Editore"s Note
Tilting at Windmills

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July 14, 2009

HOUSE DEMS UNVEIL 'AMERICA'S AFFORDABLE HEALTH CHOICES ACT'.... House Democrats were poised to unveil their health care reform package last week, but ran into a little trouble. Leaders said it would be a brief delay, but there was talk of an "indefinite" postponement.

To their credit, the committee chairs and the leadership pulled everything together quickly, and this afternoon presented what appears to be a great piece of legislation.

House Speaker Nancy Pelosi told reporters Tuesday the bill is both a starting point and a path to success. She was joined by committee chairmen and other House leaders. They stood before a banner reading "Quality affordable health care for the middle class."

Pelosi and Rep. Henry Waxman, D-Calif., said the House would pass the bill before the August recess.

There's a lot to go through, but for industrious readers, the bill is online, as are a lot of related materials from the House Committees on Education and Labor, Ways and Means, and Energy and Commerce.

The bill has already drawn enthusiastic praise from the White House. In a statement, President Obama lauded the legislation: "This proposal controls the skyrocketing cost of health care by rooting out waste and fraud and promoting quality and accountability. Its savings of more than $500 billion over 10 years will strengthen Medicare and contribute to our goal of reforming health care in a fiscally responsible way. It will change the incentives in our health care system so that Americans can receive the best care, not the most expensive care. And it will offer families and businesses more choices and more affordable health care."

As for what's next, my sources indicate that House leaders are moving as quickly as possible on this, and the House Committee on Education and Labor will begin the mark-up of the bill tomorrow afternoon around 3 (eastern).

Update: CBO scores the bill: $1 trillion, just where House Dems were aiming.

Second Update: Jonathan Cohn seems encouraged by the bill, and though it wouldn't be fully implemented for a few years, he found that it "will accomplish most of the goals on my mental checklist":

* Generous subisides, available to people making up to 400 percent of the poverty line

* Expansion of Medicaid to cover people making less than 133 percent of the poverty line

* Guarantees of solid benefits for everybody, with limits on out-of-pocket spending

* Strong regulation of insurers, including requirements that insurers provide insurance to people with pre-existing conditions without higher rates

* An individual mandate, so that everybody (or what passes for everybody in these discussions) gets into the system and assumes some financial responsibility

* A public plan, one that appears to be strong, although I'll reserve judgment on that until I hear from the experts

* Choice of public and private plan, at first just for individuals and small businesses, but later for larger businesses and--possibly--eventually for everybody

* Efforts at payment reform, if not necessarily as strong as they could be

* Investment in primary care and prevention, which is not sexy but potentially important for general health.

Steve Benen 4:10 PM Permalink | Trackbacks | Comments (39)
 
Comments

Yes, but does it have a strong public option?

Posted by: Scott F. on July 14, 2009 at 4:17 PM | PERMALINK

...but does it have a strong public option?

yep...


http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-PUBLICOPTION-071409.pdf

Posted by: neill on July 14, 2009 at 4:23 PM | PERMALINK

Yay.

Posted by: Chocolate Thunder on July 14, 2009 at 4:25 PM | PERMALINK

Now Nancy Pelosi, freshly vindicated after slanderous charges from hack republicans, confronts them and rams this legislation down their throats.

Posted by: Winkandanod on July 14, 2009 at 4:26 PM | PERMALINK

"Now Nancy Pelosi, freshly vindicated after slanderous charges from hack republicans, confronts them and rams this legislation down their throats." - Winkandanod

Good point, but she's going to have to ram it down Max Baucus's throat first. I'de like to see that.

Posted by: bdop4 on July 14, 2009 at 4:30 PM | PERMALINK

"Senator Ben Nelson, a Nebraska Democrat, said he’s “not hearing a lot” of support for a surtax on wealthy Americans. People in his state don’t like the so-called millionaire’s tax “because they are looking someday to get there themselves,” Nelson said. “It’s the American way.” - Bloomberg.

If I ever get there, I'll gladly fork it over.

