I was on Dylan Ratigan show discussing Barack Obama’s appearance on the Daily Show. There were some claims made about the impact of the health care bill that are, at best, obfuscations:

What Obama said What the health care bill actually does
“You’ve got 30 million people who are going to get health insurance as a consequence of this.” 30 million people are “covered,” but due to insufficient subsidies and cost controls  many people may not be able to “use” the coverage they have been forced to purchase.  See Wheeler, Marcy: Health Care on the Road to Neo-Feudalism.
“You’ve got a Patient’s Bill of Rights that makes sure that insurance companies can’t drop you…
a)… when you get sick if you’ve been paying premiums” There are already many states that have laws on the books prohibiting people from being dropped when they’re sick, but without an enforcement mechanism, there is little to hold the insurance companies in check.  The bill does not empower a regulatory body to keep people from being dropped when they’re sick.

Thus when it was discovered in April that Wellpoint was targeting breast cancer patients for recision following the passage of the health care bill, nothing had changed — according to Reuters, WellPoint lobbyists “helped quash proposed provisions that would have required a third party review of its or any other insurance company’s decision to cancel a customer’s policy.”

Former Wellpoint VP Liz Fowler wrote the initial draft of the heath care bill, and now works in the White House implementing oversight of the bill.

c)”…that make sure there aren’t lifetime limits” Only policies written after October 1, 2010 are mandated to adjust lifetime limits, which will be phased in between now and 2014.  The Department of Labor said that removal of lifetime limits would add less than 1% to insurance company costs because  it will impact relatively few people, a figure President Obama has echoed.  However  Anthem Blue Shield, one of the nation’s largest insurers, says that it will cause the cost of individual market plans to “rise by as much as 22.9 percent” across the board.
d)”…make sure that kids who … don’t have health insurance can stay on their parents’ health insurance until they’re 26″ As Dave Dayen wrote at the time, in May the Department of Health and Human Services “helpfully pointed out to insurance companies how they can avoid the requirement that dependents can stay on their parent’s policies until the age of 26″:  “The new policy applies only to health insurance plans that offer dependent coverage in the first place: while most insurers and employer-sponsored plans offer dependent coverage, there is no requirement to do so.” Further, insurance companies are skirting the requirement that they cover children with pre-existing conditions: six major companies have announced they will no longer write new policies for individual children.
e)”…And cuts the deficit by over a trillion dollars” Politifact: “Obama is presenting a highly speculative number as a hard fact. The CBO believes the health care bill will continue to improve the deficit in second 10 years. In an Oct. 22, 2010 presentation on the economic effects of the health care bill, CBO director Douglas W. Elmendorf said the legislation sets up a number of experiments in delivery and payment systems, but “it is unclear how successful the experiments will be.” For that reason, and others, the CBO noted that the uncertainties involved are too great to create detailed projections. And so now, as then, we rate Obama’s statement Half True.
“Well we didn’t get 100% of what we wanted, we got 90% of what we wanted, so let’s focus on the 10% we didn’t get as opposed to the 90% that we did.” Despite the fact that Obama said he supported the public option in a speech to Congress in September 2009, the New York Times reported he had already dealt it  away by July of that year.  So one can only take him at his word — he did get 90% of what he wanted.
“And right now there is a woman in New Hampshire who doesn’t have to sell her house to get her cancer treatments because of that health care bill … She doesn’t think it’s inconsequential. She doesn’t think it’s timid.” Demagoging the few people who have been helped so far just so Obama can obscure the utter failure of the high risk program and issue a positive press release is particularly dishonest.

The CBO estimated in April that by this time, there would be 375,000 formerly uninsured people enrolled in the high risk pool.  The federal government won’t release the statistics of how many are currently  enrolled nationwide, but California has received fewer than 450 applications, and Texas had enrolled about 200 people by September.  Actual enrollment is only a small fraction of what was projected.

The reason? The cost is too high, and it’s too hard for people who need the coverage to meet the eligibility requirements.  Basically, the high risk pool is the health care bill’s version of HAMP.

“Look I would love not to have a 60 vote requirement” The health care bill passed through reconciliation.  It only required 50 votes in the Senate (plus Joe Biden).
“We’ve got a whole bunch of rules about lobbyists interacting with the White House that are very different from any White House before.” Obama has enforced the rules against those who lobbied for human rights, but waived them for Raytheon and other big government contractors.
“If somebody wants to come to visit the White House, now that list is given out to everybody. That’s a change.” The White House only agreed to release the full visitor logs after they were sued by CREW.  Since that time, they have notoriously been meeting people they don’t want to appear on the logs at coffee shops near the White House.
STEWART: 2014 is when these exchanges kick in and there will be some sort of price controls, but up until that point, there’s really nothing in this bill that doesn’t allow these insurance companies to raise rates …

OBAMA: Not true … in fact what we’ve done is we have empowered state insurance commissioners to review the rate hikes that are taking place in states. In some states like North Carolina they have already used it and rolled back premium increases by 25%.

What is he talking about? The bill gave insurance commissioners money to review rate hikes, but if their state government doesn’t give them the power to adjust rates, it didn’t give them any power to do anything about it.

The 6.7% rate increase requested by Blue Cross was limited to 5.37% by the North Carolina Department of Insurance in September.  The 6.7% wasn’t “rolled back” — it was never approved in the first place.  The Department of Insurance did so under powers they already had, not by virtue of anything the health care bill gave them.

Blue Cross was, however, forced to pay $156 in one-time refunds to people because of provisions for medical loss ratios in the bill.  Medical Loss Ratio  means that if your insurer spends too much on advertising or executive salaries or lobbyists, the health care reform will require the insurer to give you a rebate. It’s really one of the only things that puts any restriction on how much money insurance companies can skim off the top.  However, the administration is in the process of granting so many waivers when large corporations threaten to drop coverage completely that its future impact is in serious question.

I’m assuming Stewart’s comment about “quid pro quo” and the deal between the drug companies and the White House over drug reimportation was a reference to this:

CARPER:   I’ll tell you — if someone negotiated a deal with me and I agreed to put up say, 80 dollars or 80 million dollars or 80 billion dollars and then you came back and said to me a couple of weeks later — no no, I know you agreed to do 80 billion and I know you were willing to help support through an advertising campaign this particular — not even this particular bill, just the idea of generic health care reform? No, we’re going to double — we’re going to double what you agreed in those negotiations to do. That’s not the way — that’s not what I consider treating people the way I’d want to be treated.

That just doesn’t seem right to me.

Obama didn’t address Stewart’s point about “quid pro quo.”