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Call Bart Stupak’s Donor PACS and Tell Them They’re Paying For His Anti-Abortion Activism

By: Jane Hamsher Saturday November 7, 2009 1:14 pm

Rep. Bart Stupak’s amendment to health care reform will effectively prohibit insurance companies from covering most women’s abortions.

If Planned Parenthood and NARAL are just going to lie down and let access to reproductive health legislation to be written by Catholic bishops, I guess they think that’s in the best interest of the women who donate to their respective organizations.

But I wonder if Bart Stupak’s donors want to be associated with his anti-choice activism?  Many PACS that donated to Stupak this year have a pretty heavy investment in consumer branding that appeals to women.  Check out the list below.

Let us know what they say in the box to the left when you call.  Thanks again for your help.

Here are some of Bart Stupak’s donor PACs with popular consumer brand companies.  Call these companies and let us know what they say.

Let us know what you hear in this form.

Stupak Amendment Could Likely Be Used By Insurance Companies To Discriminate Against Low Income Americans

By: Jon Walker Saturday November 7, 2009 11:12 am

The Stupak amendment would prevent any private health insurance plan from covering elective abortion, if even one of its customer used even one dollar of affordability tax credits. The problem is that the Stupak amendment will conflict directly with other parts of the bill. The bill would require “guaranteed issue.” This means that any insurer offering coverage to individuals on the health insurance exchange most accept all customers.

If the insurance companies offering plans on the exchange are not allowed to turn down any customers, it means no basic insurance plan on the exchange could cover abortion. There would be no way to prevent that at least one of the plan’s customer would be using affordability tax credits to help purchase the plan. So the effect is no plan sold on the exchange could offer abortion coverage as part of its basic package.

The contradiction could be solved in a different manner. The decision could be that insurance companies who offer plans covering abortion on the exchange would be allowed to turn down customers using affordability tax credits. This would create a dangerous loophole for the new guaranteed issue rule. This could lead to the ghettoizing of the health insurance exchange. Insurers would know that offering plans that cover abortion would prevent low income Americans from being able to sign up. Low income Americans tend to have higher medical costs and are less profitable, less desirable customers. Offering abortion coverage would be a simple way for an insurance company to keep them out of their risk pool. Since the exchange has dangerously weak risk adjustment mechanisms, this Stupak Amendment could become a profitable tool used by insurers to discriminate against low income Americans.

It seems the Stupak Amendment would either effectively ban any basic health insurance plan sold on the exchange (the individual and small business market) from covering abortion or would create a way to discriminate against low income Americans. Either way the Amendment will have far reaching ramifications for our health care system.

I Wonder What Bart Stupak’s Donors Think About Financing Anti-Abortion Activists?

By: Jane Hamsher Saturday November 7, 2009 10:54 am

If Planned Parenthood and NARAL are just going to lie down and let access to reproductive health legislation to be written by Catholic bishops, I guess they think that’s in the best interest of the women who donate to their respective organizations.

But I wonder if Bart Stupak’s donors want to be associated with his anti-choice activism?  Many PACS that donated to Stupak this year have a pretty heavy investment in consumer branding that appeals to women:

Gosh an awful lot more brand names want to be associated with funding a huge right-wing encroachment on the reproductive rights of women than I imagined.  I would have thought they’d want to avoid the brand damage that can come from that kind of thing, but that’s me.

If anyone happens to give them a call or mention it to them and gets a response, be sure to let me know.

Stupak’s Anti-Abortion Amendment Expected To Pass

By: Jon Walker Saturday November 7, 2009 9:22 am

Multiple sources are reporting that Stupak’s anti-abortion amendment, that would basically prevent all insurance plans sold in the individual and small group market from covering elective abortion, is expected to pass. It would be the most far reaching restriction place on abortion at the national level in years. Moments ago on MSNBC, Bart Stupak (D-Mich) affirmatively said that his amendment will pass.

It is assumed that if Stupak’s amendment is included in the bill several conservative Democrats will vote to pass the overall health care reform measure. Indications are that there not enough pro-choice Democrats willing to vote against the bill if it includes the Stupak amendment to bring down the bill.