Posted by: Rolla on July 14, 2009 at 4:33 PM | PERMALINK

Is that CBO scoring net of the 500B savings? The surtaxes used to fund the program?

Posted by: jayackroyd on July 14, 2009 at 4:33 PM | PERMALINK

'AMERICA'S AFFORDABLE HEALTH CHOICES ACT'

Gag me with a spoon. I hate these idiotic political bill-titles. I hated them when they came from the GOP, and I still hate them when they come from Democrats. They're nothing but a cynical (and blindingly obvious) attempt at political gaming. If you can't pick a name that simply says what the goddamn thing does, then I don't trust your efforts.

Posted by: Shade Tail on July 14, 2009 at 4:38 PM | PERMALINK

Looking decent. Now the hard part: preserving all the important bits in the conference report (because the Senate is certainly going to come up with something much worse).

Posted by: Steve LaBonne on July 14, 2009 at 4:45 PM | PERMALINK

Dear Senator Ben Nelson (D-NE), I have been in the workforce and paying taxes since 1979. I have gotten progressively better and better paying jobe since then. I just got my latest Social Security Statement all taxable years since then. In 30 years, I have not become a millionaire, let alone made a million in aggregate, and it's not for lack of trying.

Screw you!

Sincerely.....

Posted by: Michael W on July 14, 2009 at 4:47 PM | PERMALINK

Thanks for the 2nd update, Steve. I'm liking this more and more.

Posted by: Michael W on July 14, 2009 at 4:51 PM | PERMALINK

I couldn't put this bill down; it's that riveting.

I won't reveal the surprise ending. But if I were you, I'd make all my medical appointments for the next ten years ASAP.

Posted by: Evelyn Wood on July 14, 2009 at 4:52 PM | PERMALINK

The I suppose you've got no problem relabeling compost "rotten vegetable matter and feces"? Or maybe relabeling religions as "cults with more members"? Both are technically true after all. Marketing and phrasing are the first rules for trying to convince people to side with you; the world isn't filled with technocrats.

Posted by: Dustin on July 14, 2009 at 4:53 PM | PERMALINK

Missed a real opportunity here - the act should clearly be known as the American Community Health Opportunity Act, or ACHOO.

Posted by: steveconga on July 14, 2009 at 4:57 PM | PERMALINK

including requirements that insurers provide insurance to people with pre-existing conditions without higher rates

Will there be a required lag between getting a diagnosis and getting a new policy? It certainly would save consumers a lot of money if we could wait until after we knew what we had before we bought or upgraded our insurance.

Posted by: marketeer on July 14, 2009 at 5:02 PM | PERMALINK

Tuesday afternoon,
I'm just beginning to see
now I'm on my way...

Posted by: low-tech cyclist on July 14, 2009 at 5:11 PM | PERMALINK

Get ready folks, here comes the flood of random comments from people that never post here telling us how bad and scary things are gonna be when we get affordable health care. Oh look, there's Evelyn Wood, right on cue, trying to scare everyone about how they won't be able to make an appointment to see the doctor because the uninsured and unworthy poor people will be hogging all of the appointments. You see, it would be a hell of a lot easier on Evelyn if these people would just go ahead and die of some easily-cured ailment. Besides, she can always go hire some other poor person to clean the toilets. There's plenty to choose from.

Posted by: OhNoNotAgain on July 14, 2009 at 5:18 PM | PERMALINK

This is where we will need real leadership... We have to get this to an up and down vote in the senate...

Posted by: exhuming mccarthy on July 14, 2009 at 5:24 PM | PERMALINK

They stood before a banner reading "Quality affordable health care for the middle class."

A pity it didn't say "Quality affordable health care for Americans," if not "Quality affordable health care for all."

Posted by: Gregory on July 14, 2009 at 5:25 PM | PERMALINK

Shade Tail -- these bill names don't bother me as much as when the code names for military operations changed from somewhat random words to propaganda slogans.

Look on the bright side -- the fact that they give them marketable names is probably at least in part a reflection of the fact that information about bills is more accessible and more people are paying attention to them. The boring workaday titles of old were kind of nice, but it was also an era when nobody saw them except people who looked things up in the (hardcopy) Congressional Register.

