Abortion

Nebraska Republican: A Vote To Proceed Is A Vote For Abortion

Brian Beutler | November 19, 2009, 2:42PM

Sen. Ben Nelson (D-NE) better have a chat with his friends on the other side of the aisle.

At a press event this afternoon, Republicans lambasted the Senate health care bill for not adopting the language in the House's Stupak amendment, and reiterated their point that a vote to proceed to debate may as well be a vote for abortion.

"This first vote is the key vote," Nelson's Nebraska colleague, Sen. Mike Johanns, told reporters today.

That statehood camaraderie isn't likely to be lost on Nelson, who will soon have to decide whether to vote to allow the bill to proceed to debate. Nelson has gone to great lengths to distinguish this early procedural votes for more consequential votes down the line. But he says he still hasn't decided what his next move is, and isn't too pleased with the abortion provision in the Senate health care package.

Abortion

Senate Abortion Provision Wins Support Of Key Pro-Choice Democrats

Brian Beutler | November 19, 2009, 1:54PM

Rep. Diana DeGette (D-CO)

We now have much more clarity on how the abortion provision in the Senate health care bill will work, and it's won the support of both senior administration officials, pro-choice Senators, and the co-chair of the House pro-choice caucus.

"I am pleased that the U.S. Senate has maintained current law when addressing the abortion issue," says Rep. Diana DeGette (D-CO) in a statement to reporters. "By adopting a common-sense abortion provision, the U.S. Senate ensures that no federal funds will be spent on abortion coverage while not further restricting a woman's right to choose. The health care bill is about providing access to quality health care to over 36 million Americans. I encourage the U.S. Senate to work towards producing a bill that works for everyone."

DeGette included a breakdown of the Senate's abortion provision, which I've included below the fold. One of the key sections reads, "Issuers of health insurance plans that offer coverage for abortion beyond those permitted by the Hyde amendment must segregate from any premium and cost-sharing credits an amount of each enrollee's private premium dollars that is determined by the Secretary to be sufficient to cover the provision of those services."

Which is a fancy way of saying insurers will have to set up an accounting system to keep private money separate from federal money, and only draw upon the private money when paying providers for abortion. Compare that to the Stupak amendment to the House bill, which both requires separation of funds, but also prevents women who receive federal premium assistance from purchasing policies that cover abortion, and it's no wonder Harry Reid's compromise is being met with praise by pro-choice members.

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Health Care

No Public Option Or Mandates Until 2014 Under Senate Bill, But There Are Some Early Goodies

Brian Beutler | November 19, 2009, 9:07AM

Rep. Nancy Pelosi (D-CA) with Sen. Harry Reid (D-NV)

For liberals, one of the most frustrating aspects of health care reform is that the most tangible goodies (the exchanges, and, within the exchanges, the public option) won't be available to the public for years. In the House bill, the main structural changes to the health care system--including the exchanges/public option, mandates, taxes, and the Medicaid expansion--go into effect in 2013. Under the Senate bill, they take until 2014.

But there are some aspects of the bill that would take effect right away if the bill became law as is. For instance, the Senate bill would immediately ban insurance companies from imposing annual and lifetime caps on benefits, and would make it illegal for them to cancel people's policies (a practice called rescission) except in cases of fraud.

There's more, too, and we'll bring you a fuller set of details later today.

Abortion

DeGette: Study Confirms Radical Implications Of Stupak Amendment

Brian Beutler | November 18, 2009, 2:26PM

Rep. Diana DeGette (D-CO)

I just spoke with Rep. Diana DeGette (D-CO), co-chair of the Congressional Pro-Choice Caucus, who insisted that the findings of a new George Washington University study confirm many of her suspicions about the Stupak abortion amendment.

"Certainly if it doesn't confirm my suspicions about the intent, it concerns my suspicions about the effect the Stupak amendment would have," DeGette said. "What the findings show are that women who want to purchase policies with their own money--with their own premiums--will not be able to buy insurance policies.... That's frankly the intention of the anti-choice movement now."

DeGette says she's spoken in private to many of the pro-life Democrats who voted for the Stupak amendment, some of whom have acknowledged that they didn't realize what they were voting for.

"I will say that I have spoken privately with several pro-life members about the Stupak amendment, and they acknowledged that the Stupak amendment goes far beyond where they thought it did," she told me.

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Bart Stupak

Study: Stupak Amendment Will Eliminate Abortion Coverage 'Over Time For All Women'

Brian Beutler | November 18, 2009, 10:56AM

Rep. Bart Stupak (D-MI)

A new study by the George Washington University School of Public Health and Health Services adds some expert imprimatur to what many progressives have been saying all along: The Stupak amendment to the House health care bill--which will prevent millions of women from buying health insurance policies that cover abortion--is likely to have consequences that reach far beyond its supposedly intended scope.