The pro-choice Democrats failed to draw a line in the sand over the issue and that led to Stupak’s complete victory. Stupak’s amendment is the only Democratic amendment that will be allowed to be offered on the floor. If it is included in the final bill that passes the House it would be a huge victory for the opponents of a woman’s right to choose.

And the Catholic Bishops Endorse! A Special Thank-You To Planned Parenthood and NARAL

By: Jane Hamsher Saturday November 7, 2009 9:17 am

There’s a shit storm going down on TV right now on CSPAN as the health care bill hits the floor of the House.

Thank you Democrats, for making women take a punch in the throat from a bunch of old men who have spent the better part of the last century avoiding their own problems. So Rahm and Obama (who did nothing to stop it) can have their “w”:

The United States Conference of Catholic Bishops delivered a critical endorsement to House Speaker Nancy Pelosi on Saturday by signing off on late-night agreement to grant a vote on an amendment barring insurance companies that participate in the exchange from covering abortions.

“Passing this amendment allows the House to meet our criteria of preserving the existing protections against abortion funding in the new legislation,” the Bishops wrote in a letter to individual members. “Most importantly, it will ensure that no government funds will be used for abortion or health plans which include abortion.”

Well, you have to give the culture warriors something, so they can go around cheering about the big victory that they got in this bill.  So happy to have the chance to line it all up for you all.

Thank you, Planned Parenthood and NARAL, from the bottom of my heart, for sitting on your hands and enabling this shit.  Hope you have fun at all those Common Purpose meetings, those cocktail parties at the Pelosi’s.

You own this one.

It’s not like they haven’t been perfecting this act for a long time.   Helping the Democrats stay in power by giving them the Official Good Gyno Seal of Approval even when they do things like — oh, I don’t know, voting for Samuel Alito and tell rape victims to take a cab to another hospital if they want to get Plan B contraception.

Could they whip the pro-choice women to block the rule if they want to?  Of course they could.  Yank their endorsements and they could cause havoc in the Democratic party.  But they won’t, because Nancy Keenan and Cecile Richards value their own personal position in the veal pen pecking order WAY too much for that.

One of the things that made a fight for a public option possible was because there were no “veal pen” validators occupying the health care space.  Nobody knows who HCAN is.  The White House tried to press the unions and other veal pen groups into service but progressives standing there ready to shoot on sight made everyone else back away for fear of losing their own credibility.

People think the “veal pen” phenomenon is insignificant, but it’s not.  The abortion fight — like the environmental fight — is extremely difficult to wage online, because you can’t activate those who care about the issue if the “brand names,” the issue validators, are telling them everything is fine either by action or inaction.   And that’s exactly what the Democrats — from the White House on down to Nancy Pelosi and the House leadership — want right now.

But let’s be clear about this. The only reason that we are in the position where the price of passing health care reform is allowing even liberal Marcy Kaptur to sneeringly dismiss choice activists as narrow class warriors who don’t care about working women is because Planned Parenthood and NARAL have allowed it to happen.  They collect millions of dollars in revenue each year. They’ve exacted no price from the Marcy Kapturs of the world, who actually have to care what liberals think of them, and focused instead on anti-choice Republicans who are only empowered by their ire.  They have no scalps. There is no price for bucking Planned Parenthood and NARAL.  It isn’t a fight that the Democrats want to spend “political capital” on, and these groups insure that they don’t have to.

Forget about the fact that more Americans are now anti-choice than pro-choice for the first time since Gallup has been polling the issue.  More and more Democrats in Congress each year are anti-choice, despite the fact that the party is .  It’s acceptable now.  These groups have the lobbyists, the money, the access, and their leadership uses it for their own personal advancement while the cause they purport to defend withers on the vine.

The national Planned Parenthood organization listed $126 million in assets in 2007.  Cecile Richards made $385,163 (PDF).  The state chapters whose employees put their lives on the line so women can have the right to choose deserve support and protection within the Democratic party that she is not providing.