Posted by: Redshift on July 14, 2009 at 5:27 PM | PERMALINK

"Senator Ben Nelson, a Nebraska Democrat, said he’s “not hearing a lot” of support for a surtax on wealthy Americans..."

Gosh, imagine that, people are not spontaneously contacting their elected officials in support of higher taxes! I wonder how much support Sen. Nelson has heard for ever-increasing amounts of their tax money going to for-profit health insurance companies? Strangely, that doesn't keep him from supporting a system that does just that.

Posted by: Redshift on July 14, 2009 at 5:31 PM | PERMALINK

"Senator Ben Nelson, a Nebraska Democrat, said he’s “not hearing a lot” of support for a surtax on wealthy Americans. People in his state don’t like the so-called millionaire’s tax “because they are looking someday to get there themselves,” Nelson said.

And they will get there right after they have to declare bankruptcy because of rising health care costs.

Posted by: Halfdan on July 14, 2009 at 5:36 PM | PERMALINK

Does it still include the mandatory provision that everyone must purchase coverage? I'd rather see the US go the single-payer governmental route like most of Europe but I guess the public option is the next best thing. Hopefully, though, there is an exclusion for those of us who are expatriate citizens. I'd hate to be legally obligated to purchase coverage in the US even though I will never be able to use it where I live. I'm already a "99% donor" who pays US taxes and receives virtually no benefits or services other than theoretical assistance from the US embassy should I ever be arrested.

Posted by: GringoNoraca on July 14, 2009 at 5:40 PM | PERMALINK

People in his state don’t like the so-called millionaire’s tax “because they are looking someday to get there themselves,” Nelson said.

Nebraska must have a lottery....

Posted by: Davis X. Machina on July 14, 2009 at 5:41 PM | PERMALINK

The way most Nebraska millionaires are made is off government ag subsidies they game.

Posted by: markg8 on July 14, 2009 at 5:54 PM | PERMALINK

Does it prevent insurance companies from cancelling people the minute the get sick?

Posted by: alan on July 14, 2009 at 6:01 PM | PERMALINK

Does it prevent insurance companies from cancelling people the minute the get sick?

Yes. It bans recission, and will over time require the elimination of pre-existing condition exclusions.

Posted by: Davis X. Machina on July 14, 2009 at 6:06 PM | PERMALINK

That by itself would make it worth voting for.

Posted by: alan on July 14, 2009 at 6:17 PM | PERMALINK

Oh dear, I've discovered a fly in the ointment.

"The public option will operate on a level playing field...and it will be self-sustaining, financed only by its premiums."

How will our well-meaning (but bumbling) civil servants compete against those profit-hungry savages at Humana, United, et al.?

Posted by: Evelyn Wood on July 14, 2009 at 7:04 PM | PERMALINK

Missed a real opportunity here - the act should clearly be known as the American Community Health Opportunity Act, or ACHOO. -- steveconga, @16:57

Thanks. I've been trying to think of words which would both describe the act and produce that very same ACHOO (you're still missing one O, though). So that I could answer: Na Zdrowie! (to health).

Posted by: exlibra on July 14, 2009 at 7:26 PM | PERMALINK

Is it appropriate that it got introduced on Bastille Day? We're storming the corporate prisons and freeing the wage slaves! ... a stretch?

I'm not sure I'm happy with the "mandate" part, though. I'm not convinced that a mandate is good policy- a bit authoritarian for my tastes. Still, at this point almost anything is better than the status quo. We strike while the iron is hot- there'll be plenty of time for fine-tuning later.

Posted by: Jurgan on July 14, 2009 at 8:42 PM | PERMALINK

Dustin: "The I suppose you've got no problem relabeling compost "rotten vegetable matter and feces"? Or maybe relabeling religions as "cults with more members"? Both are technically true after all. Marketing and phrasing are the first rules for trying to convince people to side with you; the world isn't filled with technocrats."