The report concludes that "the treatment exclusions required under the Stupak/Pitts Amendment will have an industry-wide effect, eliminating coverage of medically indicated abortions over time for all women, not only those whose coverage is derived through a health insurance exchange."

In other words, though the immediate impact of the Stupak amendment will be limited to the millions of women initially insured through a new insurance exchange, over time, as the exchanges grow, the insurance industry will scale down their abortion coverage options until they offer none at all.

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Abortion

DeGette: Stupak Agenda Is Much Wider Restrictions On Abortion

Brian Beutler | November 13, 2009, 5:24PM

Rep. Diana DeGette (D-CO)

As co-chair of the Congressional Pro-Choice Caucus, Rep. Diana DeGette (D-CO) is leading the fight in the House to strip the Stupak amendment, which would forbid millions of women from buying comprehensive insurance policies that cover abortion, from the final health care bill. And she takes issue with Stupak's interpretation of the events leading up to the vote that completely changed the stakes of reform debate.

"Basically Congressman Stupak moved the goalposts, and I think it really took [House] Speaker [Nancy Pelosi] and other people by surprise," DeGette told me in an exclusive interview.

She says, after his abortion amendments went down in the House Energy and Commerce Committee (a panel on which she also sits), he demanded he get another crack at it when the Rules Committee set the contours of the floor debate.

"After we defeated him in committee," she said, "he said that he wanted to have an amendment in order on the floor... and that if he didn't have his amendment made in order then he had 40 people to vote against the rule."

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Abortion

CREDO To Send Coat Hangers To Pro-Choice Dems Who Voted For Abortion Restriction Amendment

Brian Beutler | November 13, 2009, 4:36PM

Credo Action Pro-Choice Petition Website

This isn't for the squeamish. It's about as hardball and brutal as it gets.

The liberal group CREDO Action will soon ask over 1,000,000 members to sign a petition condemning the Stupak amendment...and with each signature, CREDO will send a coat hanger to the 20 supposedly pro-choice members of Congress who voted for it.

"We know what happens when women are denied access to reproductive health care including abortion," the petition reads. "And we can't go back to an era of coat hangers and back alley abortions. Reconsider your vote on the Stupak Amendment. Tell House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid that the final health care bill that emerges from the conference committee can't turn the clock back on women's rights."

The email hasn't been sent yet, but you can read the language below the fold.

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Abortion

Stupak Sticks To His Guns, Blames Liberals For Abortion Amendment

Brian Beutler | November 13, 2009, 12:42PM

Rep. Bart Stupak (D-MI)

Rep. Bart Stupak (D-MI) says that House liberals backed themselves into a wall during health care negotiations, and got stuck with a harsher abortion amendment than they would have had if they'd just played nice. And now, he says, there's no going back.

In an interview with The Atlantic, Stupak says "Speaker Pelosi went to present [House liberals] what she agreed to with us, that it would be part of a manager's amendment.... [T]hey're the ones who insisted, 'No, Stupak doesn't get to go in the manager's amendment, we want it on the floor.' They're the ones who insisted on bringing it to a vote. They're the ones who wanted to vote against me, they were the ones who said they would win this vote."

If they hadn't rejected the Speaker on Friday night, to use their words, there would have been a less restrictive amendment that would have been part of the manager's amendment. They rejected that. They could not live with it. Even the less restrictive language. And therefore the Speaker came back and said, 'Bart, I'm sorry, but our deal's off. So I have no choice, because we made an agreement, I'm gonna have to give you an amendment,' and I said, 'Well, with all due respect, Madame Speaker, I'm not gonna send the amendment we agreed to, because if the deal's off, then I don't have to hold to that agreement, Hyde-lite, and I'm putting up the original Hyde language that I offered in committee, that Joe Pitts and I offered.' That's why it's called the Stupak-Pitts amendment.

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Abortion

Who Would Be Most Impacted By The Stupak Amendment?

Brian Beutler | November 12, 2009, 2:47PM

Rep. Bart Stupak (D-MI)

The Stupak amendment has touched off a furious argument among Democratic politicians and elites--one that could tank the entire health care reform project if it's not resolved by the time legislation comes up for a final vote in the House.

For the most part, the argument has been about justice. The Stupak amendment would forbid anybody who receives new government health insurance subsidies from buying policies that cover abortion. So why should women's health care be treated differently than other kinds of health care? Is it fair to prevent women, forced into the health care market, from buying any insurance policy she wants, even if they have some government assistance?