NARAL paid Nancy Keenan $145,538 from the Foundation (PDF) in 2007, which listed total assets of $4,119,329.  But the NARAL PAC reports $87,125 cash on hand as of September 30, 2009.

They knew this was coming since at least July 1 — and they didn’t even raise money for the fight.

HR 3962: Stupak Says Deal on Abortion Just Fell Apart

By: Jon Walker Friday November 6, 2009 9:29 pm

Just after midnight, Bart Stupak (D-MI) testified on behalf of his amendment which would effectively make it illegal for private health insurance in the individual market to cover abortion. He was there in support of his amendment, because he claims negotiations to find a compromise just fell apart. He claims as recently as earlier this evening it looked like Democrats reached an accord, but the deal did not hold up. So, he needed to “scramble” to testify in support of his amendment.

Stupak’s amendment, by not allowing a private insurance company to sell a policy to anyone if they receive any amount of affordability tax credits, would make it impossible for a private insurance plan that covers abortion to survive on the individual and small group market. Stupak has threatened to bring down the entire bill if he does not get his amendment. Rep. Stupak called all previous “compromises” that had been offered “unacceptable.”

In the past few days, several efforts have been made to try to find a compromise that would be acceptable to the bulk of the Democratic caucus. Brad Ellsworth (D-IN) had been leading efforts to find a new compromise. How many Democrats will follow Stupak’s lead and try to bring down reform over the issue is not clear at this time. With a very close vote expect on the bill, this could signal that the Democrats do not currently have the votes to pass the bill in the House.

YouTube link here.

UPDATE: The Stupak amendment will get a vote on the floor.


Live Blog House Rules Committee – Health Care Reform Part 2

By: Jon Walker Friday November 6, 2009 1:51 pm

The rules committee will meet today discuss the House health care reform bill HR 3962. It will aired be live on C-SPAN 2.

4:52 – The Rules committee comes back from recess. (There is currently some audio trouble making it hurt to health the meeting.)

4:54 – Rep. Lincoln Diaz-Balart (R-Flo) questions Rangel about how much money comes from cuts and how much comes from cuts to programs. Rangel says it is about $500 billion each. McGovern points at that the cuts are cuts in waste and abuse.

4:56 – David Dreier (R-Cal) is upset that when Republicans tried to cut waste, fraud, and abuse. The Democrats did not help them and they only cut some $40 billion. Rangel think that says something about the ineffectiveness of Republicans.

4:59 – Diaz-Balart is claiming that the “cuts” to Medicare Advantage plans (which are dramatically overpaid and would now simply be paid on an equal footing to regular Medicare) would reduce enrollment in Medicare Advantage. He claims this violates Obama pledge that people get to keep their coverage.

5:04 – Frank Pallone (D-NJ) defends the change to Medicare Advantage and claims some Medicare Advantage plans even in Diaz-Balart’s on district come in under the cost of regular Medicare. This change will only get rid of the bad plans. Diaz-Balart is basically arguing the in rural areas private insurance companies can’t be run efficently and some how we need to keep these plans in business.

5:11 – David Camp (R-Mich) is defending Medicare Advantage and basically called the CBO liars for claiming Medicare Advantage is overpaid by 14%. Diaz-Balart claims Medicare Advantage has been successful because it is “flexible.” (in reality it is “successful” because it is extremely over paid.)

5:15 – Pallone “all we are trying to do is level the playing field.” He says all this does is put the private Medicare Advantage plans on a level playing feild with fee for service. He compares this to the public option. It would complete with private plans on a level playing field.

5:17 – Pallone disputes Diaz-Balart’s claim that the public option would drive all the private plans out of business. (if private planscan’t do a better, cheaper job why should we try to protect them?)

5:18 – Diaz-Balart does point out a possible problem that the teired employer mandate might create an incentive to keep a business at a set size. (I beleive he is overstating the issue but is some case it might effect some decisions by some small business. I would prefer a flat employer mandate for all employers regardless of size.)

