
McConnell (R-KY)
Murkowski (R-AK)
Reid (D-NV)
Risch (R-ID)
Roberts (R-KS)
Sessions (R-AL)
Shelby (R-AL)
Snowe (R-ME)
Thune (R-SD)
Vitter (R-LA)
Voinovich (R-OH)
Wicker (R-MS)

Not Voting – 1
Brownback (R-KS)

Does anyone see a pattern here?

I don’t know when they will act but the NY Senators are optimistic. I hope the Senate does do the right thing. Here is a more complete story on this sad tale with the possible happy ending by ABC News

Notes added to post: I suspect I’ll be adding a bunch of notes to reflect recent events and posts I come across. Often they will be links to recent comments on news but sometimes a note from me will be here.

  1. PoliticusUSA
  2. Talking Points Memo
  3. GOP blockade
  4. Where is the outrage
  5. FireDogLake “…Hey, Jon Stewart…”
  6. Sen. Tom Coburn to block bill NPR
  7. Sen. Coburn again

Update:
They did reach a compromise. It looks like the lame-duck Congress is actually reaching some agreements. Wer’ll have to see how the new congress does in 2011.

Health care reform: Plan B for individual mandate

Health care reform: Plan B for individual mandate

Posted on by Jack

Yesterday I wrote about Plan B for the individual mandate which could be threatened by court decisions or a future congress. Health care reform ensures that insurance companies must take people with preexisting conditions. The obvious problem is that someone could skip having insurance until they know big medical bills are coming soon and then apply for insurance and companies would be powerless to refuse and so be stuck with pick payouts for relatively little in premiums. The solution in the Affordable Care Act (aka ObamaCare) is the individual mandate .

A few days ago there was a court decision that ruled the individual mandate unconstitutional (see Bloomberg News story). There will be more litigation and the issue may end up in the Supreme Court.

Striking down the individual mandate by the courts or perhaps a repeal of this provision would be bad news for heath care reform but it is good to see that someone is thinking about a Plan B (see Kaiser Health News story)just in case the individual mandate is out of the picture.

The most straight forward idea would just be to raise taxes enough to cover insurance cost for the whole country and then offer a tax rebate to each filer that would cover a reasonable insurance plan and have some sort of mechanism for insuring those who cannot afford to pay full price for a reasonable plan. This approach would probably be a hard sell in an age of “no new taxes”.

But other options are surely possible. I like the one suggest by Paul Starr of Princeton in the article cited above (Kaiser Health News). Perhaps this or some variant of the idea might be useful.

Princeton sociologist Paul Starr, who was a senior health adviser to President Bill Clinton, anticipated the risk of political backlash even before health law was passed. He outlined a more flexible alternative aimed at quelling political fires while still expanding the insurance pool.

Except for the poor (people making less than $9,350 and couples earning less than $18,700 are not subject to the mandate but would be eligible for coverage under Medicaid), people would have three choices, Starr said. They could buy insurance, with subsidies if they qualify. They could pay an annual tax penalty for going uninsured. Or they could opt out with no penalty – but they couldn’t opt back in for five years.

Those who opt out wouldn’t be eligible for any subsidies in the exchanges. And under this scenario, they wouldn’t be covered by one of the most popular protections in the legislation — the ban on insurers excluding people with pre-existing conditions. People who opted out could still shop for insurance, but there would be no guarantee that they could find an insurer to cover them, at a price they could afford.

Then there could be waiting periods or penalties for waiting (as in Medicare Part B). At any rate, if enough people think this is an important issue, I’m sure we can find a reasonable solution.

Note added: You might want to check out FireDogLake which lists 8 alternatives to the individual mandate.

implications of tax compromise to delay Bush tax hike

implications of tax compromise to delay Bush tax hike

Posted on by Jack

There is a very interesting exchange of views about the implications of the tax compromise to delay the Bush tax hike or extend the Bush tax cuts, depending on your point of view.

The HealthBeatBlog hosts a nice discussion of the implications of this tax compromise for Medicare, Social Security and Health Care Reform. The link is to Part 1. So more is coming and probably soon.

Health care debate: preexisting conditions and individual mandate

Health care debate: preexisting conditions and individual mandate

Posted on by Jack

The Affordable Care Act (aka ObamaCare) includes a provision requiring individuals to have a certain level of health insurance or pay a penalty. This is commonly called the individual mandate. And is often thought needed for the health care law’s provisions preventing insurance companies from denying coverage to those with preexisting conditions.

Depending on who you listen to there has been either elation or disappointment over the news lately that a Virginia judge has ruled the individual mandate unconstitutional. Of course this one decision and the next judge could support it or disagree but one thing we do know is there will continue to be litigation on this and the issue may end up in the Supreme Court.

Striking down the individual mandate by the courts or perhaps a repeal of this provision would be bad news indeed for those who believe our health insurance system should cover preexisting conditions. It is possible that the individual mandate will be preserved (and some think it likely) but shouldn’t those who believe we should cover preexisting conditions be thinking about a Plan B just in case the individual mandate is out of the picture.