But somewhat less prominently, these same combatants have been at odds about what the practical effect of the Stupak amendment would actually be. There's substantial lack of clarity on that score--many say it's likely that there will be no abortion coverage in the exchange at all, and others hypothesize that, over time, the norms in the exchange will come to dominate the norms across the insurance market. At this point, that's all theoretical. But there is at least some data on the immediate practical implications of the Stupak amendment: It will, at least, directly and immediately impact a small, but growing number of poor and middle-class women.

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Health Care

GOP Sees 2010 Window, Gloat That Dems Who Opposed Health Care Will Take Dual Heat

Christina Bellantoni | November 11, 2009, 5:38PM

(Top, L-R), Rep. Boucher (D-VA), Rep. Shuler (D-NC), Rep. Ross (D-AR). (Bottom, L-R), Rep. Altmire (D-PA), Rep. Nye (D-VA), Rep. Tanner (D-TN)

Much like Sen. Blanche Lincoln and Sen. Ben Nelson, looks like the 39 Democrats voting against the House health care bill Saturday are getting squeezed from both sides.

We've been writing about all the left-leaning campaigns going after Democrats on health care, and plenty of efforts to hit Republicans as party of "no."

TPMDC has been chatting with Republicans who want to pick off vulnerable House Democrats in 2010 and they (not surprisingly) are pleased as punch by the internal warfare.

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Bart Stupak

Think The Stupak Amendment Is Bad Now? It Could Have Been Worse

Brian Beutler | November 11, 2009, 2:57PM

Rep. Bart Stupak (D-MI)

Rep. Bart Stupak (D-MI) sits on the House Energy and Commerce Committee, which voted way back in July to advance health care legislation to the House floor. At the time, the legislation stipulated that no federal funds authorized by the bill would be used to pay for abortions, except in cases of incest, risk to the life of the mother, and rape. And at the time, that was good enough.

But even back then, Stupak was trying to strengthen the language in the bill restricting the availability of abortion services under the House health care plan.

A day before the bill passed out of committee, Stupak co-sponsored, and voted for an amendment written by Rep. Joe Pitts (R-PA)--distinct from the now notorious "Stupak amendment"--that would have limited the government's ability to include abortions in benefits plans to cases of incest, life of the mother, and forcible rape.

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Bart Stupak

Clyburn: Stupak Amendment Won 10 Votes

Brian Beutler | November 11, 2009, 10:15AM

Rep. James E. Clyburn (D-SC)

On Monday, I noted that 40 Democrats had voted for the Stupak amendment--which would prohibit low- and middle-class women from buying health insurance policies that cover abortion--and then voted for final passage of the health care bill. That's a large number, but a key question remained unanswered: How many of those 40 would have voted against the final bill if the Stupak amendment had failed, or not been given a vote?

Well, House Whip James Clyburn (D-SC) has some answers.

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Barack Obama

Influential Players: How Six Big Stakeholders Shaped Health Care

Brian Beutler | November 11, 2009, 8:39AM

President Barack Obama

The biggest players in the health care reform debate often blur together into a swirl of acronyms and policy jargon. But they're also key to understanding how health care reform has been shaped, and how it's come as far as it has.

At this point in the health care debate, pro-reform groups have spent more money on health care ads than have well-heeled health care opponents. That's a testament to just how important the issue is to the liberal base, but it's also the precise effect President Obama was seeking when he partnered with the health care industry's most powerful stakeholders.

What sets the following six players apart is how they've defied the usual expectations and taken positions that don't easily fit into the usual left vs. right or corporate vs. consumer paradigm.

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Bart Stupak

Controversial Stupak Amendment Sows Anger, Confusion On Capitol Hill

Brian Beutler | November 9, 2009, 6:55PM

Rep. Bart Stupak (D-MI)

When Rep. Bart Stupak (D-MI) authored an amendment several months ago to prohibit federal dollars from being used to pay for insurance policies that cover abortion, Democratic leaders and health care principals didn't take his proposal very seriously. As a result it was never subjected to the sort of rigorous analysis that controversial legislation is often treated to. That was a miscalculation. Liberals were forced this weekend to accept the amendment as the price of passing an otherwise progressive health care bill through the House. And now, everyone on both sides of the abortion issue is scrambling to try to figure out what the amendment's language actually means and the practical effect it would have if enacted into law.

As one House Democratic health care aide put it, "there are a ton of unanswered questions."

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Abortion

Nelson: I'll Filibuster A Health Care Bill That Doesn't Include Strict Abortion Restrictions

Brian Beutler | November 9, 2009, 6:32PM

Sen. Ben Nelson (D-NE)

Sen. Ben Nelson (D-NE) wants Senate health care legislation to contain strict restrictions on abortion funding, much like the House bills now does. And he says he'll filibuster if he doesn't get his way.