5:23 – Diaz-Balart is  horrified that eventually all insurance in this country would need to meet some minimum benefit to be qualified as health insurance.

5:26 – There is a lot of confusing on the employer mandate would be enforced and how the penality would work.

5:29 – Rep. Alcee Hastings (D-Flo) this country ranks terribly on most of the world health measurements while premiums continue to rise. He claims some have decide to presue fear mongering instead of offering solutions. He points out that five teabagger protest yesterday all fell ill and got government health care.

5:34 – Hasting delivers a long defense of the bill and bad mouthing the Republicans for not doing anything.

5:41 – Barton tries to defend the terrible Republican alternative. Hasting response that the CBO said there will would still leave millions of Americans uninsured.

5:45 – Barton is upset they did not ask him to help put together a bill. (Since he basically said he and the rest of his party would never vote for the bill why would the want his input?) Pallone said there just was no way they were going to come to an agreement.

5:52 – Pete Sessions (R) is claiming the taxes in the bill would be a job killer and Camp is backing him up. (Rangel’s mic is not working and it is very difficult to hear what he is saying)

5:55 – Peter Sessions is demanding to know what Republican ideas got added to the bill. Polis says that he listened to Republican ideas of citizens that lived in his district. They added interstate insurance selling mechanism, it would cut the deficit, and the size of the bill was reduced.

5:58 – Sessions seems honestly horrified that some basic regulations are going to be put on insurance like banning pre-exsisting condition and banning life time cap on health insurance policies. He says they would increase the cost of health insurance. He honestly supports charging woman more for health insurance than men.

6:04 – Sessions ask Pallone if he looked at the CBO savings of the Republican bill, Pallone said he had not.

6:08 – Sessions claims the there is a special carve out in the manager’s amendment for 3-4 Democrats’ districts physician owned hosipitals. Rangel disputes the claim that is an earmark meant to only help Democratic district. Camp and Barton claim only the few hosipitals that would be helped are in Democratic districts. Sessions ask Rangel if this carve out was done for a vote and if so would Rangel consider it an ethical violation.

6:15 – Sessions is referencing a NYT article that claims changes were made to the rules governing physican owned hospitals to help win some votes. Session and Rangel are arguing if and why this change was added.

6:20 – Sessions is freaking out that no economic analysis on the impact of jobs. Camp is claiming it would be a huge jobs kill. He wants a “guestimate” by CBO. Sessions wants Rangels to sent a letter with him to the CBO about this issue.

6:27 – Doris Matsui (D-Cal) “we can’t afford the statue quo.” Health cost are causing half of all bankrupticies and premiums keep rising faster than wages. She ask Miller to explain how it would help small businesses. He said they would get access to the new exchange and the bill would end job lock to encourage starting businesses. He said not having a universal health care system is just bad for the economy.

6:32 – Matsui, Medicare is a government program that works. She is happy about some of the small delivery reforms that will be part of the bill for Medicare.

6:40 – Pallone thinks one good idea George Bush had was to provide money to community health centers and says the bill would be a big improvement for them. Miller claims they are critical for improving the health status of Americans.

6:45 – McGovern (not Barton) joked that the committee meeting was like Gitmo.

6:46 – Virginia Foxx (R-NC) claims everyone wants everyone to have health care, but she is against these “government takeover.” She claims this is the greatest health care system in the world and this would turn it in the wrong direction. Foxx decided to use “evidence.” She claims the infant mortality rates information is a lie, because countries have a different defination for infant mortality.

6:51 – Foxx claims lower life expentancy in American is due to are bad living not our bad health care system.

6:55 – Foxx mocks people for hating the “mean and pesky” private health insurance companies claiming Medicare is worse. Foxx is attacking the AARP for how they run their Medigap program and thinks Democrats should not be proud of their endorsement. She is claiming this is a kickback. Rangel says he is proud to haver the AARP’s support.

6:59 – Dreier said he was called by the Texas AMA to tell him they were furious that the national AMA endorsed the bill.

7:06 – Foxx complains that the taxes would start for a few years before the benifits start.

