Health Care bill a “Max failure”

Senator Max Baucus, Senate Finance Committee Chairman, delivered his introduction to a new health care plan on Wednesday (September 16, 2009).

There wasn’t a single Republican standing beside him, even though the Senate bill was so heavily laced with Republican amendments and alterations that you would have thought that they wrote most of the bill themselves. House Speaker Nancy Pelosi sat off to the side and frowned through most of Baucus presentation.

As Baucus read his statement you could practically hear the air escaping from the Health Care Reform movement so earnestly promoted and supported by President Obama and progressive Democrats.

Baucus stood before the American people and presented his committee’s bill as true “reform.” However, the plan as presented was a complete sell-out to the health insurance industry.

The plan, still considered too radical for conservatives and far too weak for progressives who are insisting on federal government managed optional plans, supposedly meets some of President Obama’s stated aims.

According to Senate insiders, this bill offers the best opportunity for Democrats to redesign and improve the nation’s $2.5 trillion health care market.

The House has not yet voted on its own bill until they could see what the Senate bill included. Initial feedback indicates that House Democrats will likely reject the Senate bill in its entirety and force the Senate to start over from scratch. Nancy Pelosi pointed out that the current Senate bill, a ten-year $856 billion plan, delivers millions of new customers to the major insurance companies while providing no new competition in the form of any type of federal government supervised plan. All the Senate bill offers is the future establishment of non-competitive nonprofit local “cooperatives.”

White House press secretary Robert Gibbs delivered a weak endorsement of the Baucus bill late Wednesday, only referring to it as a “building block…I don’t think this is a mirror of what the president has talked about.”

Baucus claimed that his efforts to bring Republicans onboard would be successful. Instead, his comments drew immediate criticism from Iowa Republican Senator Charles Grassley, who in spite of being a major participant in the committee’s negotiations, is under intense pressure from the Republican leadership in both the Senate and House to hold party ranks and to refuse to support the bill.

The Senate’s Folly

Many American’s who watched Baucus’ speech on Wednesday must have wondered what the hell he was thinking. Did he not hear President Obama’s speeches over the past couple of weeks?

Anyone, especially progressive Democrats, who heard Baucus describe the key elements in this version of the Senate bill, would likely hope that the bill would fail to make it out of committee and not even come up for a vote. There were clearly far too many trade-offs made just to satisfy the Republicans on the committee, even though they have as a group vowed to vote against the bill.

To hold down the cost of the bill, subsidies to individuals who must purchase insurance will be drastically reduced.

That mandate would force people who don’t usually want to buy insurance policies because they think they don’t need or can’t afford medical insurance.

Baucus presented the idea of local, private medical insurance co-ops as an alternative to either a government run option or single payer plan. That idea failed to appease the conservatives, who said it would lead to “government controlled health care.” There is clearly no support for such a co-op plan among liberals.

Democrats are in control of both houses of Congress. They will bear the blame for the loss of a public option. The Republican minority will have proven that the Democrats, even with a popular president and the support of a huge majority of American voters, are weak, disorganized and ineffectual. In the end, it will be the American public that will lose and pay the price, while the hugely profitable insurance corporations will once again be the big winners.

Early Responses from the Public

Several interest groups and industry leaders offered varied responses supporting some elements of the bill while denouncing others.

One public interest group slammed the bill for leaving an estimated 17 million Americans, not including illegal immigrants, uninsured over the next ten years because they won’t or can’t afford to buy insurance.

In a report issued by the Kaiser Family Foundation, studies showed that insurance premiums would cost the average family $13,375, a 5% increase over the past year -- in spite of a general reduction in national purchasing power of 1.5 to 3%.

Major Details of the Senate Plan

The plan would cost $856 billion over a 10 years period. It would not add to the deficit because the plan includes tax increases and some major spending cuts.

The plan requires individuals by law to buy insurance. Insurance companies would be banned from denying coverage for pre-existing conditions or dropping customers when they became ill or injured.

The bill offers $463 billion in credits to help lower-income people to pay for their insurance coverage. Small businesses would get $24 billion in tax-credits to encourage them to offer insurance to their employees.

Nonprofit insurance co-ops would offer other choices in addition to current corporate provided private insurance. This plan uses cooperatives to replace the federal open public option plan that is a major part of the House bill.

Large employers would be required to offer insurance to all of their employees and would pay penalties if they refuse.

Insurance “exchanges” would offer standardized policies and allow purchasing across state lines. Access to similar exchanges would be open to owners of small businesses in exchange for subsidies for covering employees.

Medicaid expansion would allow everyone earning up to 133% of the federal poverty level ($30,000 a year for a family of four and $14,400 for individuals) access to the federal program. A new Medicare commission, appointed by the president, would recommend changes to Medicare during years when costs grow out of control.

There would be increased taxes to raise revenue by imposing a 35% excise tax on so-called “Cadillac” insurance plans costing more than $8,000 a year per person, or $21,000 a year per family.