"As a pro-life person, I believe that something like the [Rep. Bart] Stupak amendment should be included in the Senate version," Nelson told reporters this evening. "But if it isn't included to that effect, to make it clear that no government money should be used for support, for the subsidies, or direct payments, or even tax credits, should be used to support abortions," he will oppose it.

"If it doesn't make it clear that it does not support abortion, does not pay for abortion, you can be sure I will vote against it."

I asked Nelson if his promise extended to procedural supermajority votes. He had a one word answer: "Yes."

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Health Care

A Closer Look At The Health Care Vote

Eric Kleefeld | November 9, 2009, 3:15PM

United States Capitol

Let's take a look at the breakdown of the vote on the health care bill -- the people who went against their leadership, or the people whose votes run seemingly counter to their districts' presidential votes in 2008 -- and in some cases, both.

Much has been made of the Democrats who voted no, and the fact that most of them come from districts that voted for John McCain. Thus, a vote against a major Obama policy initiative would certainly seem to be the safe thing to do -- just as Rep. Joseph Cao (R-LA) became the only Republican to vote yes, and his district voted 75% for Obama.

The single largest group, however, is one that hasn't been commented on very much: Republicans from districts that voted for Obama, and who voted no on the bill. There are 32 of them in all: Judy Biggert (IL); Brian Bilbray (CA); Mary Bono Mack (CA); Ken Calvert (CA); Dave Camp (MI); John Campbell (CA); Mike Castle (DE), currently a Senate candidate in an Obama state; Charlie Dent (PA); David Dreier (CA); Randy Forbes (VA); Elton Gallegly (CA); Jim Gerlach (PA); a candidate for governor in an Obama state; Mark Kirk (IL), a Senate candidate in Obama's home state; Leonard Lance (NJ); Tom Latham (IA), Frank LoBiondo (NJ), Dan Lungren (CA), Donald Manzullo (IL); Thaddeus McCotter (MI); Buck McKeon (CA); Erik Paulsen (MN); Tom Petri (WI); Dave Reichert (WA); Mike Rogers (MI); Peter Roskam (IL); Ileana Ros-Lehtinen (FL); Paul Ryan (WI); Lee Terry (NE); Patrick Tiberi (OH); Fred Upton (MI); Frank Wolf (VA); and Bill Young (FL).

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Health Care

All Eyes On Reid After House Passes Health Care

Brian Beutler | November 9, 2009, 9:34AM

Senate Majority Leader Harry Reid (D-NV)

House Democrats have a lot to be smiling about, but they'll also likely be sitting on their thumbs for the next several weeks. After they passed a historic health care bill over the weekend, all eyes turned to the Senate, and specifically to Majority Leader Harry Reid, whose health care bill still hasn't been unveiled.

The White House is still pushing for Congress to complete action on health care by years-end--last week White House Chief of Staff Rahm Emanuel conveyed that message to Reid directly--but before that can happen, members want to see the bill, and before that can happen, the CBO has to weigh in on the package Reid sent their way last month.

There's some speculation that CBO numbers could be available by the end of the week, but no guarantees, and members will almost certainly be back in their states for Veterans Day before anything official comes down the pipe.

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Joseph Cao

Cao To Steele: Come And Get Me -- Just Remember You Need My District

Versha Sharma | November 8, 2009, 1:26PM

Rep. Joseph Cao (R-LA)

Rep. Joseph Cao (R-LA), the lone GOP vote for the House health reform bill that passed late last night, has responded to RNC Chairman Michael Steele's warnings about stepping outside of party lines. (WATCH Steele: "We'll come after you.")

Cao told CNN that Steele retains "the right to come after those members who do not conform to party lines, but I would hope that he would work with us in order to adjust to the needs of the district and to hold a seat that the Republican party would need." He represents the second congressional district of Louisiana, a solidly Democratic district that includes New Orleans. Cao said earlier today that he put the needs of his district over what was popular with his own party.

Cao's opponent was former Rep. William Jefferson (D-LA), who was under indictment on corruption charges at the time of the election, widely seen as the sole reason the Republican was able to triumph in this specific district. His unique victory was celebrated by Steele and other GOP leaders, a fact which the young lawmaker is not letting party leadership soon forget.

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Anthony Weiner

Weiner Withdraws Single-Payer Amendment

Brian Beutler | November 6, 2009, 12:44PM

Rep. Anthony Weiner (D-NY)

Early in the health care debate, Speaker Nancy Pelosi promised single-payer advocate Rep. Anthony Weiner (D-NY) that the House would hold a mostly-ceremonial vote on a Medicare-for-all amendment. It was a move intended to appease the sizable faction of House liberals who felt they'd had to swallow too many compromises during the committee process.