7:12 – John Kline (R-Minn) claims this bill would be bad for small business but the Republican bill would be. Miller gets angry. Says that doing more health saving accounts would not work.

7:16 – (More mic trouble makes it hard to hear anyone)

7:17 – Foxx says the bill will make government funding of abortion and that Democrats should allow a vote on an amendment. (She seems to being refering to the Stupak amendment.) Pallone defends the current language about abortion in reference to the exchange. Claims the exchange will not subsidizes abortion.

7:22 – Foxx thinks it is absurd that there could be trillions of more in saving in this plan. She claims “never in the history of this country has the government do anything cheaper than the private sector.”

7:28 – Dennos Cardoza (D-Cal)  is not wild about the bill and has never really been wild about any bill which needs to work through this long multi-committee sausage making process. Cardoza tells Camp that he does not beleive the Republican plan would cover his people.

7:34 – As a blue dog Cardoza thinks we need to focus on cost more. He thinks technology needs to be used increase efficency.

7:36 – Michael Arcuri (D-NY) ask Camp if anyone who wants insurance can go out and buy insurance in the Republican plan. Camp dances around answering. The exchange because heated with Arcuri repeating his question again and again.

7:43 – Arcuri attacks Camp’s claim that the bill would be a major job killing and argues that his analysis is not based on the bill.

7:50 – Arcuri compared the rhetoric to the current bill to that attacks on Medicare and says like Medicare this will be popular soon after it passed.

7:53 – Ed Perlmutter (D – Col0) makes it personal. He talks about his daughter of epilepsy and how the pre-existing condition would make her uninsurable. He calls the current discrimination terrible and he considers it unconsitutional. He is proud that this Congress will take on this subject. Perlmutter attacks the Republican bill for allowing discrimination based on pre-existing conditions. Camp defends his bill for not banning pre-existing conditions. He claims the Republican bill would only be a first step and will not be a way to get to universal coverage.

8:03 – Perlmutter slams the Republican bill for doing almost nothing. He reads the USA Today editoral attacking the Republican “alternative.”

8:06 – Chellie Pingree (D-ME) wants to finish this evening so they can send the vote to the floor and get the bill passed. Her brother was diagnosed with skin cancer. He was unable to find an insurance company, so he get rid of every asset he had so he could be on Medicaid. He unfortunately died a few months later.  This was twenty years ago and even back then we were talking about the problem of pre-existing conditions. Pingree is tired of waiting. “Let’s just get this done.”

8:11 – Jared Polis (D-Colo) said there is nothing in this bill in “any way shape or form” that is a government take over of health care. He thinks we have spent about the right amount of time on this bill. Polis is a support of the public option and is glad Congress will be able to choose the public option. Camp lies claiming his bill would not result in an increase in the number of uninsured in this country. Polis calls him out for his falsehood using the CBO analysis to prove that more people without insurance.

8:18 – Polis comes out strongly in defense of allowing illegal immigrants to buy health insurance with their own money. He says it would save the government money. Pallone completely agrees with Polis and say it is purely a political move but very bad policy.

8:21 – The panel of witness from the three committees who work on the bill have been dismissed.

8:23 – The Committee will finally start dealing with amendments.

8:24 – Nathan Deal (R) lists several amendment he wants to be able to offer.

8:28 – Greg Walden (R) offers two amendments that were adopted in committee but were stripped out. The first would make sure that new Health Benefits Advisory Committee had members from rural medicine. The second would make sure there was significant rural repersentation on MedPAC.

8:34 -Michael Burgess (R-TX) offers an amendment would that would give states a bonus for achieving compliance with making Medicaid the payer of last resort. Burgess wants insurance companies to have the power to use smoking to set rates.  His amendment would let them could charge smokers a ratio of 1.5 to 1. His third amendment would put in place the extreme tort reform found in the Republican alternative. The next amendment would set Medicaid reimbursement at a minimum rate. This amendment would allow members of congress to be part of Medicaid. This amendment would make Medicaid expansion contingent on having an acceptable level of access to a sufficent provider network. This amendment is very funny. It would require CBO to project cost every year and for the next 100 years!!! The last amendment would not allow the public option to use the U.S. treasure as a means for capitol reserve fund.