Additional spending cuts of $500 billion would come from reducing payments to Medicare health maintenance organizations (HMOs) paid more than traditional fee-for-service plans.

The Bottom Line

Let’s face it. This plan will have absolutely no Republican support in either the Senate or the House. The lack of any real public option plan will pretty much limit its support by either media pundits or progressive Democrats.

Max Baucus tried really hard to put together a bi-partisan bill that would satisfy the three Republicans on the Finance Committee (Enzi, Snowe and Grassley), but his efforts were an exercise in futility since not one of them has expressed any indications of supporting the bill they helped put together. Senator Olympia Snowe said the bill doesn’t have her support, while Senators Charles Grassley of Iowa and Mike Enzi of Wyoming, the two other Republicans on the Finance Committee, have expressed their disappointment with the current bill and say they won’t support it.

The Democrats Only Choice

From the beginning it should have been clear that there was no way to get any Republican support for a medical insurance reform bill -- absolutely none. In spite of that obvious fact, Senator Max Baucus attempted to put together a bill that rewards the medical insurance industry with millions of new customers, who would be forced to buy insurance or face having to pay penalties for failure to have insurance, whether they can afford it or not, and without any type of effective and affordable public option.

This bill offers the public no real savings or protection from continued misbehavior on the part of insurance companies. The plan even allows the insurance companies to require waiting periods and higher premiums for many pre-existing conditions. So what has really changed?

Essentially the process in the Senate over the last four months has been a complete boondoggle, a tragic and total waste of time -- all in the name of “bi-partisanship.”

So what can progressive Senate Democrats do to pass a meaningful medical insurance reform bill that fits with President Obama’s plan for the future?

First of all, Democrats should follow the example of the Bush Administration. What’s good for Republicans should also be good for Democrats too -- right?

When President George W. Bush pushed for tax cuts for the wealthy at a cost of $1 trillion, how did the Republicans manage to pass it in the Senate? Very simply: They used Budget Reconciliation.

Note that now that this option is available to the Democratic majority in the Senate, Republicans are already crying foul!

Senate Republicans are such hypocrites. They object to the procedure when the Democrats threaten to use it, but they mastered its use during the eight years of the Bush Administration. Republicans used Budget Reconciliation to pass the following Bush backed bills:

• The 2001 Bush Tax Cut
• The 2003 Bush Tax Cuts
• Tax Increase Prevention and Reconciliation Act of 2005
• The Deficit Reduction Act of 2005
• Republicans used the Reconciliation Act to allow domestic drilling in the Arctic National Wildlife Refuge in 2005.

Congress used budget reconciliation during the administrations of other presidents, including Clinton and Reagan, and when either party had a majority.

The Republicans also used Budget Reconciliation to pass through the major provisions of their “Contract with America” (heavily promoted by House Leader Newt Gingrich) during Bill Clinton’s Administration. Now Gingrich is implying that should the Democrats try to push medical insurance reform through the Senate by using budget reconciliation, that it would be “unfair” and “possibly unconstitutional.”

Time for the Democrats to Act

The Democrats should give up on any idea of trying to make medical insurance reform a bi-partisan act. If they don’t pass this reform bill now they will suffer dearly at the polls in 2010. They need to remember who voted them into office -- and why -- in 2006 and 2008.

The Democrats need to rewrite or create a new bill and present it for a vote in the Senate under the rules of Budget Reconciliation. They need to remember that if there is no public option in the bill, both President Obama and the American public will consider the bill a failure and a waste of time. They might just as well do it right or not do it at all.

Whatever the Democrats do, whether they revise, rewrite, or start over from scratch, they need to realize that they will receive absolutely no Republican support. They need to remember that all they need is 51 votes and they can pass the bill that their president and their constituents want and need without Republican consent.

The Democrats need to stop being intimidated by the Republicans. Can we really let a minority party that panders to mostly southern white evangelical regressive neo-Confederates take over Congress and stop the changes that our President (and most Democrats) promised to deliver during his first term?

My guess is that if the Democrats simply ignore the Republicans and just get on with the nation’s business, that the Republicans will do nothing but sit and sulk and whine on Fox News and continue to call the President nasty names and accuse the Democrats of being unfair.

I’d rather see forty Republican Senators have their feelings hurt than the American public have to continue to suffer under the tyranny of the medical insurance oligarchy. Let them go back and explain to the voters why they would not support a comprehensive medical reform bill that would benefit everyone in their state.

The voters can give us the answer as to whether the Congress made the right decision, whatever it might eventually be, in November, 2010.

I’m sure they will -- in spades…

Click on the link below if to read the Senate Finance Committee’s “Markup” copy of the Health Care Bill. You’ll find 223 pages of technical and legal text that really “hides” the facts and critical details of the plan. You’ll probably know less about the plan after you read it than by simply looking online for a brief synopsis.

Americas Healthy Future Act (Senate Finance Committee -- 09/16/2009)