But if you allow a vote on one amendment you might get drowned in them, so Pelosi and Weiner have come to an understanding and are walking away from the agreement.

"I have decided not to offer a single payer alternative to the health reform bill at this time," says Weiner in a statement. "Given how fluid the negotiations are on the final push to get comprehensive health care reform that covers millions of Americans and contains costs through a public option, I became concerned that my amendment might undermine that important goal."

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Health Care

Conservatives Celebrate Embarrassing CBO Analysis Of GOP Health Care Bill

Brian Beutler | November 6, 2009, 12:20PM

Rep. Mike Pence (R-IN)

I noted yesterday that, in its own quiet way, the Congressional Budget Office gave the Republicans' health care bill a failing grade: A package seemingly meant to address the problem of the uninsured that does almost nothing to expand insurance or lower premiums.

But somehow, someway, conservatives don't seem to have noticed. In fact, they're celebrating!

"As a result of the House Republican bill, the non-partisan Congressional Budget Office now confirms that families will see their health care premiums reduced by up to 10 percent and hard-working taxpayers can expect deficits to decrease by $68 billion over the next decade," reads a statement from Rep. Mike Pence (R-IN).

Let's go to the tape:

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Health Care

Hoyer: Vote Expected Saturday, But Could Be Pushed Back

Brian Beutler | November 6, 2009, 10:51AM

Rep. Steny Hoyer (D-MD)

On a conference call with reporters this morning, House Majority Leader Steny Hoyer (D-MD) said that Democrats are "very close" to securing the 218 votes needed to pass health care legislation, but that Republican delay tactics, and perhaps even intra-Democratic disputes over abortion and immigration issues, could force a delay on final passage, potentially until Tuesday of next week.

"Assuming...that we follow the schedule we have set, my expectation is we will finish debate on the bill, on the Republican substitute, and will be voting on the rule and the substitute and the bill, and will have final passage...by 7 to 8 o'clock tomorrow night," Hoyer said.

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Health Care

House Democrats Set The Stage For Vote On Landmark Health Care Legislation

Brian Beutler | November 6, 2009, 9:34AM

Speaker Nancy Pelosi (D-CA)

The stage is being set for a rare and historic weekend vote on landmark health care legislation in the House of Representatives. Speaker Nancy Pelosi has left herself enough wiggle room to delay the vote in the event that the thorny issues of abortion and immigration prevent her from rounding up the 218 votes she needs to pass the bill, but she and other House health care leaders will be working throughout the day to resolve the concerns of the conservative Democrats who are still withholding support.

Any final agreements Pelosi makes with her caucus will be cemented by the Rules Committee, which, by procedural norm, will set the contours of the debate and vote on the House floor.

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Barack Obama

Obama Meeting With Newly Elected Rep. Owens, Caucus Pushed To Saturday

Christina Bellantoni | November 5, 2009, 10:23PM

Capital Building and President Barack Obama

Bill Owens will have been a member of Congress less than five hours when he is treated to a private sit-down with President Obama.

The White House said Obama is scheduled to meet with Owens in the Oval Office Friday at 4:25 p.m. after the president returns from a visit to Walter Reed.

Owens (D-NY) was elected Tuesday night after defeating Conservative Party candidate Doug Hoffman. Speaker Nancy Pelosi will host the swearing-in ceremony around noon Friday.

He was a bright spot in a lousy night for the party in the elections in the Northeast, and the first Democrat to hold the seat since the Civil War.

TPMDC reported earlier that Obama is meeting with House Democrats during a caucus meeting before they vote on health care. That was scheduled for Friday but the White House just announced the meeting will be Saturday instead.

Late update: Vice President Biden on Friday will speak via phone to "members of the House of Representatives about the need to pass health insurance reform." In announcing Biden's schedule, the White House didn't specify if he was speaking to Democrats and Republicans or just one party. TPMDC will update when we find out.

Nancy Pelosi

Pelosi: Republican Health Care Proposal 'Scandalous'

Brian Beutler | November 5, 2009, 11:53AM

Speaker of the House Nancy Pelosi (D-CA)

At her weekly press conference this morning, House Speaker Nancy Pelosi bucked the conservative spin that Tuesday's election was a boon to the GOP by noting that the results actually make health care reform easier for her to pass.

"Tuesday night we won two more votes for health care," Pelosi said. Both candidates won, she noted, amid a flurry of anti-reform ads in their districts and, despite the fact that one of the new members hails from a red-leaning district, both will vote for the plan.

"Bill Owens will be a great representative, independent voice, for his district," Pelosi said this.