8:54 – Marsha Blackburn (R) offers 6 amendments.

9:05 – Next was Rep. Gingrey (R) who submitted 7 amendments.

9:10 – Buck McKeon (R) has 5 amendments.

All summary of all amendments can be seen here on the Committee on Rules page and the Committee on Rules Republican page has a link to the text of the amendments.

9:18 – Gingrey and Burgess join the chorus of Republicans who have recently been attacking the individual mandate.

9:22 – Sessions claims to still be finding out things that “scare him to death.” He claims people will go the jail for not pay mandates.

This theme that the failure to pay the individual mandate could technically be a tax violation and could therefore result in the maximum penality for tax evasion is very popular with Republicans. Expect to see more talk about this line of attack moving forward.

9:30 – Cardoza vows to help Walden work to address the issues in his amendments. That will probably not be dealt with in this bill but could probably be dealt with in the future.

9:38 – Cardoza, in response to Sessions fear mongering, said what is really scare is our current health care system.

9:47 – Foxx and Walden spend a long time focusing on the fact that his amendments, approved by bipartisan voted in committee, were stripped out of the final bill.

(You get the strong sense that the Republicans are doing everything they can to drag out this process.)

9:54 – Perlmutter defends the mandate and says the claim that people would go to jail because of the individual mandate is silly and gets into a heated debate with Sessions.

9:58 – Dreier keeps harping on the fact that his bill HR 3962 was technically not marked up in committee. (This is just plain silly. It is the combined versions of HR 3200 that were marked up in three committees. Do expect to see Republicans try to use this strange extremely technical attack moving forward.)

10:12 – Dreier is reading Pelosi’s promise for a “New Direction” to change they way Congress works. One of the promise was that a bill would not be marked up in the rules committee later than 10:00 pm the day before the bill comes up for debate. Oh snap it is 10:14 pm.

10:15 – Kevin Brady (R) has 8 amendments. He is talking about one that would insure there is no “rationing” in Medicare.

10:20 – Shelley Berkley (D) tells a very entertaining story about how a Jewish doctor (her eventual husband) tricked her into getting a bone density test. It was very funny story and a moment of lightness needed during a long day. The amendment would provide funding for bone density test.

10:26 – Steven Kagen (D) offers an amendment to openly disclose all payment data. It would create real tranparency in health care pricing.

10:35 – Hank Johnson (D) offers two amendments. His first amendment would cap prescription drug cost. His second would change the out of pocket annual cap to four quarterly caps.

10:41 – Phil Roe (R) offers his amendment.

10:52 – Sheila Jackson Lee (D) offers two amendments. They would help physician owned hosipitals.

11:02 – Steve Scalise (R) offers an amendment so that no one making under $250,000 will pay any new taxes. He offers another amendment that would put a four year sunset on the bill. And finally he offers one dealing with the FDA putting regulations on oysters.

11:07 – Mark Kirk (R) offers one amendment to “protect” the doctor patient relationship. He offers a second amendment to basically gut the individual mandate.

11:15 – John Fleming (R) offers an amendment to force members of congress on to the public option. (This is a standard theme among several Republican amendments.) He says the public option will slowly morph into single payer.

11:21 – Ron Klein (D) he offers an amendment to make changes to the Medicare Advantage program. It would slow the phase in of reform to Medicare Advantage.

11:51 – Mark Kirk and Perlmutter get into an argument about how health care reform will work. Kirk is defending a bold face lie that a 27 year old with serious medical problem would pay less now than after reform. Kirk must literally have no idea what the current private insurance market is like.

11:55 – Sessions is a broken record who will not give up on the claim that people will go to jail for not buying health insurance.

12:02 – Bart Stupak (D-Mich) claims that they had an agreement and that it just feel apart moments ago on the issue of abortion. Stupak offers his anti-abortion amendment. (It would effectively make it illegal for private insurance in the individual market to cover abortion.) Stupak calls all “compromises” offered unacceptable.