Considering the context, I'm guessing you're replying to me. And since I was specifically writing about Congressional bills and not random everyday things, I have no idea how you think going on about compost or religion is the least bit relevant. (Though I *have* long agreed with that definition of religion, but I digress.)

Anyway, give me one good reason why something like "Public Option Act" or "Health Insurance Reform Act" wouldn't work just as well. They are perfectly accurate names (they had damn well *better* be accurate), and they would do the job for marketing since the public option and insurance reform are unquestionably popular issues.

+++++

Redshift: "Look on the bright side -- the fact that they give them marketable names is probably at least in part a reflection of the fact that information about bills is more accessible and more people are paying attention to them. The boring workaday titles of old were kind of nice, but it was also an era when nobody saw them except people who looked things up in the (hardcopy) Congressional Register."

The thing is, when dealing with a popular idea (and the Public Option is unquestionably a popular idea), the "boring workaday titles" would be more than enough to get people on board. Using this kind of flowery fluff title on a bill makes it look like there's something to hide.

I don't much trust Congresscritters in general, even when they aren't acting like they have anything to hide. When they make it look like they *do* have something to hide, all bets are off.

Posted by: Shade Tail on July 14, 2009 at 9:03 PM | PERMALINK

Really the only thing I would like to see added in the amendment process is one that ties Republican Members of Congress' health care coverage to the passage of this one. We'll see then how much they are really against government-funded health care.

Posted by: Chris on July 14, 2009 at 10:12 PM | PERMALINK

Shade Tail, @21:03,

"American Health Security Act" (as per Pluege, a couple of days ago), or a version thereof would, I think, be better still. But, for all our superiour (should I say "elite"?) education, we seem to be stuck on substance and lousy on spin/frou-frou. The opposite of the opposition, that is. Just think back (2 yrs ago? 3?) to our "New Direction". Which, "doubtful", with his pitch-perfect ear, immediately re-dubbed as "nude erection"...

Posted by: exlibra on July 15, 2009 at 12:24 AM | PERMALINK

having just read the public option section i have to say that it is not good. read it for yourself, dont let the spin replace the analysis.

to whit:
1. only available to those making less then $40k. if you dont qualify for the subsidy you dont qualify for the plan. there goes costs savings from increased competition. oh, and if you make over $40k a year and aren't covered by an employer, good luck and enjoy the irs enforced mandate.
2. the entire thing (except for the risk part) is contracted out. there goes administrative cost gains.
3. only partial rx drug negotiating power (any drugs covered by medicare/aid are excluded). there goes the gains from reduced drug prices.
4. only doctors/hospitals covered are those that accept medicare.
5. payments to drs based on medicare rates are only limited for the first 5 years. after that they get set based on the rates other plans are paying.


why is it so hard for the democrats to get it right? there may be a public option in this bill but it is extremely neutered and will not produce any systemic cost savings.

Posted by: Beauregard Janglez on July 15, 2009 at 2:35 AM | PERMALINK

Dear Senator Ben Nelson (D-NE) ... - Michael W @ 4:47

milk out nose LOL

close with: What are you hearing _now_ Senator?


Evelyn Wood
Is that all you've got?

Posted by: Kevin on July 15, 2009 at 3:51 AM | PERMALINK

It's essentially preservation of the status quo in the name of reform.

Posted by: impartial on July 15, 2009 at 9:06 AM | PERMALINK

""American Health Security Act" (as per Pluege, a couple of days ago), or a version thereof would, I think, be better still."

Feel free to think that. I think otherwise. I'm willing to be persuaded, but so far, nobody has given me a single reason to believe that the substance and the spin must be different things. I think the substance *can* be the spin, you just have to be aggressive in pushing it.

Posted by: Shade Tail on July 15, 2009 at 10:22 AM | PERMALINK

You are better off searching for a business that is a fit for you. What works for another person may not work for you. If you are looking for the quickest way to become a millionaire you are probably overlooking some of the most important factors before starting a business. For instance if you get pulled into all the hype out there by all the strong sales pitches you might actually over look what is actually involved in succeeding in the business opportunity being advertised.

Posted by: make money on July 20, 2009 at 1:20 AM | PERMALINK
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