She also took aim at the Republican health care plan, denouncing it in no uncertain terms.

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Health Care

Obama Gets More Visible On Health Care As House Prepares Weekend Vote

Christina Bellantoni | November 5, 2009, 10:28AM

Capital Building and President Barack Obama

President Obama will travel down Pennsylvania Avenue Friday to speak privately with House Democrats on the eve of a critical vote on health care.

The White House may be attempting to put more of a stamp on the legislation as it weaves its way through the halls of Congress, and administration officials have been forcefully pushing back against reports suggesting health care won't happen until next year.

Last night, White House Chief of Staff Rahm Emanuel and administration health care staffers huddled with Senate Majority Leader Harry Reid and leadership senators Dick Durbin, Chuck Schumer and Patty Murray on Capitol Hill.

Leadership and administration officials were mum on the details.

Meanwhile, the DNC's Organizing for America has been urging supporters to phone their member of Congress before the Saturday vote.

"We expect it to be very close," Mitch Stewart, director of OFA, wrote to the campaign's 13 million-strong email list.

Health Care

Republican Health Insurance Reform Bill Insures Almost Nobody

Brian Beutler | November 5, 2009, 9:05AM

House Minority Leader John Boehner (R-OH)

Earlier this week, a spokesman for House Minority Leader John Boehner made a prediction. The Republican health care plan, he said, "will cover millions more Americans" than the Democrats' plan. Bold. But here's what the experts say:

By 2019, CBO and JCT estimate, the number of nonelderly people without health insurance would be reduced by about 3 million relative to current law, leaving about 52 million nonelderly residents uninsured. The share of legal nonelderly residents with insurance coverage in 2019 would be about 83 percent, roughly in line with the current share.

Oops. You can read the entire analysis here (PDF).

To Boehner's dismay, the GOP bill was leaked to the media earlier this week, and quickly became a focus of derision for experts and activists who noted that, among other failings, the bill didn't include some of the most popular insurance regulations in the Democrats' bill, including a ban on pre-existing condition discrimination.

What else does CBO find?

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Health Care

White House Talking Points: GOP Health Care Plan Puts Families At Risk

Brian Beutler | November 4, 2009, 4:13PM

House Minority Leader John Boehner

The White House could probably laugh off the House Republicans' health care bill. But when the Democrats' bill comes to the floor conservatives will no doubt complain that their, better proposal is getting short shrift, so the Obama administration is getting out in front of that.

"House Republican Health Care "Plan": Putting Families at Risk," is the title of White House talking points, hitting a number of key aspects of the GOP plan.

"Unlike the House Leadership bill, the Republicans' bill takes us backwards rather than forwards."

"No Elimination of Discrimination Based on Pre-existing Conditions."

"The Republicans' bill leaves affordable health insurance out of reach for millions of Americans."

You get the idea. Read the entire sheet below the fold. It'll give you a sense of the plans failings, and the line Dems will be taking against it in the days (and possibly weeks) ahead.

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Bill Owens

Republican Leadership Aide: Owens Implies He'd Oppose Health Care Reform

Brian Beutler | November 4, 2009, 3:00PM

NY-23 candidate Bill Owens (D)

In response to this scientific post by TPMDC, a Republican House leadership aide sends over a link to Bill Owens' campaign website to suggest that Owens ought to oppose "the Pelosi health care bill". Here are the key bullet points.

Bill Owens is opposed to:

• Opposes: Medicare benefit cuts. We can all agree that there are inefficiencies and waste in the system, but any savings should be used to strengthen Medicare.
• Opposes: Taxing health care benefits.
• Opposes: Increasing taxes on the middle class in any way.

Of these, the only one that could legitimately cause Owens any grief is the first. The House bill doesn't tax health care benefits or the middle class. It does extract waste from Medicare, in part by reining in over-payments by Medicare Advantage plans, and those savings are not rerouted back into Medicare. But does that mean he should oppose the bill. It doesn't sound like he thinks he should, but we have a call in to his campaign staff for some clarity.

Ben Nelson

Nelson, Landrieu Say Election Results Do Not Diminish Their Health Care Goals

Brian Beutler | November 4, 2009, 1:44PM

Sen. Mary Landrieu (D-LA), Sen. Ben Nelson (D-NE)

Today is a day for thumbsucking. After Republicans won gubernatorial elections in New Jersey and Virginia, and Democrats picked up two House seats, everyone in Washington is spinning away, hoping to change the conventional wisdom, and, perhaps politics on Capitol Hill. But will it work? Today, two of the most conservative Democrats in the Senate said yesterday's election results won't have any effect on their votes on health care.