12:20 – Hastings just said it is unlikely that he would vote for reform if this admendment became part of the bill.

12:35 – Steve King (R-Iowa) offers a several amendments on a range of topics. He offers several dealing with “illegals.”

1:02 – King claims that he saw news reports that only two amendments will be accepted.

1:04 – The hearing portion of HR 3962 and HR 3961 has comed to the end.

1:05 – The Stupak Amendment will get a floor vote and the Republican substitute amendment will also get a vote.

1:10 – The Republicans on the committee offer many amendments which are all reject by party line votes.

1:34 – The debate will start tomorrow at 9.

1:37 – The bill passed out of the Rules Committee.

ACTION: Treat Patients, Not PhRMA Tricks

By: Jane Hamsher Friday November 6, 2009 1:39 pm

Help Medical Students Fight PhMRA for affordable generics with their POP video:

1) Click here to automatically Tweet about this video

2)  Post to your Facebook Page

3)  Copy and paste this to your FB status:  Beat PhRMA! Votes on health care tomorrow.  Watch this video and share:  http://bit.ly/3VnBFj

4)  Rate and favorite this video on YouTube

5)  Recommend on Reddit & Digg

6)  Sign the petition

5)  Email this to your friends and ask them to do the same!

CBO Predicts An Incredibly Weak Risk Adjustment Mechanism In The New Exchange

By: Jon Walker Friday November 6, 2009 1:30 pm

The CBO and CMS have both been pointing to the lack of sufficient risk adjustment mechanisms in the new exchange, and how that would hurt the public option. The new CBO analysis of the House bill demonstrates how weak the CBO believes the new risk adjustment mechanism will be:

Risk adjustment payments to health insurance plans are reflected in the top portion of Table 2 as outlays of $65 billion. Those amounts are offset by risk adjustment collections of about $69 billion, shown in the revenue portion of that table. Risk adjustment funds are collected from all insurers in the market for individual plans and then distributed to insurers based on how the characteristics of their enrollees compare to the average enrollee. Although risk adjustment collections and payments would be equal over time, CBO expects payments for risk adjustment to lag slightly behind collections, resulting in a net deficit reduction of about $4 billion between 2013 and 2019.

$69 billion is an incredibly small amount of money to set aside for risk adjustment. In the same time period, the government will provide $602 billion in affordability tax credits to people buying health insurance on the new exchange. Individuals getting tax credits would likely contribute roughly an equal amount of money out of their pocket toward premiums. Plus 30% of people on the exchange would get voucher from their employers to buy coverage, and not tax credits from the government. All told, probably over $2 trillion in premiums will be paid to insurance plans on the exchange. That means the risk adjustment mechanism would only redirect about 2-4% of all premiums on the exchange.

If this is how reform is implemented, that is a dangerously inadequate risk adjustment mechanism. It would definitely lead to adverse selection for the public option, and create a huge financial incentive for private insurance companies to try to game the system and drive away less healthy customers. The Dutch “managed competition” health care system, which has one of the best designed risk adjustment mechanisms, uses over 50% of the premiums as a fund to redistribute, based on the health of individual plans’ risk pools. This part of the CBO analysis should be another wake up call about what is the Achilles Heel of market-based health care system.

Live Blog House Rules Committee – Health Care Reform

By: Jon Walker Friday November 6, 2009 11:05 am

The rules committee will meet today at 2pm to discuss the House health care reform bill HR 3962. It will aired be live on C-SPAN 2.

2:06 – Rep. Charles Rangel begins by reading on opening statement in support of the reform plan.

2:10 – Rep. George Miller is next to read his opening statement in support of reform. He list many of the improvements that would be made by HR 3962.

2:16 – Rep. Dave Camp (R-Michigan) ranking member of Ways and Means slams the bill in his opening statement. Claiming it would hurt Medicare and increase debt. Calls it tax increase and claims it would cover illegal immigrants. He ask that the Republican alternative be offered. Claims that what the American people wants is not the Democratic bill but the Republican alternative.