"There are no lessons in there for me, other than a lesson that I already had and that is we need to be very cautious and careful on spending," said Sen. Ben Nelson (D-NE) . "[W]e need to redirect a lot of our attention right back to the basic economy and trying to figure out ways to help with the economic woes that we have, and that may mean that we have to readjust some of the other priorities around here."

So this doesn't have an effect on the limits you'd like to impose on reform, I asked.

"No," he said.

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Health Care

The Public Option Fight Continues--But How Exactly Does Reform Work?

Brian Beutler | November 4, 2009, 1:00PM

Speaker of the House Nancy Pelosi (D-CA), Senator Harry Reid (D-NV)

After weeks of waiting and wondering, leaders in both chambers of Congress have announced their intentions with respect to the public option. House Speaker Nancy Pelosi is rounding up the votes for a bill with a government insurance plan that will negotiate rates with providers. Senate Majority Leader Harry Reid is standing behind something similar--with the addition of a clause allowing states to opt out--and is trying to keep his caucus together in the face of unanimous Republican opposition. But what about the rest of reform?

Right now, it's impossible to compare what the Senate is trying to do with what the House is trying to do because Reid hasn't unveiled his bill yet. But though there will surely be some major differences, both proposals will contain some of the same underlying architecture.

The basic theme of health care reform is that insurance would be mandatory, subsidized and regulated. As is the case today, for the first many years after enactment, most people in the country would be insured by their employers--in fact, large and medium-sized businesses would be required to provide insurance for their employees. Uninsured people would either be roped into existing entitlement programs like Medicaid, or required to buy regulated insurance--typically through an "exchange," which, comprised of hundreds of thousands, or even millions, of customers, would theoretically have the bargaining power needed to keep premiums down.

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Health Care

Yesterday's Overwhelming Historic Republican Victory Makes Democratic Health Care Reform Just A Bit Easier

Brian Beutler | November 4, 2009, 10:04AM

Lt. Gov. John Garamendi (D-CA) and Congressman-elect Bill Owens (D)

Most of the commentary about last night's elections has centered around Republican pickups in the New Jersey and Virginia statehouses. But what's gone largely unnoticed is that the two congressional seats up for grabs last night both went to Democrats, and that will have immediate ramifications for health care reform.

The NY-23 seat abdicated by Republican John McHugh (who resigned to become Secretary of the Army) went to Democrat Bill Owens--the first Democrat to hold the seat in over a century. And the CA-10 seat abdicated by Democrat Ellen Tauscher (who resigned to become Under Secretary of State for Arms Control and International Security Affairs) went to Democrat John Garamendi.

That creates some simple arithmetic. Yesterday, Democrats had 256 voting members in the House. By week's end, they'll have 258. Last week, House Speaker Nancy Pelosi could afford to lose no more than 38 Democratic votes on a landmark health care reform bill. Next week, after Owens and Garamendi are sworn in, she can lose up to 40. For legislation this historic and far-reaching, she'll need every vote she can get--and both seem likely to support reform.

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Health Care

Pelosi Unveils 'Manager's Amendment' Finalizing House Health Care Bill

Brian Beutler | November 3, 2009, 10:42PM

After hearing from all sides of her caucus, House Speaker Nancy Pelosi has announced some minor changes to the health care bill she unveiled last week, enshrined in a so called "Manager's Amendment" to the greater bill she plans to bring to the floor.

You can read the Manager's Amendment here (PDF). By agreement, it will have to be online for at least 72 hours before the bill can come to the floor, meaning we could see action by the end of the week. At a glance I see some tweaks firming up the provisions ending the anti-trust exemptions for insurance companies, and creating some real consequences for violators.

Again, at a glance, I see no changes to the public option, particularly one, requested by House progressives, to create a ceiling on the rates negotiated between the government and health care providers. I also see not a single word about abortion--Rep. Bart Stupak (D-MI) wants to ban any and all federal money--including money spent on subsidies for private insurance plans--from paying for abortions, and he's been raising quite a fuss about it.

But it's legislative text, so we're still going through it, and will certainly have more for you in the morning.

Late update: Pelosi has issued a statement on the amendment, which I've pasted below the fold.

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Health Care

Republican Health Care Bill Circulating On Capitol Hill Contains No Surprises

Brian Beutler | November 3, 2009, 12:31PM

House Minority Leader John Boehner

TPMDC has obtained a copy of a Republican health care bill, making the rounds on Capitol Hill. Republican leaders have not officially unveiled the package, and warn that it is still changing, but the early draft, contains almost surprises.

Among the legislation's major goals are to enact malpractice reform, allow consumers to buy health insurance over state lines, cancel a federal comparative effectiveness research program created by the stimulus bill, and prohibit taxpayer-funded abortions.