2:21 – Rep John Kline (R-Minn) calls the bill a vast expansion of government and creates many new bureaucracy. It points to the many powers of the new exchange Commissioner. He lists each page where the Commissioner is given a job.

2:24 – Rep. Joe Barton (R-Texas) starts off by point out that the unemployment rate just reached 10%. Barton is upset the bill is long. If page count is an issue we just need to switch to smaller margins on future bills. Barton is disappoint that 8 Republican amendments accepted in his Energy and Commerce committee were dropped from the final merged bill. Barton asks for more than normal time for debate.

2:31 – Chairman Lousie Slaughter and Dave Camp have a back and forth about what Republicans have ever down to reform health care.

2:34 – She grills Camp about the Republican bill and how little the bill would do. Slaughter points out how much more money the Democratic bill would reduce the deficit in the long run.

2:36 – Rangel expresses disappointed that there has been a lack of bipartisan work on health care and the lack of a Republican “alternative” until the very last minute.

2:37 – Waxman is not at the meeting to testify. No reason is given to explain why Waxman is missing. Instead Frank Pallone is speaking in his place. He delivers an opening statement in support of reform and the importance of the new consumer protections for the insured.

2:40 – Slaughter tells a story about a young man who used up his lifetime cap and quickly became uninsured.  Pallone thanks Slaughter for her work on genetic non-discrimination in health care.

2:44 – Pallone points out that most of the potential savings have not been scored by the CBO but some reforms could end up saving trillions.

2:46 – Slaughter does not know what time the bill will be put on the floor tomorrow. Instead of leaving the three committee chairs and ranking member stay to talk about HR 3961, the Doc fix to the SGR.

2:48 – Rangel delivers his opening statement in support of 3961 and ending the need for a yearly short term fix to the SGR.

2:50 – Camp says the SGR needs to be fixed but it should be paid for. To this Slaughter responds by slamming the Republican Medicare act of 2003 which is responsible for a huge amount of our debt. Not a dime of that was paid for.

2:52 – Pallone defends the SGR and say it is just accepting the reality that SGR will always be patched and never go into effect.

2:55 – Barton agrees we need to fix the SGR. He says it should be index to medical inflation but it needs to be paid for.

2:57 – Ranking Member David Dreier points out this is the “only hearing” on the bill. A silly technically distinction. The bill is built from HR 3200 which has had many hearings in three different committees. He claims Pelosi is breaking her 72 hour rule because a slight change might be made to the manager’s amendment. He says the American people don’t want this bill. He is very offended that Slaughter claims Republicans have done nothing to reform health care. Dreier makes an absurd argument that the White House failed to acknowledge that there was a Republican plans for reform even though there has not been a Republican bill until a few days ago.

3:03 – Dreier spend a lot of time talking about how great it is there is TV cameras in the Committee meeting. It is indeed a good thing. Slaughter and Dreier get into an argument about cameras in the rules committee.

3:10 – The Republicans are making a fuss that the Doc fix did not get separate hearings as a stand alone bill. It was part of the bill that was debated for months, it is just that the bill has now been split into two bills.

3:12 – Dreier and Slaughter go back and forward about repealing a legislative trigger about Medicare spending that produces a report.

3:15 – Jim McGovern (D) claims that this process has been very transparent with many hearings. He compares it to the lack of hearings for Medicare Part D and how that bill was not paid for.

3:18 – Dreier claims his bill would address pre-existing conditions, McGovern said the Republican bill will not and does not expand coverage. McGovern calls it a historic moment. “We can’t let this opportunity pass.”

3:23 – Virginia Foxx (R) is claiming that twice as many people on Medicaid use the emergency room as the uninsured so expanding Medicaid is bad. McGovern thanks Foxx for making the Republican case that there should be more uninsured.

3:26 – Pallone claims the bill would fix this problem by increase Medicaid payment rates to primary care providers. So Medicaid patients would go to primary care doctors instead of hospital.

3:28 – The meeting breaks for series of floor votes.

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