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Health Care

Landrieu On Health Care Reform: 'Doing Nothing Is Not An Option'...Unless, Perhaps, It Includes A Public Option

Brian Beutler | November 3, 2009, 11:25AM

Sen. Mary Landrieu (D-LA)

In the stately Mansfield room, where Democrats meet for their weekly caucus lunch just off the Senate floor, Sen. Mary Landrieu (D-LA), appeared this morning alongside Sen. Tom Harkin (D-IA) and a number of entrepreneurs from around the country, at an event dedicated to the idea that health care reform is crucial to the survival of small businesses in America.

It was at once fitting and unusual for Landrieu to appear at this pro-reform event. On the one hand, as chair of the Small Business Committee, how could she miss it. But on the other, she's one of a handful of conservative Democrats openly suggesting she might support a Republican health care filibuster, particularly if the public option in the Senate bill isn't affixed to some sort of trigger mechanism.

About nine minutes in Landrieu channeled her inner Democrat. "While we may not yet completely agree on all of the specific details," Landrieu said, "one thing we can all agree on is doing nothing is not an option."

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Health Care

Grijalva Requests Changes To Health Care Bill, Vote On Robust Public Option

Brian Beutler | October 30, 2009, 4:22PM

In a curt, terse letter delivered today, public option champion, and progressive caucus co-chair Raul Grijalva says he wants to see some major changes to the House's health care bill--reflected in a so-called manager's amendment--before it comes to the floor.

• Americans in every state in the nation must be able to take advantage of the benefits of the bill; thus the bill shall explicitly state that the public option must be available without any triggers or opt-out provisions.
• If the Secretary is forced to negotiate provider reimbursement rates in the public plan, a ceiling shall be determined and set for such rates.
• The bill shall fully repeal the McCarran Ferguson Act for health and medical malpractice insurance, as oppose to merely amending the Act.

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CBO

Wait A Minute--The Public Option's Premiums Would Be Higher On Average?

Brian Beutler | October 30, 2009, 2:11PM

Speaker Nancy Pelosi (D-CA) and CBO Director Doug Elmendorf

Health care reformers have a number of arguments for the public option, but the main one is this: that by injecting fairness and competition into the market the public option will lower premiums for everybody, including those paying for private plans. Unfortunately, a new CBO study finds that it may not have that effect at all.

The theory behind the public option is that, by injecting a major non-profit insurer into the marketplace, it will force private competitors to cut down on administrative waste and other excesses, and, therefore, drive premiums down for everybody. Last week, when House Speaker Nancy Pelosi was on the verge of losing the fight for a muscular public option, she said "There's no philosophical difference between a robust public option and negotiated rates. It's just a difference in money."

But is that true? Yesterday, in an analysis of House health care legislation, the CBO concluded that the six million people expected to enroll in the public option by 2019 will be paying, on average, higher premiums than will people buying private plans.

"[A] plan paying negotiated rates would attract a broad network of providers but would typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges," wrote CBO chief Doug Elmendorf.

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Barack Obama

Luntz Memo: Obama Not So Popular...But Don't Attack Obama!

Brian Beutler | October 30, 2009, 11:46AM

A new Frank Luntz strategy memo may provide some insight into the Republican's playbook as the fight over reform enters its final stages.

The memo, which you can read here, is one of many similar memos that have been circulated to politicians and activists over the last several months, including by Luntz himself.

In his previous memo, Luntz warned conservatives not to tie health care reform efforts to President Obama--the President's name, he warned, helped buoy the overall level of support for reform. Luntz now says that's not true--but he nonetheless counsels reform opponents not to use the term 'Obamacare.'

"[y]ou can talk about opposing "President Obama's Plan," Luntz writes. "But don't. While you no-longer [sic] shoot yourself in the foot by criticizing the President, you would do much better to criticize Congress."

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Health Care

Conrad: House Health Care Bill Much Improved

Brian Beutler | October 29, 2009, 6:48PM

Sen. Kent Conrad (D-ND)

Sen. Kent Conrad (D-ND) let it be known in numerous ways that early versions of the House health care bill would not meet his budgetary muster. Now, with CBO saying the House bill is a long term deficit reducer, Conrad has some very kind words for it.

"Much improved," Conrad told me. "It's now paid for, has deficit reduction over the first 10, and savings over the second 10...that's a big improvement. I commend the House. They've made significant strides and they deserve credit for it."

"They did make this sound from a budgetary standpoint, far more sound, and in terms of the public option, they no longer have it tied to Medicare levels of reimbursement which is, as I see it, terribly unfair to the low reimbursement states," he added.

One consequence of not tying the public option to Medicare? The CBO predicts that average premiums will be higher in the public option than in private plans.